Canada’s health system is failing women—and, by extension, gender-diverse people who face similar or even greater barriers to care. This failure isn’t just about services; it’s embedded in the foundational assumptions of what “women’s health” even means.
Women are not merely reproductive machines, yet our national approach to women’s health remains fundamentally structured around gynecology, pregnancy, and fertility. This narrow lens has created a profound policy failure, contributing to the suffering of millions and the stagnation of progress in women’s health research, care, and infrastructure.
Reproductive health is vital, but it is not sufficient. Women live with chronic pain conditions like endometriosis, adenomyosis, fibroids, pelvic floor dysfunction, and persistent genitourinary issues for years—often decades—without answers, treatments, or support. These conditions are common, debilitating, and expensive, yet they remain sidelined in policy, research funding, and health infrastructure design.
The term “OBGYN” itself encodes a bias: obstetrics and gynecology. But what happens when a woman is not pregnant, does not want children, or has persistent pelvic pain that no specialist can solve? She falls through the cracks of a system that was never built for her.
The result is unconscionable. For the past five years, Statistics Canada data has shown women to be approximately 25 to 50 per cent more likely than men to report unmet health care needs—a systemic gap persists despite decades of equity commitments. This number is even higher among racialized, Indigenous, rural, and gender-diverse communities.
For many women, seeing a gynecologist means long wait times, dismissal of pain, and limited treatment options rooted in generalized hormonal regimens that rarely address root causes or surgical excision. The biopsychosocial reality of living in a female body is more complex, and it deserves an equally sophisticated response.
Canada is one of the only G7 nations without a national women’s health strategy. The United Kingdom introduced its Women’s Health Strategy in 2022. Australia, too, has launched multiple national action plans on endometriosis and reproductive health. The United States launched its White House Initiative on Women’s Health Research in 2023, with Dr. Carolyn Mazure appointed to lead a $100-million investment. In Canada, we have no permanent federal office, no long-term plan, and no dedicated research institute. We rely on time-limited project funding and patchwork provincial policies, leaving women with inconsistent, inequitable care.
In 2023, the Canadian Institutes of Health Research (CIHR) announced the National Women’s Health Research Initiative, a landmark $20-million investment co-led with Women and Gender Equality Canada. As a co-investigator on one of these grants, I celebrate its existence, but the initiative remains a drop in the ocean. There is still no line item for women’s health in federal funding, no integration into CIHR’s core strategic priorities, and no national accountability framework.
Language matters. When we reduce women’s health to reproductive organs, we reproduce the very harms we aim to fix. A woman who experiences pelvic pain, autoimmune disease, cardiovascular risks, or adverse drug reactions deserves a system that sees her in full. We need to move beyond categorizing women’s health as simply a subset of reproduction and toward a systems-level transformation: funding multidisciplinary care centers, integrating social determinants of health, mandating sex- and gender-based analysis in all clinical trials, and designing public health campaigns that reflect real, lived experience.
Canada has the talent, evidence, and will to lead. Patients, researchers, and clinicians are pushing boundaries across the country. What we lack is sustained political leadership. Women’s health is a national crisis. It deserves national action.
We need a permanent federal office for women’s health, housed within Health Canada or the Public Health Agency of Canada. We need a national research institute dedicated to women’s health and sex-based science. We need a ministerial task force on women’s health equity that brings patients, clinicians, policymakers, and researchers together to set actionable targets. These aren’t just nice-to-haves; they are the bare minimum if we’re serious about equity.
For too long, the female body has been misunderstood, underfunded, and deprioritized in our national health architecture. It’s time to stop treating women as wombs and start building a system that sees them as whole. Not just when they’re pregnant. Not just when they’re bleeding. Always.
Shay Freger is a Ph.D. student in clinical sciences at McMaster University, with a background in medical science and public health. He co-leads a CIHR-funded National Women’s Health Research Initiative project, works towards developing policy alongside EndoAct Canada, and has represented Canada at the World Endometriosis Organization.
The Hill Times