I'm going to lay this out how I understand it:

The NIH Revitalization Act of 1993 was supposed to bring women back into medical research. The reality was that women were always included, HOWEVER in 1977,(1) because of the outcomes from thalidomide (causing birth defects), "women of childbearing potential" were excluded from the phase 1, and early phase 2 trials (the highest risk trials). They're still generally generally excluded, even after the passage of the act. This was/is to protect the women, and potential children.

According to Edward E. Bartlett in his meta data analysis from 2001, men have been routinely under-represented in NIH data (even before adjusting for men's mortality rates) between 1966-1990. (2)

There's also routinely twice as much spent every year on women's health studies vs men's by the NIH. (3)

It makes sense to me, but I'm biased. Logically, since men lead in 9 of the top 10 causes for death, that shows there's something missing in the equation of research. (4 - It's not a straight forward table, you can view the total deaths, and causes and compare the two for men, and women)

With that being said, it doesn't tell us about the quality of the funding or research topics, maybe the money is going towards pointless goals, or unproductive researchers.

Are there gaps in research? Most definitely, like women who are pregnant. This is put in place to avoid harm but that doesn't help them when they fall into them. Are there more? Definitely. I'm not educated enough in the nuances to go into them.

If you have information that counters what I've posted, please share it, I would love know where these folks are blind so I can take a look at my bias.

(1) https://petrieflom.law.harvard.edu/2021/04/16/pregnant-clini... (2) https://journals.lww.com/epidem/fulltext/2001/09000/did_medi... (3) https://jameslnuzzo.substack.com/p/nih-funding-of-mens-and-w... < I spot checked a couple of the figures, and those lined up. I'm assuming the rest is accurate (4) https://www.cdc.gov/womens-health/lcod/index.html#:~:text=Ov...