Inequality due to a lack of knowledge about the female brain

On average, women wait four months longer for a correct diagnosis than men. This is not because their bodies are inherently more complex, but because clinical science has been modelled on men for centuries.

On International Women’s Day (March 8), we celebrate the progress made in women’s rights. Simultaneously, it is a moment to reflect on the blind spots that persist. One of the most significant is the lack of comprehensive knowledge regarding the female body and brain—and the subsequent impact on health, behaviour, emotions, and executive function.

In other words, gender inequality in the workplace and society is not merely a product of social structures; it is deeply rooted in a historical deprivation of clinical knowledge concerning female biology.

TL;DR (Too Long; Didn’t Read)

Women wait four months longer for an accurate diagnosis because clinical studies have historically prioritized male subjects.

This systemic bias continues to have repercussions in medicine, the workplace, and for neurodivergent women.

Biological differences, social expectations, and corporate culture intersect. Women often shoulder the “invisible labour” of the household, face “nice girl” expectations, and are forced to adapt to systems designed for the male brain.

Actionable steps: Distribute parental leave equitably, foster workplace flexibility and transparency, recognize differences without pathologizing them, and involve women in decision-making processes.

An inclusive workplace does not require women to adapt to the status quo; it requires systems that accommodate the reality of every individual.

💡 Ask yourself: What marginal change can you implement today to make your professional environment more equitable?

How the clinical world overlooked women

For centuries, society was governed by men, and medicine was no exception. The female body was frequently dismissed as “too complex,” and research involving women was deemed expensive and arduous. It was argued that cyclical hormonal fluctuations would unnecessarily complicate scientific variables.

The legacy of this exclusion remains palpable. For over a hundred conditions—ranging from endometriosis, migraines, and diabetes to autism—women face significantly longer diagnostic delays than men. This even extends to life-threatening conditions such as heart failure and oncology.

Physicians rely on the knowledge imparted during their training and codified in medical textbooks. This is precisely where the problem lies. These manuals often teach that the primary symptom of a heart attack is crushing chest pain radiating to the arm. Or that ADHD is characterized primarily by hyperactivity and externalized concentration issues.

This is accurate—but predominantly for men.

In women, these same conditions often manifest differently. Heart issues may present as nausea, back pain, or respiratory distress. ADHD is more likely to manifest as motivational struggles, sleep disturbances, or disordered eating. For many of these disparities, we still lack a fundamental understanding of why they exist.

For decades, the “75 kg, 1.80m white male” served as the universal biological norm. Women were treated as “smaller versions” of men, merely distinguished by a uterus and breasts. Consequently, knowledge of female physiology remained underdeveloped. In many landmark studies, women were explicitly barred from participation.

It was only in the 1990s that this began to shift. The systematic exclusion of women from scientific research is becoming increasingly unacceptable. Researchers are now striving to align their study groups with the actual population, and new specialized research units are focusing exclusively on women’s health.

Nevertheless, inequality is far from eradicated. Only 22% of participants in drug safety and dosage trials are women. Furthermore, while two out of three Alzheimer’s patients are female, only 12% of research funding is allocated to projects specifically targeting women.

A similar dynamic has long been visible in psychology. During the Freudian era, women who deviated from social norms were swiftly labeled “hysterical.” Today, many psychiatric diagnostic criteria are still predicated on models where the male experience is the benchmark.

Why equality fails without equity

It is a startling reality: we possess more knowledge about the moon than we do about the female body, brain, mind and nervous system. This knowledge gap has tangible consequences. Women are disproportionately subjected to misdiagnoses, unconscious bias, or the dismissal of their symptoms. This results not only in medical complications, but also in burnout and stunted professional trajectories.

Gender-sensitive research is therefore imperative. Recent studies increasingly demonstrate that biological differences between the sexes influence emotions, behaviour, and cognitive functioning.

According to Patricia Clement of the MIRA Neuro research group (Ghent University), women undergo far more profound hormonal transformations throughout their lives than men. While male hormones remain relatively stable, female hormonal levels are in a state of flux—during the menstrual cycle, pregnancy, and (peri)menopause.

These fluctuations affect more than just the body; they affect the brain. For instance, cerebral blood flow shifts during the menstrual cycle. Around ovulation, many women experience heightened energy and mental acuity, whereas the subsequent period may bring irritability or fatigue.

During pregnancy, researchers have observed temporary structural changes in specific brain regions. Areas associated with memory may decrease in volume, while others become hyperactive to facilitate bonding and caregiving. The brain essentially reconfigures itself for motherhood.

Significant shifts also occur during perimenopause. Hormonal volatility can impact concentration, energy levels, and memory. Yet, in professional settings, these symptoms are often marginalized or misinterpreted.

While the female brain is, on average, 10% smaller than the male brain, this does not correlate with lower efficiency. Researchers suggest that female neurons may be more densely connected, enabling comparable cognitive performance with less volume.

Inequality beyond biology

Biological divergence is only one piece of the puzzle. The inequities women encounter in the workplace arise from a complex interplay of biological factors, societal expectations, education, and social norms.

The “Nice girls don’t get the corner office” mentality

From childhood, girls are typically rewarded for being nurturing, empathetic, and compliant. In a professional context, these very traits are typically misinterpreted as a lack of assertiveness or ambition.

