Women’s Health Doesn’t Need More Promises—It Needs Better Questions

For decades, women’s health has been framed as a problem of inadequate treatments, lack of funding or persistent inequities. These issues are very real. Yet it’s important to recognize that they often stem from a deeper, long-standing failure: a failure to collectively identify the questions that matter the most 

Questions set priorities; they determine what issues get addressed, where funding is directed, and which populations get seen or overlooked. When systems of knowledge and fields of practice start with the wrong questions, they build the wrong science, invest in the wrong priorities, and design and implement innovations that overlook the people who are most in need.

A few years ago, The GovLab launched an initiative to develop a new method to collectively identify the most important questions across a range of topic areas. Titled the 100 Questions Initiative, the project deployed a global, multi-phase process involving topic mapping, crowdsourced question generation, deliberation among a “bilingual” expert network (individuals fluent in both domain and data/innovation expertise), and a public voting phase that drew on the expertise and experience of practitioners, policymakers, researchers, and other stakeholders. This method has now been used in domains such as migration, gender, air quality, future of work, disinformation, governance, and food systems and sustainability.

Earlier this year, in collaboration with the Centre for European Policy Studies (CEPS) and the Gates-funded Research & Innovation (R&I) project, we added women’s health innovation to the list. Crowdsourcing a list of questions from an expert body of  more than 70 bilinguals, we identified the Top 10 Questions that should guide women’s health research and innovation.  In this article, we describe our methodology--part of a broader effort to create a new science of questions--list and briefly describe the top ten questions, and conclude with a discussion of reoriented priorities that should flow from these questions. 

The full methodology, evidence base, and extended analysis underpinning this work are available in a pre-publication report on SSRN.

The Cost of Asking the Wrong Questions

Asking the wrong questions is not a minor oversight--it is a structural failure with broad and long-lasting ripple effects. Poorly framed questions distort what gets measured, who gets included, and which problems appear worthy of attention. They shape research agendas, funding priorities, and the design of entire systems. Across fields--from criminal justice to education to climate policy--we have repeatedly seen how narrow or misguided questions generate narrow evidence and misconceived interventions. The risks to excluded populations are recursive: bad questions lead to bad evidence, and bad evidence produces systems that perpetuate inequity.

There are few areas of life where the cost of asking the wrong questions is more visible--or more damaging--than in women’s health. Despite representing half the world’s population, women have been systematically understudied and underserved across nearly every area of health research and innovation. Until 1993, women in the U.S. were largely excluded from federally funded clinical trials, despite clear evidence of sex differences in drug safety and dosing. Even after policy reforms, many studies continued to under-recruit women or neglect sex-disaggregated reporting, leaving persistent gaps in the evidence base that informs diagnosis, treatment, and decision-making today.

These research gaps translate directly into clinical inequities. Women wait longer for pain treatment in emergency departments, and are more likely to have symptoms dismissed or attributed to psychological causes. At the same time, market incentives reinforce these disparities: although women are estimated to make the majority of household health-care decisions in many countries, women’s-health companies received only 2.3% of healthcare venture-capital funding in 2024. As a result, conditions that disproportionately affect women—such as endometriosis, autoimmune disorders, and menopause—remain chronically underfunded and under-researched.

At the population level, these inequities compound into long-term health burdens. Women live longer than men yet spend more of those additional years in poor health or with disability—a pattern documented across multiple countries and known in public-health research as the “health–survival paradox,” where longevity does not translate into healthy life expectancy.

These are not isolated failures but structural outcomes of a research and innovation ecosystem built around a male-default model. Poor questions create poor evidence, and poor evidence creates poor health outcomes. The challenge is not simply to increase investment or develop new technologies, but to fundamentally re-interrogate the questions that shape women’s health research, innovation, and policy.

The Top 10 Questions 

To identify the most consequential questions in women’s health, we undertook a structured discovery process. As described above, we began by mapping the field in collaboration with experts across clinical research, public health, policy, technology, and advocacy, and then gathered a wide range of candidate questions reflecting gaps in evidence, practice, and lived experience. This broad set of questions was refined through deliberation with more than 70 domain and data experts (“bilinguals”) and then prioritized through a public voting phase designed to surface what stakeholders viewed as most urgent and most actionable. 

Based on this process, we developed the Top 10 Questions for Women’s Health Innovation: those with the greatest potential to drive evidence, innovation, and policy change. These questions are not merely a list; they function as diagnostic tools, revealing where evidence is missing, where systems are failing, and which assumptions continue to distort women’s health. By asking better questions, we create the conditions for better science—and, ultimately, better outcomes.

1. What structural, social, and policy factors perpetuate women’s disadvantages across health, political, and economic domains, and what evidence-based transdisciplinary strategies can effectively dismantle these barriers?

