Welcome to everyone. I’m Dr. John White, Chief Medical Officer here at WebMD. Let me ask you—does your biological sex influence your health? Could it factor into diagnoses, treatments, and the symptoms you experience? Absolutely. That’s something we now recognize, though it wasn’t so widely accepted 5, 10, or certainly 20 years ago. Fortunately, pioneers like today’s guest, Phyllis Greenberger, played a huge role in bringing attention to women's health research. Phyllis has a new book that I highly recommend. It’s titled Sex Cells: The Fight to Overcome Bias and Discrimination in Women’s Healthcare. Please join me in welcoming my dear friend, Phyllis Greenberger.

Thank you.

Phyllis, it is wonderful to have you here.

It’s great to be here as well.

You know, you and I have been advocating for this issue for over two decades now.

At least.

People often assume everyone naturally agrees that biological sex matters in health care. But as you state in your book, not everyone’s on board with this. Why has it been so difficult for society to accept that women aren't just smaller versions of men?

Well, the root of it lies in the longstanding belief that men and women were seen as the same, aside from their reproductive organs. So, if a treatment or device worked for men, it was assumed it would also work for women. Unfortunately, we still have a lot to learn, and there’s a general lack of trust, disbelief, and even ignorance. We’ve made progress, but the road ahead is still long.

And in your book, you emphasize that this journey is far from complete. What’s continuing to obstruct progress? Is it simply a matter of misinformation, or is it that people don’t fully grasp the science? What’s the biggest hurdle?

A lot of it does come down to misinformation. I gave a talk about 20 years ago on this very topic—the gaps in medical education regarding women’s health. Back then, medical curricula didn’t even separate “women’s health” as an integral topic. They discussed general health issues, cardiovascular disease, osteoporosis, maybe breast cancer, but nothing specific about the impact of sex differences. When I recently asked someone if things had changed in light of the attention the book is getting, I was told it hadn’t. Even when "women’s health" is included in the curriculum, they often don’t delve deeply enough into sex-based differences. And yet, we know that while gender is a social construct, biological sex deeply influences how diseases manifest and evolve. There’s still a glaring gap in research that makes it difficult to fully teach it.

Your book outlines what still needs to be done. We know women need to be better represented in research, yet progress remains slow. What else needs to change?

Well, when I first started advocating, our focus was on getting women into clinical trials—and you’re right to mention that there are still challenges in rural areas. Women often face barriers like travel, child care responsibilities, and some ethnic groups harbor mistrust about participation in these trials. In the future, technology, like broadband, may help, although access remains an issue in some places.

For women listening today, what can they do now? How can they ensure they’re receiving the best care possible? What should they ask their doctors, especially knowing that sex matters in health care?

That’s a great question. The issue is, it depends largely on whether your doctor has been educated about this. As I mentioned earlier, medical students today might not even have been properly taught about sex differences. Surprisingly, I sometimes think younger doctors may be better informed on current research than doctors who’ve been practicing for 20 or 30 years. So yes, women should ask direct questions about their treatment, but the response may depend on their doctor’s awareness and education on the subject.

Phyllis, you’ve been an activist for years in Washington, DC, advocating for legislation and reform. What actionable steps would you like to see taken now? While changing medical curriculum will take time, where can we focus our efforts immediately?

Another good question. If curriculum reform is slow, what women can do today is ask their doctor if their prescribed medication has been tested on women. However, if the answer is no, and it's still the most effective treatment available, they’ll still have to take it. On the brighter side, the Biden administration has recently allocated $100 million toward women’s health research, which is a huge step forward.

What do you hope to accomplish with your book?

What I’m really hoping is that organizations such as the American Medical Women’s Association (AMWA) will find value in it. AMWA represents women medical students, and I think they’re an important audience for this content. Many non-medical readers have told me they found the book fascinating, but the real key is reaching future doctors. They’re the ones who can make a difference moving forward.

It’s worth noting that under your leadership, the Society for Women’s Health Research became a powerful force in Washington—pushing forward the establishment of the Office of Women’s Health and broader health research efforts. Phyllis, your book, Sex Cells: The Fight to Overcome Bias and Discrimination in Women’s Healthcare, is an essential read. Thank you for all your tireless work for women’s health. We couldn’t be where we are today without your leadership.

Thank you so much, John. I really appreciate the opportunity to discuss this important issue.

This interview was originally published on WebMD on May 23, 2024.