Her Voice Belongs in the Room

Washington has a way of making any gathering sound important. Put researchers, advocates, physicians, entrepreneurs, and people who write policy in one room to talk about women's health, though, and it gets hard to dismiss how much of the problem lives outside any one of their fields.

The WHH Washington, D.C. Summit Wednesday, Oct. 7, presented by Women’s Health Horizons in partnership with the Society for Women's Health Research and Women’s Health Advocates, provided exactly this kind of room. Our executive director, Dr. Odessa Lacsina, was there to speak about The State of Women Institute and the work of moving past awareness and into action. She also brought two guests — Uschi Keszler and Dr. Vonnya Pettigrew, who may be familiar to you from earlier posts — and we were proud to have them both there.

Two Women, One Phone Call

Uschi Keszler's first career was elite sport. She competed in the Olympics, then became a six-time Olympic coach who worked with some of figure skating's most accomplished competitors. After surviving breast cancer and uterine cancer, the discipline she had spent years asking of athletes went into Pennies in Action, which she founded in 2007 to support cancer research and clinical trials that may carry promising new treatments to patients.

A few months ago, Dr. Lacsina was preparing to speak to a room of Caribbean women about cancer and, being a scientist, looked up the numbers first. Barbados, she found, has the third-highest mortality rate in the world for triple-negative breast cancer — an aggressive form of the disease with no standard targeted therapy that falls hardest on women of African descent. Dr. Lacsina is of Barbadian and Guyanese descent, and some of the women in that risk group came from her ancestral homeland. Many of them, she noted, may not even know the risk exists.

She picked up the phone and called Keszler, a close friend.

Dr. Lacsina advises Pennies in Action on science, and the organization supports Dr. Brian Czerniecki's immunotherapy research at Moffitt Cancer Center, so it turned out to be exactly the right call. It grew into a collaboration with Queen Elizabeth Hospital in Barbados, Czerniecki's team, the V Foundation, and others. They won a feasibility grant, then wrote a proposal to the Department of Defense for a larger international grant to bring DC1 immunotherapy research to Barbados.

It’s an inspiring story, but the catch also makes it concerning: The magic worked, this time, because two people already knew each other. Progress should not rest so much on who has access to whom. Plenty of people who see a number like that have no one to call.

Before the Stereotype Does

Dr. Pettigrew started in media. She founded Root Branch Media Group in 2006, and it has since grown to include a film academy for K–12 students, a marketplace for local small businesses, a job-training program called G.R.O.W., and an arts and outreach institute. The aim, she has said, is to let people tell their own stories before someone else does — or before a stereotype does.

That sounds like a media goal, and it is. It is also a health goal. What a woman knows about her own risk; whether she sees anyone like herself in the institutions meant to serve her; and whether she has somewhere to learn, work, and belong all shape how she deals with the health system. Whether a woman gets screened, or trusts the person explaining her results, can depend on whether she has ever seen anyone who looks like her in that office. It’s a crucial question to the conversation about women’s health: What does health equity look like outside the hospital?

The Numbers That Meant Nothing

Access was also the subject of Dr. Lacsina’s talk — though she came at it from a different direction. As an NIH Fogarty International Fellow, she worked at a community hospital in Kenya that had received donated equipment from well-meaning organizations — cutting-edge machines for a small rural lab. The lab ran out of the reagent needed to calibrate one of them. Staff kept running tests anyway, because patients had waited for hours and no one wanted to tell them the results meant nothing. People were making life-and-death decisions from those numbers.

Dr. Lacsina placed the responsibility on how researchers in the global north — herself included — design studies as though one size fits all. Care without infrastructure, she said, is only the appearance of care. Washington is where policy gets written and funding gets decided. Whoever does the deciding hears about a missing reagent only if someone who has stood in that lab is there to say so.

She also told a smaller story alongside it: a college classroom where a professor once asked her to count the female professors. She counted one. Her daughter is 11. Dr. Lacsina would like her to walk into a classroom someday and find women who look like her leading the room.

One Conversation

Keszler, Dr. Pettigrew, and Dr. Lacsina each address representation, advocacy, and women’s health from different angles. That’s what made Wednesday’s room so impactful, and it’s what makes the next room, and the next one and the next, so essential. Lived experiences, passions, expertise, connections. Women’s voices and stories. They belong in every room.

