Gender discrimination and inequality in access to healthcare in the EU

On International Women's Day, the European Equality Law Network shares its latest thematic report: 'Tackling Gender Discrimination and Inequality in Access to Healthcare: scoping possibilities and opportunities for EU law'. A comparative analysis of EU member states reveals widespread gaps in healthcare coverage that disproportionately affect women. The report takes stock of existing EU law that directly or indirectly shapes gender equality in access to healthcare, and how it can be used and/or improved.

While health law and policy may not seem an obvious fit with EU equality law, the two are deeply connected. Through provisions such as the Goods and Services Directive, the Recast Directive, and the Violence Against Women Directive, Union law directly and indirectly shapes gender equality in healthcare access. This report maps those possibilities and draws on comparative national expertise covering healthcare system coverage, gender-sensitive care, obstetric violence, and sexual harassment in healthcare settings. 

The comparative analysis reveals widespread gaps in healthcare coverage that disproportionately affect women. Member States frequently fail to fund treatments primarily needed by women, including abortion, contraception, and endometriosis care. Specialist shortages across Croatia, Poland, Portugal, Slovenia, Sweden, and the UK compound the problem. In the UK alone, around 750 thousand women are on gynaecological waiting lists. 

Concerning research and education, a "male as default" approach to medical research produces systematic failures in diagnosis and treatment. In the Netherlands, up to 80 percent of individuals with unexplained conditions are women. In France, awareness gaps around how heart attacks present in women contribute to a potentially critical 15-minute treatment delay. Widespread "medical gaslighting" (dismissal of women's pain) makes things worse across many countries. 

Finally, despite anti-discrimination legislation existing in nearly all surveyed states, relevant case law is strikingly absent. Key enforcement barriers include patients' difficulty recognising and proving discrimination, the power imbalance between professionals and patients, fragmented complaints mechanisms, and equality bodies that lack the powers and resources to act effectively.