It’s been an intense couple of months of in-person and virtual speaking engagements: I gave a talk on sustainable AI for the Manchester Responsible AI Network (MRAI), hosted by the NatWest Group, and recently delivered a keynote on deepfake porn to the Lloyds Banking Group.

I was also a panellist at the Women’s Health Tech Summit 2026, where leaders from healthcare, research, technology, investment and entrepreneurship came together to share ideas and explore practical solutions to improve women’s health.

The event was co-hosted by Diversity UK and the Greater Manchester Connected Health Ecosystem, and coordinated by the University of Manchester’s Digital Futures, the Christabel Pankhurst Institute.

I spoke on the Feminist AI panel, which explored how artificial intelligence can be developed and used to better serve women. I was joined by Dr Allysa Czerwinsky, AI Trust & Security Research Fellow at the University of Manchester; Dr Nicola Hodson, former Chair of IBM UK and Ireland; and Maryam Yaqub, AI Lead at the Fawcett Society. Anthony Wilson, Deputy Director of the Christabel Pankhurst Institute, moderated the discussion.

During the panel, I was asked what good frameworks for developing and governing AI systems look like.

I started with what doesn’t work.

When it comes to specific frameworks for designing and governing AI systems, what doesn’t work is having none. Unfortunately, this happens routinely because organisations either wait for the “perfect” framework or, more commonly, don’t believe they need one. For example, people working on what’s called “tech for good” may rely on their good intentions and the virtue of their mission as an imaginary shield against biases. Also, those who see technology as “neutral” may not see the need for AI governance.

Then, I discussed what is effective

What I see working are adaptive governance models that incorporate feedback from those developing and using the solutions (i.e., not simply “cuting & pasting” frameworks developed by other organisations) and development frameworks that embed users’ perspectives throughout the process, from the design to the decommissioning of the AI systems. Also, those that monitor deployment and are intentional about the terms of service, including how data is handled.

I finalised my intervention by sharing my wish list

I would like to see a shift from statements of fairness and transparency to justice, because justice is about recognising differences, spotting structural asymmetries, and enacting reparations. Also, I look forward to organisations embeddig a commitment to delivering sustainable AI products.

In addition to my intervention, I also want to share what energised me, irritated me, and saddened me from the event.

What energised me

Dame Lesley Regan DBE, Women’s Health Ambassador for England, delivered a thought-provoking keynote challenging myths such as that women’s health is only about sexual and reproductive health or that the gender health gap is concentrated at the end of life.

It especially resonated with me her call to move from insights to action:

We need to stop writing reports and admiring the problem in women’s health and start developing the solutions.

Dame Lesley Regan DBE, Women’s Health Tech Summit 2026

As I mentioned in the article Seven Ways Big Data Leaves Women Out of the Equation, throwing around the seemingly harmless sentence “We need more data” is a great strategy for stalling initiatives aimed at increasing gender equity.

Because, do we really need more data to substantiate that

• In the UK, Black women have much worse birth outcomes than White women
• Or, peri- and post-menopause are very disruptive for a lot of women

before we act?

What irritated me

Two issues upset me. First, the insistence on ROI for women’s health, which reinforces the idea that we need to make a business case for women to receive high-quality healthcare. Do we require an ROI for human rights, too?

The other was to see how uncomfortable one of the speakers was about the term “medical misogyny”. The person said the term was not appropriate because “misogyny” is about the hatred of women, and the healthcare profession does not hate women.

Fortunately, other panellists and attendees validated the term “medical misogyny” as the set of healthcare beliefs and practices that enforce patriarchy. For example, the normalisation and dismissal of women’s pain.

What saddened me

One innovative aspect of the summit was that after each panel session, attendees had about 15 minutes to discuss the topic with the other members at their table.

When discussing our healthcare experiences – and that of other women in our lives – at our table, it disheartened me to hear women who were 5, 10, and even 20 years younger than me experiencing the same gaslighting and contempt from our healthcare systems that I have endured myself.

It also reminded me that one of those experiences prompted me to write an article about how the contempt for women’s pain justifies substandard healthcare for half of humankind about five years ago.

The resulting essay first appeared in Certain Age Magazine under the title Levels of Pain. Thanks to the amazing Jean Shields Fleming for allowing me to republish it below.

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Levels of Pain

Recently, I underwent a small surgery. I woke up in the operating room, and I was asked for my level of pain from 1 to 10. I was puzzled by the question. Through the pain and the anesthesia fog, I searched for examples of past pain to rank it appropriately. Two memories came up.