Dr. Lacsina closed with a reminder of why the room exists. Washington is where policy gets written, where funding gets decided, where the decisions that shape health infrastructure are made. The State of Women Institute came to support, collaborate, and amplify the work being done, and her ask was a simple one: if your work touches any of our three pillars — mental health and wellness, maternal health equity, and preventive wellness — start a conversation with her and with The State of Women Institute.

We have a couple of those conversations already underway — with Keszler and Pennies in Action around cancer research and preventive wellness, and with Dr. Pettigrew and Root Branch around health equity, media, and mentorship for women coming up in health communications — as well as with some other amazing women and organizations we’re beginning to work with, some of whom we just met at the summit.

We intend to keep going. If your work belongs in the room too — and we believe it does — you know where to find us.

The State of Women Institute is a global 501(c)(3) nonprofit advancing women's health equity through research, innovation, and community engagement across three pillars: Mental Health and Wellness, Maternal Health Equity, and Preventive Wellness. Learn more at thestateofwomen.org.

A Letter to the Girls Who Are Already Everything

By Dr. Odessa Lacsina, Executive Director, The State of Women Institute

This week, world leaders are gathered in New York at the United Nations. They are talking about trust. About transformation. About a world that delivers for all.

I want to talk about you.

You are eleven. You want to be an astronaut. You want to lead the mission to Mars. You have said this since you were four years old and not one word of it has changed.

But let me start a little earlier than that.

I homeschooled you. When you were small I taught you that math is the language the whole world speaks exactly the same. You heard that and you made it yours. You told me once that math is everything. I believed you then. I believe you now.

When we got to space, something shifted. You watched every documentary. You read every book you could find. You were fascinated in the way that some children are fascinated by things they recognize, not things they are discovering for the first time. Then we read a book about Dr. Mae Jemison. You could not let it go.

At four years old, you met her.

You, who have never once in your life been at a loss for words, went completely silent. And when you found your voice again, you said: I want to be an astronaut. I want to lead the mission to Mars.

That declaration has not changed once. Not in seven years.

While that dream has been growing, so have you. You compete with your robotics team. You compete on ice. You advocate for literacy because you understand that words are power and not everyone has equal access to them. You report on the world as a youth correspondent. And since you were six years old you have been hosting a reading podcast, interviewing guests, introducing books to audiences, building something season by season that is now in its fifth year.

More often than not, you are the most prepared person in the room. You are just not expected to be.

My heart silently bursts with pride when you introduce yourself as the first Madam President of Kids In Action. And I blush with awe when I think of the impact you will have in this world.

Now let me tell you what I know as a scientist, because I think you deserve the honest version.

The years just ahead of you are the ones the research watches most closely. Girls enter school with math confidence nearly equal to boys. By middle school a measurable gap has opened. Not because something changed in the girls. Because something changed in what the world reflected back to them. The cultural pressure that peaks between twelve and fifteen does not just ask girls to lower their ambitions. It asks them to doubt the ones they have held the longest. The ones that arrived early and stayed.

You have held yours for seven years.

There will be rooms you walk into where someone will look at everything you are and quietly suggest you pick one thing. The robotics or the ice. The podcast or the math. The advocacy or the astronaut. They will mean well, most of them. They have been taught that focus means subtraction.

What they have not yet understood is that the most important questions in science — the ones about access and equity and how we build systems that work for everyone — cannot be answered by people who only know one thing. A girl who performs under pressure alone on ice and builds machines as part of a team and has been communicating ideas to a public audience since she was six is not scattered. She is the most prepared person in the room.

She is just not always expected to be.

Research on girls who persist in STEM through adolescence and go on to lead points to one factor above most others: a documented record of competence they can point to when the world starts telling them they don't belong. You have five seasons of that record already in your podcast alone. Season six is being made right now. You built that before anyone told you it would matter.

The United Nations is in New York this week saying that women's leadership is failing to advance globally. That in many countries it is moving backward. They are right, and that matters, and people like me are working on it.

But I am also watching an eleven-year-old who already leads, already advocates, already competes, already reports, already builds teams and stands alone on ice and has held a microphone since she was six and has known since she was four — since she stood silent in front of the woman who proved it was possible — exactly where she is going.

The research does not have a framework for you yet. You are ahead of it.

Some may not be ready for you. Walk in anyway.

With love and with evidence, A scientist (who is also your mom).

Restoring Trust Means Building Institutions Where Women Can Lead

EVIDENCE TO ACTION | Science Made Simple UNGA Edition | The State of Women Institute

By Dr. Odessa Lacsina, Executive Director, The State of Women Institute

This week, world leaders are gathered at the United Nations in New York. The theme of the 81st General Assembly is restoring trust. One of the conversations running through the week — anchored by the Gender Snapshot 2026, launched just days ago by UN Women and UN DESA — is about where women stand in leadership globally. The short answer is that progress has stalled. In many countries it is moving backward.

