President Donald Trump has done something that even some of his fiercest critics should welcome. He has ordered the creation of a Women's Health Division at the National Institutes of Health, with first lady Melania Trump championing the initiative.
We can acknowledge the awkwardness in welcoming this. Trump has a contentious record on women's health, to say the least, and his administration has faced serious criticism over cuts to federal medical research. Yet the announcement addresses a longstanding failure of American medicine. Women have too often been diagnosed and treated according to evidence drawn primarily from men.
Washington has recognized this problem before. NIH established its Office of Research on Women's Health in 1990, and Joe Biden launched a White House women's health research initiative in 2023. So what makes Trump's effort different?
This administration wants to get research out of laboratories and into doctors' offices. A new NIH division would work alongside the existing women's health office, while a White House task force would try to make federal agencies work together. It is a sensible ambition, although anyone familiar with Washington's fondness for creating offices to coordinate other offices may reasonably reserve judgment.
We should also note that the initiative comes with no additional announced research funding. This is common territory for executive orders, which generally direct agencies to work with money Congress has already appropriated. Trump's order places the task force's administrative costs on the Department of Health and Human Services and makes implementation subject to available appropriations. The money must therefore come from existing budgets unless Congress provides more. Nobody has yet specified how much the new division will receive or what other work might have to make room for it.
Still, the absence of a new check is not a reason to dismiss the entire enterprise. Presidents can change priorities before Congress changes budgets and the real question is whether the new priorities produce anything beyond meetings.
Consider what is at stake.
Heart disease remains the leading cause of death among American women, while conditions such as endometriosis and menopause have long exposed gaps in medical knowledge and care. Research has improved, but the distance between what scientists know and what women experience in examination rooms remains steep.
Melania Trump's involvement in the initiative is worth taking seriously. Even those who find just about anything that this administration has done objectionable should take a second and acknowledge that the first lady is doing something worthy of attention.
Trump himself seemed surprised that NIH had no women's health division.
"Who the hell wouldn't have a women's health division?" he asked at the announcement.
An understandable question, although NIH has had a women's health research office for 36 years. The persistence of the problem suggests that recognition alone has been insufficient.
Here is where the new initiative could make a difference. Trump's order specifically calls for greater accountability among researchers receiving NIH grants to ensure that biological sex is considered in their studies. It also directs the new division to improve the translation of research into clinical practice.
To play devil's advocate, there is a pretty strong argument against giving the administration too much credit for these moves.
Biden's women's health initiative was associated with nearly $1 billion in federal investments, according to the previous administration, and Trump's order revokes his predecessor's directives. Meanwhile, the administration's cuts to medical research have raised questions about whether a new division can make much progress while the broader scientific enterprise faces financial and staffing pressures.
And there is an obvious political dimension to this all. Women's health is a subject on which the administration can seek common ground with voters who disagree with it on abortion and other reproductive issues. Smart political thinking, at least in theory. The timing, with the midterm elections approaching, adds a layer to it all. This is American politics at its finest—a president wants credit for doing things that voters might like.
As usual, post-announcement behaviors will be more telling than the actual announcement, so we'll have to wait and see what happens. Trump and Melania deserve credit for taking women's health seriously, whatever one thinks of the president's broader record, but whether they deserve lasting gratitude depends on whether this becomes yet another Washington office or actually makes a difference in women's lives.