2. What measurable social, economic, and health outcomes are associated with prioritizing women’s health (including reproductive health and postpartum care) as shared societal infrastructure rather than an individual burden?

3. Which emerging or underserved areas in women’s health—including promising technologies and commercially viable but underfunded innovations--warrant strategic investment to drive transformative breakthroughs, improve health outcomes, and advance health equity?

4. What financing instruments, funding models, or regulatory approaches could attract and sustain investment in women’s health research and development (R&D), including women-led innovations in underserved areas?

5. What strategies, methodologies, and types of evidence are most effective in identifying and closing gaps in women’s health research that address barriers to scaling innovations for underserved populations?

6. How can public funders of research & innovation (R&I) ensure that biomedical studies consistently collect and report sex- and gender-disaggregated data, and what proportion of current research meets this standard globally?

7. What strategies to engage men and boys through violence prevention, caregiving, and reproductive health are most effective in challenging harmful social norms and improving health outcomes for women and gender minorities especially in low- and middle-income countries?

8. How might gaps in women’s health data affect the accuracy of artificial intelligence (AI) diagnostics and what strategies can ensure AI systems are designed to serve everyone, not just the statistical majority?

9. What are the effects of estrogen and progesterone on non-reproductive organs such as the brain muscles, metabolism, and digestion; and how does hormone therapy influence these systems?

10. How can policy, public health, and innovation systems better integrate sex- and gender-based data to close the gap between female longevity and female quality of life in old age?

Reorienting the Women’s Health Agenda

The Top 10 Questions point to something deeper than isolated research gaps: they reveal a structural misalignment between what women need and what health systems, research institutions, and markets have historically prioritized. Taken together, the questions form a map of where today’s women’s health ecosystem is failing.

What emerges from the above list is not just a disparate number of priorities but a set of core themes that provide an actionable framework for how women’s health should be understood, funded, researched, and governed. Across expert deliberation and public input, five themes in particular rose to the surface:

• Structural Barriers: The highest-ranked question focuses on how social, economic, and policy systems—not individual choices—produce inequities, and which transdisciplinary strategies can dismantle them. This reframes women’s health not as a standalone clinical issue but as a systems-level challenge rooted in institutions, norms, and power.
• Women’s Health as Infrastructure: Participants emphasized that women’s health is a public good with measurable social and economic returns. As such, it should be treated as shared societal infrastructure rather than a private responsibility to be borne by individuals.
• Financing and R&D Gaps: Several of the questions highlighted chronic underinvestment and fragmentation in women’s health R&D. There is a need for new financing instruments, regulatory reforms, and targeted investment strategies to support women-informed and led and underserved areas of innovation.
• Data Blind Spots and AI Risks: Incomplete sex- and gender-disaggregated data undermine both biomedical research and emerging AI diagnostics. Participants called for stronger reporting standards and safeguards, for instance to ensure AI systems do not reinforce existing inequities at scale.
• A Life-Course Approach: There was clear demand for deeper clinical research into how hormones influence brain function, metabolism, muscle health, and aging—areas central to chronic disease and healthy longevity.

These themes reflect a shift: from viewing women’s health as a set of discrete clinical issues to understanding it as a complex, interconnected system. They point toward a framework in which progress depends not on isolated interventions but on coordinated change across multiple layers of the health ecosystem. Finally, they make clear that only by addressing these themes in relation to one another—not as silos—can women’s health research and innovation begin to meet the scale and complexity of the need.

From Questions to Action

Asking better questions is only the beginning. To translate this agenda into impact, the institutions that shape research and innovation—public funders, regulators, journals, investors, and global health agencies—must align their practices with the priorities revealed by the Top 10 Questions. Doing so requires not only new commitments but a shift in how these actors understand their responsibilities within a shared women’s health ecosystem.

A more effective women’s health ecosystem will require coordinated shifts across three main axes of systems change: funding, policy, and institutions.

• Funding: Treat women’s health as essential infrastructure by creating dedicated budget lines, multi-year mission portfolios, and financing models that de-risk women-led and underserved areas of innovation.

• Policy: Mandate sex- and gender-disaggregated data in biomedical research, strengthen reporting requirements for journals, regulators, and federally funded research; and ensure AI systems meet standards that prevent the amplification of existing inequities.

• Institutional Alignment: Build intentional, well-incentivized cross-sector partnerships—e.g., linking health, gender, and technology agencies—to ensure that innovations in one area translate into system-wide benefits.

While action across these three axes alone will not deliver all the change we need, it could shift the system from a reactive, piecemeal approach to a proactive, question-driven model capable of generating the evidence, investments, and innovations women’s health has long lacked. By rooting action in the right questions, we create the conditions for a women’s health ecosystem that is more equitable and capable of sustained progress—for everyone. Taking women’s health seriously is not a women’s issue alone; it is a foundational investment in society as a whole.