This creates a double bind: if a woman acts assertively, she is perceived as “bossy” or “emotional.” If she remains compliant, she is overlooked for leadership roles.

The household manager

Despite the increasing involvement of partners, women still shoulder the lion’s share of the mental and organizational load of family life. Managing schedules, school activities, and domestic chores—the invisible orchestration of daily life—frequently remains their responsibility.

This constant accountability consumes time and energy that is then unavailable for professional development, networking, or restorative downtime.

Unequal socialization and role models

In many educational settings, girls are still encouraged to be cautious and “stay within the lines,” while boys are granted more latitude to take risks. This later translates into disparities in self-confidence within the labour market.

Furthermore, the scarcity of female role models in executive and STEM positions subtly reinforces the notion that these domains are less accessible to women.

The myth of the “ideal worker”

Many organizations are still structured around the “ideal worker” model: an individual who is available full-time, perpetually flexible, and devoid of primary caregiving duties. Historically, this model was built for a man with a stay-at-home partner.

This framework fails to reflect the reality of the modern family.

The invisible struggle of neurodivergent women

For certain demographics, inequality is amplified. Neurodivergent women exist at the intersection of multiple challenges: living as a woman in a patriarchal society while processing, feeling, and communicating in ways that diverge from social expectations.

In boys, autism is often identified early. In women, diagnosis is frequently delayed until middle age. Girls often learn to adapt socially from a young age, developing sophisticated strategies to camouflage their difficulties—a process known as masking.

Consequently, autism in women often goes unnoticed for years. Combined with other neurodivergent neurotypes, a diagnosis may only surface following total exhaustion or burnout. Research also indicates that autistic women often have atypical sensory processing. Some are hypersensitive to stimuli, while others possess an exceptionally high pain threshold. This often leads to physical or mental overexertion being recognized far too late.

Moreover, autistic women often express pain or distress differently than the “typical” presentations described in medical literature. Their symptoms are frequently misattributed to stress, anxiety, or fatigue. It is not uncommon for them to receive misdiagnoses of depression or borderline personality disorder before autism is even considered. This is a modern echo of the Freudian era, where anything misunderstood about the female experience was dismissed as “hysteria.”

Women navigate various daily roles: the “nice girl” expectation, the “household manager,” and other societal pressures. This imposes immense pressure and is particularly taxing for neurodivergent women who struggle with unwritten social codes, sensory processing, or executive functions such as planning and time management. Meeting these expectations requires significantly more energy and often leads to overwhelm. An introverted mother who requires solitude or avoids a stimulating school event is often judged harshly by society. This was poignantly highlighted in Ellen Jansegers’ recent book, Introvert Ouderschap (Introverted Parenting).

A Path Toward Progress

The solution is not to demand that women “try harder”. Structural change requires the commitment of society as a whole.

Men — particularly those with the most social privilege — play a vital role. Sociologist Joris Luyendijk famously illustrated this with his “7 Ticks” concept: those who are male, white, highly educated, heterosexual, and socially privileged possess a significant inherent advantage.

Our society has long been constructed according to male and neuronormative standards. It is time to critically re-evaluate this model to make it more inclusive.

Denmark is often cited as a benchmark for how structural reforms can foster true equity.

Hereby, some examples of workplace shifts to create a more equitable environment.

Equitable parental leave

Reserving a significant portion of parental leave specifically for fathers deconstructs the assumption that only women take career breaks for caregiving.

Family-friendly scheduling

Avoid scheduling critical meetings during peak family times (evenings or Wednesday afternoons). If parents cannot attend, the meeting should arguably not take place.

Flexibility and transparency

Cultivate a culture of flexible working that respects an employee’s current life stage. This benefits not just women, but neurodivergent staff as well.

Acknowledge that bodies go through different phases (such as the menstrual cycle or perimenopause) without viewing these as professional failures.

Gender-neutral education

Encourage children to pursue interests regardless of stereotypes. Support girls in STEM and boys in care-oriented fields. Invest resources in role models who can inspire the next generation.

Recognizing differences

Pas als we erkennen dat ieder individu verschilt, en een one-size-fits-all-aanpak niet meer werkt, kunnen we stappen zetten naar een gelijkwaardigere maatschappij en werkomgeving. Daarom is het ook belangrijk om steeds te kijken naar het individu zelf, wat er speelt. Ga in dialoog met elkaar.

The “Nothing About Us Without Us” principle

It is essential that women and other marginalized groups are empowered stakeholders at the decision-making table.

What women truly deserve

To evolve into a society where women have fair opportunities, we require equity, not just equality. Equity means acknowledging our differences and calibrating our systems accordingly.

Women deserve medical research that accounts for their physiology, fair professional opportunities, and an equitable distribution of domestic labour.

An environment that accommodates the needs of women and neurodivergent individuals — characterized by flexibility, clear communication, and a human-centric approach — ultimately creates a superior workplace for everyone.

Immediate steps for organisations

I invite leaders, HR professionals, and colleagues to reflect on the following:

• How gender-sensitive is our current organizational policy?
• Who is represented at the table when pivotal decisions are made?
• Is flexibility treated as a rare privilege or a cultural norm?

Genuine transformation often begins not with a grand reform, but with an honest, open conversation.

Ask the women in your team: what small change today would make the most significant difference for you?