Over the years, not enough attention was paid to the differences between women and men when it comes to research, treatments, medical care and medical conditions.

Biological differences that affect diagnosis, response to treatments or to rehabilitation have been mostly ignored, while there has been reluctance to include women as research subjects, using, for instance, hormonal cycles  to justify the potential unpredictability of the results.

Additionally, it seemed that women’s health was just reduced to the reproductive period, establishing a category of interest (15-49 years) and ignoring everything else during women’s life cycles.

Historical data sets, sometimes used in algorithms, are often not gendered.

This resulted in misdiagnosis or diagnosis coming in late – sometimes too late – because their symptoms or complaints were ignored, or because the medicine in question was not as effective for women.

A classic example is heart diseases, including coronary artery disease, mainly diagnosed in men while women have typically received a different diagnosis.

Failures in women’s healthcare cost women and societies dearly.

In 2019, the total annual EU direct and indirect medical costs were over €4.76 trillion. This represents 9.9 per cent of the EU’s GDP that is spent on health, plus 2.4 times that from lost earnings and reduced productivity.

The total cost is close to 30 per cent of the annual EU GDP.

Some can be attributed to a lack of healthcare received by women, for some diseases only (endometriosis) or in majority (migraines) presented in women.

Both diseases have a total cost of € 301.3 billion per year.

That is where mainstreaming gender into health policy is key if we want to ensure adequate treatment and medical care.

We know that cancer has a different impact on women and men throughout the disease pathway.

Europe’s Beating Cancer Plan acknowledges these differences and includes a gender perspective throughout the various areas such as research and innovation, prevention, early detection, care and reducing inequalities.

Sex inequalities are included in the European Cancer Inequalities Register.

It is of the essence that we reflect on a gendered approach to health in legislation, policymaking and funding priorities- Helena Dalli

Furthermore, the European Cancer Imaging Initiatives makes an EU atlas of cancer-related images, including through making use of health data and artificial intelligence, which could be trained to consider gender differences, provided data are of high enough quality.

Regarding prevention of cancers, the European Commission proposal for a council recommendation on vaccine-preventable cancers calls, for instance, for a target to vaccinate 90 per cent of girls and a significant number of boys against Human Papillomaviruses HPV by 2030.

Next to this, the commission promotes a comprehensive approach to mental health. This will ensure that mental health issues are linked to the situation of women and men. 

Women and girls cannot be fully empowered to thrive while suffering from health issues that impact their everyday lives.

We have taken some steps but there is still a long way to go. Therefore, it is of the essence that we reflect on a gendered approach to health in legislation, policymaking and funding priorities; include a gender mainstreaming approach into research; train professionals and artificial intelligence; and invest in our attention to health conditions affecting women that, so far, still are underdiagnosed.

To advance gender equality, gender mainstreaming in health policies is key.

This is the approach put forward by the European Commission.

Recognising and investing in a gender approach goes beyond women’s healthy life prospects and saving costs. It ensures robust and resilient societies that contribute towards building the future of the EU and its economy.

It is, thus, paramount to include a gender lens into health research and to ensure that data collection is performed with the necessary breakdowns by sex.

Helena Dalli is the EU’s Commissioner for Equality.