Should I compare it to what appeared to be twisting my ankle during a badminton game while I was doing my PhD in Canada? That was very painful. An 8. Definitely. That evening, I limped from the court to my home in the snow. The next day, I went to the university infirmary. I was reassured – without X-rays to prove it – that I wouldn’t be able to walk if something was broken. I was referred to the site physiotherapist, who performed a rather painful 30-minute massage on my ankle. They booked me for a follow-up session, and I walked home resigned. After three days of limping back and forth between my home, the lab, and the supermarket, a work colleague kindly drove me to the hospital. There, after begging – and covertly threatening – the doctor, I finally got my X-ray. The diagnosis? The physician, half amused, half puzzled, shared that my fibula was fractured. I got a 6-week blue cast as a prize for my persistence.

Or maybe I needed to compare it to my skull fracture in 2019. I fell during a teamwork activity on a Friday evening. That night and the subsequent days, I experienced strong headaches. Unfortunately, I’d been so well indoctrinated by this society to minimise my pain that it was only the following Wednesday – when I felt my body shutting down – that I finally contacted the emergency services. Again, it took several calls to reassure my puzzled respondents that I was not messing around. Maybe worried about a lawsuit, they finally sent an ambulance. Again, I spent several hours moving from room to room and chair to gurney while numerous interlocutors tried to dissuade me that it couldn’t be so bad since I hadn’t called before. In the end, my perseverance won and I got an MRI reassuring us all that this ‘needy’ woman hadn’t wasted everybody’s time, but indeed, she had a small skull fracture. As for pain, a 9 maybe?

Back to the operating room and my auto-assessment of my pain. I replied, “Six”. I got some analgesics. We waited. I was asked again if the pain had subsided. I said no. I was given codeine. We waited. I was asked again. I said it was still the same.

They told me this was “kind of inconvenient.” The reason? If I was still requesting to alleviate my pain, that required that they give me morphine. And the nurses in the ward wouldn’t appreciate the extra work, because it meant they’d have to monitor me periodically.

A silence followed. It was my turn to decide. Their intent gaze at me appeared to suggest that this was my cue to reconsider my initial answer: Was I so selfish that alleviating my pain was more important than the additional work for the nurses? Maybe it was not hurting so bad, after all.

In a moment of clarity – surely from a lifetime of learning that the only way to entitle my body to the care it deserves is perseverance – I replied that I wanted to be relieved from pain. I got my morphine and about 45 minutes later I was without pain. I don’t know how many angels I killed with my stubbornness, but it was worth it.

During my convalescence at home, in which unpleasant symptoms came and went, I reflected on my history with pain. For each time I’d fought back, there were plenty when I’d resigned myself to thinking, ‘This too shall pass’. Like the shoulder problem that took a year and a half to fix itself, after both the doctor and physiotherapist gave up, my pain not cooperating with their treatment.

I realised that not all women’s pain is the same.

Three kinds of female pain

Society boxes female pain into three groups. First, we have the “because you’re worth it” or perfection pain. An oxymoron. Perfection is ethereal, joyous, carefree, calm, in control. Pain is real, demands action; it’s unrestrained; it’s political.

Perfection pain is driven by society’s ever-changing beauty standards for women. From fasting, miracle diets, and Botox all the way to anorexia, bulimia, and cosmetic surgery. Pain should be ignored as collateral damage in the worthy pursuit of beauty. It’s our duty as women to take care of our appearance. On the other side, it’s our fault if the pain doesn’t translate into the coveted photoshopped version of ourselves. Shame plastic surgery, anyone?

Then, we have the “pride” pain linked to fecundity: Childbirth and the loss of virginity. Curiously, as far as I remember, I’ve received contradictory messages about them. The most excruciating pain. The pain that makes you a woman. Both linked to rites of passage with blood and spectators ranking performance. These two are the only female pains where bodily fluids are welcome.

As I don’t have children, my experiences of pain have often been minimised by health professionals and other women. Apparently, without experiencing birthing pain, it’s impossible for me to correctly assess any pain. My threshold is too low. I wonder if men are told the same.

That doesn’t mean it’s easier for mothers. The pain of women who give birth is everybody’s business. Everyone has an opinion and feels entitled to police future mothers. Is it compatible to be a caring mother while refusing to undergo birthing pain? Many people think it isn’t. A relative of mine endured an exhausting and painful 23 hours of childbirth with her first baby. Upon learning about medical alternatives to reduce pain, next time she opted to be under anesthesia, which reduces pain although it still doesn’t remove the contraction pain. Still, the hospital personnel reprimanded her for being selfish and only thinking about herself when choosing to get sedated. This, even though the outcome was a healthy 4.350 kg baby boy!