That backdrop makes a systematic review published September 1 in eClinicalMedicine, The Lancet's open-access journal, worth reading closely.

The Research

Researchers from Monash University and the University of Glasgow reviewed 57 studies evaluating 52 women's leadership development programs across 23 countries. Their central question was whether these programs — which organizations have invested in for decades — were producing measurable organizational change or simply changing individual women.

The finding deserves a full stop: most programs successfully built confidence, leadership skills, and professional networks in individual participants. Very few produced documented change at the organizational level. The structures those women returned to largely stayed the same.¹

The Pipeline Exists. The Progression Does Not.

This is the heart of it.

Women comprise 70 percent of the global health workforce. They hold roughly 25 percent of its leadership positions. In STEM more broadly, women make up 35 percent of graduates worldwide and 28 percent of the workforce — numbers that have improved slowly over decades — but they represent only 18 percent of director-level and above roles in technology.²

The pipeline exists. The progression does not.

The research points to why. The European Commission's own analysis, cited in the literature, identifies that systemic inequities in the workforce are perpetuated by gender-based barriers stemming from organizational constraints and culture, unrelated to individual capability.¹ What that means in practice is that sending a woman to a leadership program addresses her readiness while leaving untouched the promotion criteria, the meeting cultures, the sponsorship patterns, and the institutional norms that shape who actually advances. The program becomes a way of appearing to solve the problem without solving it.

The Economic Case — and Why It Hasn't Been Enough

The economic case for getting this right has been made repeatedly. The World Economic Forum's Global Gender Gap Report 2026 notes that hiring based on skills increases the proportion of women in candidate pools by 24 percent, and that closing the STEM gender gap could add trillions to global GDP.³ A 2020 McKinsey report found that organizations in the top quartile for gender diversity in executive teams were 25 percent more likely to have above-average profitability.⁴ Women-led clinical teams have been shown to improve patient outcomes. Women on research teams correlate with higher quality scientific output.

None of this is new information. What the September review adds is precision about why the gap persists despite the evidence: Interventions have been aimed at individuals rather than institutions. Fix the woman, not the system.

Commitments Are Not the Same as Architecture

The Gender Snapshot 2026 makes the same point at the global scale. Commitments are not the same as architecture. Representation is not the same as power. And programs designed to prepare women for institutions that were built around a different set of assumptions will keep producing the same result: better-prepared women encountering the same ceiling.²

What the research says actually works is less comfortable for organizations to hear: structural change, transparent promotion criteria applied consistently, sponsorship rather than mentorship alone, accountability mechanisms with teeth, and flexible work policies designed not as accommodations but as standard practice. These are not program costs. They are decisions about how an institution is willing to operate.

The world is in New York this week to talk about trust. In the context of women and science, women and leadership, women and the economy, the trust question is whether institutions are willing to move from running programs about women's leadership to building structures where women can lead.

The research suggests those are two different things. The data on where women actually end up suggests we have mostly been doing the first one.

Sources

¹ Morris D, Rauf S, Riach K, Teede H. "Women's leadership development programmes and gender equality: a systematic review in healthcare, academia and beyond." eClinicalMedicine (The Lancet). Published September 1, 2026. https://doi.org/10.1016/j.eclinm.2026.104185

² UN Women and UN DESA. Gender Snapshot 2026. Launched September 17, 2026.

³ World Economic Forum. Global Gender Gap Report 2026.

⁴ Dixon-Fyle, S., Dolan, K., Hunt, V., & Prince, S. Diversity Wins: How Inclusion Matters. McKinsey & Company, May 2020. https://www.mckinsey.com/featured-insights/diversity-and-inclusion/diversity-wins-how-inclusion-matters

Additional data: UNESCO STEM data 2026.

Dr. Odessa Lacsina is the Executive Director of The State of Women Institute, a 501(c)(3) nonprofit working across three health equity pillars: Mental Health & Wellness, Maternal Health Equity, and Preventive Wellness.

To learn more or support women's health leadership, visit thestateofwomen.org or follow @thestateofwomen.

Science Made Simple: What Motherhood Does to the Brain (and Why It Matters)

EVIDENCE TO ACTION | Science Made Simple Mother's Day Edition | The State of Women Institute

By Dr. Odessa Lacsina, Executive Director, The State of Women Institute

This Mother's Day, we honor all the ways mothering shows up in our lives.

