By: Sadie Mecham
Edited By: Andrew Bongiovanni
Abstract
The Trump administration’s policy on “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” and “Ending Radical and Wasteful Government DEI Programs and Preferencing” have both led to a cascade of restrictions in the field of research. These policies will disproportionately impact research in the already underrepresented field of women’s health. Historically, women have been both actively excluded and underrepresented in clinical trials, which has often led to increased consequences and misinformation. Women were excluded from trials until 1993. Exclusion from past trails has limited understanding of medical problems in women today. Heart attacks and Osteoporosis are treated the same for men and women despite different risk factors and symptoms because we never studied these in women. Medical conditions more prevalent or exclusive to women such as headache disorders, endometriosis, and postpartum depression are not well researched or understood.
The National Science Foundation (NSF) recently leaked a list of words that if included in research proposals will trigger immediate review, and “female” is included. Simply including women in your study or wanting to study women is enough to bring funding into question. The impact of this can further be seen in the archiving of a NIH policy to require female animals be used in their studies. The new policies bring the future of women’s health into question through uncertainty of funding and approval. While the exact long-term consequences cannot be predicted, the implications on the future of women’s health are grim.
Background
Historically, women are underrepresented in clinical trials. In 1962, thalidomide was linked to over 10,000 newborn deaths and birth defects.1 This spurred the adoption of policies that excluded women from medical test. A 1977 FDA policy preventing women who were of “reproductive potential” from being included in phase 1 and 2 trials was a direct reaction to the thalidomide catastrophe.2 Not until 1993 did the FDA reverse its 1977 guideline by mandating the inclusion of women in research while Congress passed a law that required women be included in NIH-sponsored studies.3 No one considered how exclusion would impact the quality and existence of scientific knowledge about women’s health and treatments.
The underrepresentation of women continued even after requirements to include them were promulgated. Not only are women still significantly underrepresented in clinical trials,4 but information on how diseases also affect women differently and on diseases that predominantly affect women are lacking. Medical advice treats men and women identically despite showing different symptoms, disease prevalence, medical needs, and drug interactions.5 Heart attack symptoms differ between men and women; however, the symptoms most recognized (chest pain, left arm numbness) are symptoms men experience, not women.6
Drug studies have similar gender bias. The female body reacts differently to pharmaceuticals when compared to men due to higher body fat, reduced metabolism of the drugs, and hormone levels.7 Despite this, prescription dosages frequently only vary based on patient weight with no account for gender.8 Women reported adverse drug-related events fifty-two percent more than men, and fatalities thirty-six percent more frequently.9 If a disease predominantly,10* or only, affects women, they are more likely to go unfunded. In 2020, only one percent of research funding went to conditions that only women experience.11 Historical exclusion and reduced funding in women’s health research have led to disparities in treatment, diagnosis, and knowledge that persist today.
Current Research Landscape
The landscapes of healthcare, healthcare research, and women’s health are rapidly changing under the current administration’s guidance. For context, at the time this article was written, President Trump had issued 89 executive orders.12 This reflects the volatility of the current policy environment, contributing to uncertainty in health policy — particularly for women. Two specific policies the administration has put forth target gender identity and females. The policies, Executive Order 14168: “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” and Executive Order 14151: “Ending Radical and Wasteful Government DEI Programs and Preferencing,” have already changed the research landscape.13
The former aims to reinforce definitions of gender, while the latter stops DEI programs that aim to increase female representation in workplaces. Under Executive Order 14168, government websites removed references to gender identity; this included CDC and FDA links to resources aimed at women or information on clinical trials inclusion.14 The policy changes have impacted research opportunities and funding, with annual NIH funding expected to decrease by $4 billion under the new guidelines.15 The requirements to obtain funding have also changed, as under these new policies using gender-identifying words, such as “female” would prompt an immediate review when applying for government grants.16 According to the leaked list of words from the NSF, using “female” would decrease the chance of funding in an area that already is underfunded.17
NIH policies have also changed in response to the executive orders. A 2016 policy that required female animals in studies appears to have been rolled back.18 While it still appears in the guidelines, it has been removed from the website documentation.19 The policy, which can still be found in an original release, required researchers to include sex as a variable or justify its exclusion. Male animals are considered “easier” to work with due to lack of hormone changes that may affect results. However, these changes to results are exactly why females need to be included. If the results would change in laboratory experiments, it would be illogical to assume it would be different outside the lab.
Reactions within the research community suggest a level of cautiousness so as not to trigger repercussions from executive orders20 Funding cuts, aimed to decrease government spending, will cause many projects to be canceled or underfunded. Research into women’s health will be impacted on a greater level due to the already limited funding it receives and the limitations to gender inclusion in wording of proposals.21
Future Prospects in Women’s Health
Given the current changes, the future of research into women’s health is incredibly uncertain. A positive outlook can be found in individual action and technology integration. Those concerned can hope scientists continue to use guidelines that include female participants in their studies. Increased venture capital and private equity funding into women’s health can be alternatives to traditional, inadequate funding. Technological advances in AI data aggregation tools can synthesize large sets of data to garner information about women’s reactions, symptoms, and other areas of health. Spreading awareness of gaps in funding and knowledge can spur change and action to fill these gaps, even in the precarious position the field finds itself.
