33 studies out of 38 pointed the same way: women are offered less active treatment
What happened
Researchers at the University of St Andrews have published a review of global research into how men and women are treated for the same illnesses. The answer was uncomfortable. Women were less likely to be offered what doctors call "active" treatment. That means things like surgery, a stent, a transplant or a strong painkiller, rather than simply being given tablets and monitored. The team started with 1,112 published studies. They narrowed these down to 38 that directly compared the care given to male and female patients using real patient records. Of those 38, 33 found a significant difference in the treatment men and women received. The review was published on 16 September 2026 in the journal PLOS One. This is not one small study in one hospital. It is a look across many studies, in many countries, covering heart disease, kidney disease, liver disease, Parkinson's and pain management. When that many separate pieces of research point the same way, it is worth paying attention.
Why this matters
Most of us assume that if two people walk into a hospital with the same problem, they will be offered the same options. This review suggests that is not always what happens. The pattern showed up in some of the most serious conditions there are. Heart attacks. Heart failure. Kidney failure. Liver failure. These are situations where the treatment you are offered can shape how long you live. It also matters because it is fixable. This is not a problem that needs a new drug or a scientific breakthrough. It needs awareness, and it needs patients and clinicians asking one more question in the room. And there is already momentum. Concern about the gender health gap has been growing in the UK for years. In March, the then health secretary, Wes Streeting, said women were being let down by "medical misogyny". The previous Conservative government appointed Lesley Regan as England's first women's health ambassador to help tackle the gap. So this review lands in a system that is already looking at the problem.
What the evidence actually says
Here is the detail, because the detail matters. For heart problems, women with a myocardial infarction (a heart attack), heart failure or an irregular heartbeat were more likely to be given medication. Men were more likely to receive a coronary bypass, a stent or other surgery. Women were also less likely to be prescribed statins. For Parkinson's disease, men were more likely to be referred for deep brain stimulation. For liver failure, men were more likely to receive a transplant. For kidney patients needing dialysis, women were less likely to be given permanent access. That meant spending longer using a catheter, which is less comfortable and carries more risk of infection. Women were also less likely to be given opioids for pain. Now the important balance. The review did not find this everywhere. For stroke and diabetes, there was no significant difference between the sexes. And for dementia, women were actually more likely to be treated. So this is a pattern, not a universal rule. The researchers also checked the obvious innocent explanation: perhaps guidelines genuinely recommend different treatment for women, for good clinical reasons. They found that none of the studies identified any guideline recommending different treatment by sex. That leaves the question open. Dr Andrew O'Malley, who co-led the study, said: "For clinicians, the findings are a prompt to check whether treatment is being offered on clinical grounds rather than assumption." He noted that studies show doctors more often attribute women's symptoms to anxiety, and make more diagnostic errors with female patients, even when test results are positive. Dr Miriam Veenhuizen, an honorary lecturer in the School of Medicine at St Andrews, said: "While the direction of the findings was not a surprise, the consistency was. The same pattern appeared in cardiology, surgery, transplant medicine and emergency care, and it survived statistical adjustment in most studies." One honest limit: a review like this can show a consistent pattern, but it cannot prove why it happens in any individual case. The researchers are careful about that, and so should we be.
Practical advice
None of this means you should distrust your doctor. Most clinicians want to get this right, and many will be glad you asked. Here is how to have a useful conversation. Ask what the full range of options is. A simple, polite question works well: "What are all the treatment options for this, including surgery or a procedure?" That one question opens the door. Ask why this option, for me. Try: "Why is this the right choice for me specifically?" You are not challenging anyone. You are asking them to say the clinical reasoning out loud, which is exactly what Dr O'Malley suggested clinicians should check. Be specific about pain. If you are in pain, describe it in concrete terms. How bad out of ten, what it stops you doing, how long it lasts. Vague descriptions are easier to underestimate. Do not let a symptom be filed away as stress. If you feel your symptoms are being put down to anxiety and you do not think that fits, say so plainly and ask what else it could be. Ask for the test if you think you need it. Take someone with you if you can. A second pair of ears helps you remember what was said, and makes it easier to ask the follow-up question. Write down your questions before you go. Appointments are short. A list means you leave with the answers you actually came for. Ask for a second opinion if you are genuinely unsure. You are allowed to. It is not rude.
What to know
A University of St Andrews review, published in PLOS One on 16 September 2026, sifted 1,112 studies down to 38 that compared treatment of male and female patients. In 33 of those 38, women were less likely to be offered active treatment such as surgery, a stent, a transplant or a strong painkiller. The pattern appeared in heart, kidney, liver and Parkinson's care, and in pain management. It did not appear for stroke or diabetes, and women were more likely to be treated for dementia. The researchers found no guideline recommending different treatment by sex, and said the findings should prompt clinicians to check that treatment is offered on clinical grounds rather than assumption. If you are a patient, the single most useful thing you can do is ask what all the options are, and why this one is right for you. Sources: The Guardian, "Women with same health conditions as men 'less likely to be offered active treatment'", 16 September 2026, https://www.theguardian.com/science/2026/sep/16/women-with-same-health-conditions-as-men-less-likely-to-be-offered-active-treatment ; EurekAlert (University of St Andrews), "Women less likely than men to be offered active medical treatment for the same conditions", 16 September 2026, https://www.eurekalert.org/news-releases/1144062 ; Medical Xpress, "Women less likely than men to be offered active medical treatment for the same conditions", 16 September 2026, https://medicalxpress.com/news/2026-09-women-men-medical-treatment-conditions.html This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. If you are worried about a symptom or about the treatment you have been offered, speak to your GP or specialist.
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