The uterus crisis

May 28th is the World Day for Women's Health. This year, the Catalan Society of Health with a Sex and Gender Perspective, of the Academy of Medical and Health Sciences of Catalonia and the Balearic Islands, has coincided its annual conference with it: Healing Gazes. As I head there, a figure I read the other day chills me: in the United States, in 2024, Black women were more than three times more likely to die during childbirth than white women. The African American maternal mortality crisis is difficult to digest, yes, but Dr. Kemi Doll, a gynecological oncologist and equity scientist, proposes a broader perspective. She reminds us that women spend most of their lives not pregnant, and yet, women's healthcare is mainly for reproductive health. And it is precisely in this long journey (from the first menstruation to beyond menopause) where a silenced suffering accumulates: fibroids, underdiagnosed endometriosis, bleeding that leaves anemic women walking around – as if it were normal – and, at the end of the journey, endometrial cancer. The “uterus crisis,” as Doll calls it.What makes the argument powerful is not just the denunciation, but how it strikes at the heart of science itself. The standard protocol for detecting endometrial cancer is based on measuring the thickness of the uterus by ultrasound when bleeding occurs. It sounds objective, neutral, universal. It is not. This method works worse in Black women, who have more and larger fibroids. This fact generates detection errors and, therefore, late diagnoses and, consequently, fewer treatment options. A seemingly impartial algorithm hid a bias built on who had been included (and who not, of course) in the trials that validated it.Here is a lesson that goes far beyond the United States and skin color, and that the Glances that heal workshop highlights. All research that forgets a part of the population ends up producing medicine that fails precisely those who need it most. It is the heart of sex bias in science. For decades, the male body has been the norm and the female body, a little-studied deviation. Women's health has shrunk to mean almost only pregnancy, contraception, and little else, as if the uterus only mattered when gestating.When we talk about "women's health" thinking only of maternity, we leave out chronic diseases that affect millions of people and that carry a historic deficit of funding and research. When public debate reduces contraception to an ideological issue, we forget that many of these medications treat endometriosis or fibroids. Demonizing them has a real health cost.The challenge now is for science not to fall behind or cede ground to disinformation. Because recognizing biases does not weaken rigor; it improves it. And listening to the whole bodies of women, throughout their lives and not just when they are pregnant, is not a concession. It is, simply, doing the job well.