Looking back on the history of research into women’s health reveals persistent gaps that have led to conditions being underdiagnosed and undertreated. New policies limiting gender terms and reducing financial support for certain research initiatives heighten concerns for the future of knowledge regarding female patients. Sustained efforts and new innovations from individuals and supporters will counteract barriers that have made research in women’s health an afterthought.
Works Cited
1.AAMC. 2025. “Why We Know So Little About Women’s Health.” Association of American Medical Colleges. https://www.aamc.org/news/why-we-know-so-little-about-women-s-health
2. Ibid.
3. Ibid.
4. Clayton, Janine A., and Francis S. Collins. 2016. “Policy: NIH to Balance Sex in Cell and Animal Studies.” Nature 509 (7500): 282–83. https://pmc.ncbi.nlm.nih.gov/articles/PMC4800017/
5. Clayton, Janine A. 2022. “Sex Differences in Biomedical Research.” Journal of Women’s Health 31 (4): 267–74. https://pmc.ncbi.nlm.nih.gov/articles/PMC9043984/
6. Harvard Health Publishing. 2016. “Understanding the Heart Attack Gender Gap.” Harvard Health Blog, April 15, 2016. https://www.health.harvard.edu/blog/understanding-heart-attack-gender-gap-201604159495
7. Clayton & Collins. 2016. “Policy: NIH to Balance Sex in Cell and Animal Studies.”
8. Ibid.
9. McKinsey Health Institute. 2024. “Closing the Women’s Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies.” McKinsey & Company. https://www.mckinsey.com/mhi/our-insights/closing-the-womens-health-gap-a-1-trillion-dollar-opportunity-to-improve-lives-and-economies
10. Nature. 2023. “Women’s Health:end the disparity in funding.” Nature. https://www.nature.com/articles/d41586-023-01472-5.
*migraines, anorexia, endometriosis, chronic fatigue syndrome
11. Perelel Health. 2025. “The Women’s Health Research Gap.” https://perelelhealth.com/blogs/news/womens-health-research-gap?srsltid=AfmBOoqM_6EI5iasBCC9FGNbRt-_xVuNGctJMkfMJkgWMXrQpvo6qgKH
12. Federal Register. 2025. “Executive Orders by Donald Trump (2025).” Federal Register. https://www.federalregister.gov/presidential-documents/executive-orders/donald-trump/2025
13. The White House. 2025a. “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.” Presidential Actions, January 23, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/; The White House. 2025b. “Ending Radical and Wasteful Government DEI Programs and Preferencing.” Presidential Actions, January 23, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/ending-radical-and-wasteful-government-dei-programs-and-preferencing/
14. U.S. Food & Drug Administration (FDA). n.d. “Clinical Trials: What Patients Need to Know.” FDA. https://www.fda.gov/clinical-trials-what-patients-need-know; The Washington Post. 2025. “CDC Website Removes Gender and LGBTQ+ Data.” The Washington Post, January 31, 2025. https://www.washingtonpost.com/health/2025/01/31/cdc-website-gender-lgbtq-data/
15. The New York Times. 2025. “NIH Trump Funding Cuts.” The New York Times, February 13, 2025. https://www.nytimes.com/interactive/2025/02/13/upshot/nih-trump-funding-cuts.html
16. Grant Writing & Funding. 2025. “Banned and Trigger Words in Federal Grant Writing in the Trump Administration 2.0.” https://grantwritingandfunding.com/banned-and-trigger-words-in-federal-grant-writing-in-the-trump-administration-2-0/
17. Ibid.
18. National Institutes of Health (NIH). 2025. “NIH Appears to Archive Policy Requiring Female Animals in Studies.” The Transmitter. https://www.thetransmitter.org/policy/exclusive-nih-appears-to-archive-policy-requiring-female-animals-in-studies/
19. National Institutes of Health (NIH), Office of Research on Women’s Health. n.d. “Sex as a Biological Variable (SABV) Poster.” NIH. https://orwh.od.nih6).gov/sites/orwh/files/docs/SABVPoster508C.pdf
20. Mervis, Jeffrey. 2025. “Scientific Backlash over Federal Policies on DEI.” Nature. https://www.nature.com/articles/d41586-025-00827-4
21. National Institutes of Health (NIH). 2025. “NIH Appears to Archive Policy Requiring Female Animals in Studies.” The Transmitter. https://www.thetransmitter.org/policy/exclusive-nih-appears-to-archive-policy-requiring-female-animals-in-studies/