Finally, we have the “shame” pain. This is inevitably linked to periods. Both to their presence and absence. I still remember the TAMPAX ads of the 80s. Women in white trousers smiling or in their Lycra jumping on the beach. How can you complain about your period pain if you’re only a tampon away from happiness? In fact, society ensures that we learn to downplay period pain to such a degree that women with endometriosis may endure excruciating pain for years under the perception that painful periods are “not worth mentioning”. A man taking a day off from work to recover from binge drinking after watching a football match? Boys will be boys. A woman taking a day off because of menstrual pain? The weaker sex.

And what do we talk about when periods are gone? Nothing. Until recently, menopause was ignored by Western societies, in spite of women spending an average of 20-35 years in that stage of their lives.

Things are changing and we hear more about it – which is great. Yet again, another excuse to police women. Society pits the “natural remedies” group against the “hormone replacement therapy (HRT)” side.

Unfortunately, there is much less information about the collateral conditions around menopause. Take osteoporosis, a health condition that weakens bones, making them fragile and more likely to break. On average, women lose up to 10 percent of their bone mass in the first five years after menopause. What’s more, research suggests that about one in two women over the age of 60 will experience at least one fracture due to osteoporosis. Still, getting a £100 DXA or DEXA scan, the specialised X-ray technique that measures bone density, is a privilege you need to fight for in the UK. Apparently, it’s cheaper to wait for women to break their wrists, arms, and hips rather than monitor the density of their bones when they start undergoing menopause.

Those stories of beauty, childbirth, and shame pain have trained society and women to police our pain. We are quick to tell other women when it’s fine to experience pain, what’s the ‘right’ threshold and, more importantly, when they should minimise it. Otherwise, they’d better be prepared for an ‘It was worse for me’ reply. Or even better, ‘Wait until you give birth’.

How are women going to be confident if society keeps trivialising and disregarding our pain? Moreover, if all attempts to dissuade women that they are experiencing pain fail, we’ll always have our brains to blame. Often, female physical pain has been attributed to mental problems – hysteria, madness, stupidity – or even better, personality traits of the bearer such as neediness and attention-seeking.

Some women are more equal

In my case, in addition to persistence, and the luxury of having the time to be persistent, I’m White. That means that I may be perceived as needy and whiny but I’m also regarded as delicate and fragile.

Other women don’t have that prerogative. For example, Black women. There is Serena Williams and her story about how she almost died giving birth to her daughter as a result of health professionals dismissing her symptoms. Unfortunately, there is a wealth of data about higher pregnancy mortality for Black women going back decades in the US and UK. Most of the reasons given for the ethnic divide try – yet again – to put the onus on women. Their weight, their socioeconomic status, their education…. the list goes on.

This is not a bug but a feature of the system. White people – including women – have largely benefited from assigning Black and other non-White women groups a different threshold for pain. Why do I say “benefitting”? Because if we recognise that Black and other non-White groups experience as much pain as White people, then we’ll need to acknowledge that historically we’ve attributed stereotypical superhuman strength traits to those groups in order to ignore their suffering caused by the cruel Western colonising practices.

Unfortunately, non-White women are not alone in enduring double healthcare standards. Whilst public health authorities in the US record the use of contraceptives by women with disabilities, their pregnancies go under the radar and they don’t get standard maternity care. Wheelchair users may go through their entire pregnancy without being weighed, they are disproportionately scheduled for C-sections, and decisions about their delivery are made without their input. This is compounded by obstetricians’ reluctance to care for them for fear of added complexity. And all that, in spite of research corroborating that women with and without disabilities want children to the same extent.

What if we didn’t neglect women’s pain?

What if we finally came to terms with the fact that women do experience pain and that this pain deserves attention?

• We’d invest in endometriosis research at least as much as in baldness ($2 billion). In the US, the cost of endometriosis was estimated to be $119 billion but only $26 million of federal funding was approved for its research in 2020.
• We’d stop making women pay for period painkillers. What’s more, we’d design painkillers specifically to alleviate period pain, rather than prescribe the same drugs and doses used for toothaches and colds.
• We’d plan for women’s overall health instead of ‘maintaining them alive’. We often hear that, on average, women live longer than men. What we don’t talk about is that women’s health during their lives is consistently worse than men’s.

What will it take to stop ignoring the pain of 4.0 billion human beings?