For those who've given birth. For those raising children not born to them. For those who've lost their mothers too soon. For those who've lost babies they'll never stop loving. For those waiting, hoping, and navigating the complicated terrain of becoming a parent.

And for those who mother in ways the world doesn't always count: aunts, teachers, mentors, chosen family.

Today's science recognizes what many have known all along: motherhood fundamentally changes you. And those changes last a lifetime.

The Research That Changed Everything

A groundbreaking study published in Scientific Reports analyzed brain scans from over 19,000 women aged 45 to 82. Lead researcher Valentina Rotondi and her team, working across multiple European institutions, wanted to answer a question that had never been asked at this scale:

Do the brain changes of motherhood endure for decades?

The answer was unequivocal: Yes.

Mothers showed widely distributed higher gray matter density compared to women who had never given birth, particularly concentrated in the frontal and occipital regions — areas involved in empathy, understanding others' emotions, and processing social information.

Here is what's remarkable: The brain scans were taken decades after these women had given birth. The youngest participant was 45. The oldest was 82. Yet the structural changes remained visible, measurable, and undeniable.

And fathers? No corresponding brain changes were observed. This transformation appears unique to those who carry, birth, and biologically mother children.

The study also found that both mothers and fathers reported a higher sense of life's meaning compared to those without children — but only mothers showed the corresponding structural changes in the brain.¹

What This Means

For years, mothers have described feeling fundamentally different after having children — not just behaviorally, not just emotionally, but in some deeper, harder-to-name way.

"I'm not the same person I was before."

Science now confirms it. The brain has been restructured. And those changes don't fade with time — they become part of who you are, woven into the architecture of your mind.

For Those Who Grieve

We want to acknowledge something important: this research studies those who gave birth and raised children. But mothering — and the love that drives it — exists in many forms.

If you've lost your mother, her impact on your brain is real. The neural pathways formed in childhood, shaped by her care, remain part of you.

If you've lost a child — whether through miscarriage, stillbirth, or after years together — you are a mother. Your body changed. Your brain changed. That transformation doesn't disappear with loss. The love remains, and so does the biological evidence of mothering.

If you're waiting to adopt, fostering, or raising children not born to you, you are mothering. While this particular study focused on biological birth, emerging research suggests that caregiving itself reshapes the brain — that the act of nurturing, of being attuned to a child's needs, creates its own neural adaptations.

The Complexity of Meaning

The researchers found that motherhood was associated with a higher sense of life's meaning. But this finding deserves care.

Meaning isn't a competition. Women without children — by choice or circumstance — live profoundly meaningful lives. The study shows an association, not a judgment.

For some mothers, that meaning comes mixed with struggle, exhaustion, grief, or regret. Motherhood is not universally joyful, and finding it difficult doesn't make you less of a mother or your brain changes less real.

The brain changes are a biological fact. The meaning is personal, complex, and yours to define.

Why This Research Matters

Understanding that the brain undergoes permanent restructuring during motherhood helps explain why postpartum mental health support is so critical. You are not "bouncing back." You are becoming someone new.

For aging and dementia research, these enduring brain changes may offer insights into protective benefits and long-term maternal mental health. For the women who have always said they were changed by motherhood — science now backs them up. This isn't weakness. It's transformation.

Motherhood, in its many forms, leaves an imprint — on the brain, on the body, on the heart, on who you become and who you'll be for the rest of your life.

This Mother's Day, we honor that transformation wherever it appears: in those who've given birth, in those who've adopted or fostered, in those who mother in ways uncounted, and in those who carry both the love and the loss.

The science shows us what mothers have always known: you never go back to who you were before. And maybe that's exactly how it should be.

To all the mothers, in all the ways that word can mean: We see you.

Source

¹ Rotondi, V., et al. "Enduring maternal brain changes and their role in mediating motherhood's impact on well-being." Scientific Reports, Vol. 14, July 18, 2024. https://doi.org/10.1038/s41598-024-67316-y

Study population: 19,043 women and 17,612 men aged 45–82, drawn from the UK Biobank.

Dr. Odessa Lacsina is the Executive Director of The State of Women Institute, a 501(c)(3) nonprofit working across three health equity pillars: Mental Health & Wellness, Maternal Health Equity, and Preventive Wellness.

To learn more or support women's health leadership, visit thestateofwomen.org or follow @thestateofwomen.