The Long Fight for Women's Health

Women’s History Month invites reflection on not only the achievements of the women who came before us, but on the systems that have shaped women’s lives, bodies, and access to care. Few areas illustrate this more clearly than women’s sexual health, a field that historically has been shaped by underinvestment, moral judgement, and exclusion.  

Understanding how we got to where we are now is essential to moving us forward, and to understanding why inequities persist in clinical care, research funding, and women’s health outcomes today. 

Throughout many pre-modern societies, women were the primary sources of reproductive and sexual health information. Midwives and healers provided care related to menstruation, fertility, pregnancy, childbirth, sexual pain, and menopause. 

As medicine modernized, particularly in Europe between the late Middle Ages and the Early Modern period, authority over health shifted from community-based practitioners, to institutional, male-dominated systems of care. Licensing laws and professional organizations often excluded women entirely, reframing their knowledge as “unscientific” or “dangerous.” 

This reframing delegitimized the expertise of women. Sexual and reproductive health became fields in which women were treated as subjects to be studied, rather than sources of knowledge. 

It wasn’t until the 19th century that modern gynecology emerged, alongside advances in surgical techniques and anatomical studies. However, the developments of the 19th century occurred within deeply unequal racial hierarchies. Some of the foundational gynecologic procedures were developed through experimentation on enslaved Black women without their permission or anesthesia. 

As a whole, the field of gynecology benefitted from racist practices while excluding the women whose bodies made the new knowledge possible. This history remains relevant today, as racial disparities in pain treatment, black maternal health, and reproductive outcomes persist. 

For much of medical history, women’s sexual and reproductive symptoms were characterized as psychological, or their own moral failure, rather than as physiological conditions. Diagnoses like “hysteria” were used to explain pelvic pain, irregular bleeding, sexual discomfort, mood changes, and fatigue. Sexual pain, in particular, was rarely treated as a legitimate concern unless it interfered with reproduction, or male sexual function. 

Not only was this characterization dismissive, it shifted responsibility away from the field of medicine, and onto the woman herself. Symptoms were normalized, attributed to emotional instability, and minimized, reinforcing clinical dismissal that continues to persist in women’s health today. 

The 20th century brought about significant improvements in reproductive health, including expanded contraception, new tools for cervical cancer screening, and safer obstetric care. These advances, though, were not enough. 

Women were routinely excluded from clinical trials, particularly women of reproductive age, leading to gaps in knowledge about how medications affect women differently than men. Sexual function, desire, and pleasure were rarely prioritized in research. 

Conditions such as endometriosis, polycystic ovary syndrome, vulvodynia, and chronic pelvic pain remained under-researched, despite their prevalence. Until recently, menopause, experienced by all people with ovaries who live long enough, received limited clinical attention. 

The gaps in women’s sexual health research are not the result of insufficient science. They are the result of funding decisions, research priorities, and policy choices that have historically devalued and dismissed women’s quality of life.

Sexual health is general health, but it is often still treated as secondary. In recent history, patient advocacy, new research, and increased public conversation have begun to change the story. There is a growing understanding that sexual health is not just about sex, but that it includes pain management, hormonal health, informed consent, autonomy, and the ability to be intimate without harm. 

Progress is slow, and uneven, with many patients continuing to report being dismissed, misdiagnosed, or told their symptoms are “normal.” Understanding the historical context is imperative, because it explains not only why progress was delayed, but why it has persisted. 

Women’s History Month is not only about honoring the past. For too long, women’s sexual health has been long marginalized within medicine. Recognizing that history shows us why advocacy, investment in research, and education are still needed. 

At SHE+, sexual health is general health, and we know that advancing women’s sexual health requires groundbreaking research, education, and advocacy.