A landmark Victorian inquiry has exposed deep, system-wide failures in how women’s pain is treated. The policy response now requires national leadership.

Women’s pain has long been under-recognised within healthcare systems, but the evidence has often been fragmented or dismissed as anecdotal. Victoria’s Bridging the Gender Pain Gap inquiry changes that.

Drawing on the experiences of more than 13,000 women and girls, alongside carers and clinicians, 
the Inquiry provides a comprehensive picture of how women’s pain is assessed and treated across the entire health system – from first contact with GPs and paramedics through to specialist care.

While many of the findings may not surprise clinicians or patients, their scale, consistency and depth give them substantial policy significance.

The inquiry found that 90 per cent of respondents experienced pain lasting longer than a year, with more than half reporting daily pain. Seventy-one per cent said their pain had been dismissed or downplayed by healthcare professionals.

These experiences cut across age groups, care settings and medical conditions, including cardiovascular, neurological, reproductive and autoimmune disorders.

The broader impacts were significant. Nearly nine out of ten respondents reported negative effects on their mental health, while many described disrupted employment, education and relationships.

Cost was identified as a major barrier to care for 68 per cent of respondents, with many delaying treatment until the symptoms became severe.

These findings align with international research showing persistent gender disparities in pain assessment, diagnosis and treatment. Women are more likely to have symptoms attributed to psychological causes and are less likely to receive timely or adequate pain relief. Similar patterns have been documented in emergency cardiovascular care and out-of-hospital cardiac arrest.

A distinctive feature of the Victorian inquiry is its focus on the entire care pathway.

The executive sponsor for the project was Victoria’s Chief Paramedic Officer, Dr Louise Reynolds, reflecting the recognition that gender bias can influence early clinical judgement and decision-making well before a patient reaches the hospital.
Paramedics and first responders are often the first point of contact for women experiencing acute pain crises. They encounter patients at times when delayed care, cost barriers or prior dismissal may have allowed pain conditions to worsen. Early assessment, communication and decision-making can shape both clinical outcomes and patient trust in the health system.

From a policy perspective, this underscores the need to include primary care and pre-hospital services in any response to gender bias in pain care. Training frameworks, clinical guidelines and service design all influence how pain is assessed and managed at this critical initial point of care.

In response to the inquiry, the Victorian government has committed to implementing a Women’s Pain Standard to establish clear expectations across public health services, a Women’s Pain Action Plan to drive systemic reform, expanded access to pain relief during procedures such as IUD insertions, and a dedicated clinic for young people with conditions including endometriosis.

These initiatives expand responsibility for diagnosis and treatment from individual clinicians to embrace the health system as a whole, setting clearer expectations for care and embedding gender equity into policy, workforce development and service delivery.

The inquiry delivered 27 recommendations spanning research, policy, workforce training, models of care and affordability. Importantly, these recommendations are adaptable rather than prescriptive.

From a national perspective, the policy question is whether other jurisdictions should replicate the inquiry or build on its findings. Given the scale of the Victorian study, there is a strong case for using it as a shared evidence base and focusing efforts on implementation rather than duplication.

Australia is not alone in addressing pain disparities. Internationally, governments are responding to diagnostic delay and dismissed symptoms. In the United Kingdom, steps are being taken to roll out informative posters on Jess’s Rule across primary care. This is a patient safety initiative to prompt clinicians to critically re-evaluate patients who present repeatedly with unresolved or escalating symptoms.

In Aotearoa New Zealand, recent research has highlighted the substantial economic burden of endometriosis and chronic pelvic pain, providing the first nationwide cost-of-illness estimates using a modified World Endometriosis Research Foundation methodology.

These two examples reinforce that women’s pain is not a niche issue, but a systemic challenge with significant human and economic consequences.

The authors of the Bridging the Gender Pain Gap inquiry are to be commended for their rigorous and compassionate work in elevating the voices of thousands of women and girls, and for providing a robust foundation for systemic reform.
Addressing gender bias in pain care requires coordinated policy responses across the full continuum of care. Victoria has shown that it is possible to move beyond awareness and into the implementation of meaningful change.

The evidence is clear, the policy tools are available, and the costs of inaction are well understood.

The challenge is for other jurisdictions to act on the available evidence.

The central question is whether Australia’s federated health system can translate Victoria’s leadership into cohesive national reform, or whether women’s pain will continue to be acknowledged but not consistently addressed and resolved.