Recognition Without Consolidation: Women’s Health Governance and Lived Experience in Portugal

This article examines how gender shapes the framing, governance and lived experience of women’s health within a national health system, and what this reveals about translating gender equality commitments into social policy practice. Using a convergent mixed-methods design, the study combines analysis of national policy documents and parliamentary debates in Portugal (2014–2024) with interviews with key actors (n = 13) and an exploratory national survey of women (n = 268). Across policy and political arenas, women’s health is widely recognised within gender equality and rights-based discourse, yet remains weakly consolidated within mainstream health governance. Reproductive framings dominate, while life-course dimensions such as menopause, women’s mental health and health literacy are under-articulated and weakly operationalised. Actor perspectives emphasise prevention, health literacy, communication and continuity of care, pointing to diffuse ownership and limited accountability. Survey respondents’ accounts both reproduce and extend dominant framings, highlighting mental health, information needs, access barriers and the importance of accessible and trustworthy health information. Reported care experiences reveal a pattern of “respect without responsiveness”, where positive interpersonal treatment coexists with organisational and communicative shortcomings. The article conceptualises this as a governance paradox of recognition without consolidation and shows how policy silences shape not only what becomes actionable within gendered health systems but also the informational conditions that support informed engagement with health and care. The findings have implications for designing life-course-oriented, communication-sensitive and accountability-anchored approaches to women’s health governance.