2026 Goals

The Changes Women’s Health Cannot Afford to Delay

The past decade (or 2025 for that matter) has shown that progress in women’s health does not result from being polite, patient, or quiet. It advances when individuals speak uncomfortable truths openly and persistently, prompting necessary change.

Below are my 2026 goals. They are clear, direct, and necessary.

1. Deregulate Testosterone

Testosterone is a natural hormone.
When prescribed appropriately, it is not dangerous.
It is also essential for women.

Yet the 1991 Anti Doping Act passed by US congress put it on a DEA regulated list. Yes, DEA agents have been known to go to physicians’ homes who prescribe testosterone. It is the only natural hormone on this list. It requires more licensing, more frequent prescribing (can’t do a year of refills), and more barriers to care, including putting your name on a list of people prescribed restricted drugs (depending on your state) and requiring physicians to log into state databases every time they want to prescribe.

People are forced to navigate absurd barriers to access physiologic doses of a hormone their bodies already make. Clinicians are scared to prescribe. If it is on a DEA list, it must be addictive or dangerous, right? No. Patients and clinicians are confused.

In 2026, we will advocate for:

• Rational deregulation (make testosterone just like any other prescribed medication)

• Evidence-based prescribing

• The elimination of fear-driven hormone policies

These are not radical proposals; they reflect fundamental endocrinology and physiology, and they are based on accurate labeling, not the Olympic doping scandals of the 1980s.

2. FDA-Approved, Female-Dosed Testosterone

Women deserve medications developed and dosed explicitly for their needs.

This should not mean having to purchase and microdose a man’s product. In addition, insurance only covers what is FDA approved, putting the cost of care more on women than men with low testosterone.

We need FDA-approved, female-specific testosterone products that reflect accurate physiology and robust research. This hormone is important for libido, bone health, muscle, mood, and cognition.

The lack of approved options is not due to scientific limitations.
It is a matter of prioritization.

Every woman will outlive her ovarian hormone production, about 20% of men will. And men have a dozen available products. Women have zero.

This is not a niche issue. It is a systems failure.

Testosterone is not a “male hormone.” It is a human hormone with meaningful impact on women’s health across the lifespan. Yet women are expected to improvise, pay out of pocket, and accept workarounds that would never be tolerated in men’s healthcare.

When half the population predictably loses ovarian hormone production—and lives decades beyond it—having zero FDA-approved testosterone options is not neutral. It is a choice. A choice about whose health is worth funding, studying, approving, and covering.

Women do not need permission to want evidence-based care.
They need a system willing to build it.

Female-dosed, FDA-approved testosterone is not radical.
It is overdue.
Do your part, let the FDA know how important this is:
1-888-INFO-FDA
or email: druginfo@fda.hhs.gov

3. Over-the-Counter Vaginal Estrogen

Low-dose vaginal estrogen is localized, effective, and safe for most individuals who require it.

However, access remains unnecessarily restricted. Patients are apprehensive, clinicians are overly cautious, and suffering is often normalized.

Symptoms such as dryness, pain, recurrent UTIs, and infections are quality-of-life issues affecting millions. Making vaginal estrogen available over the counter is a responsible approach.

It demonstrates compassion.
It is supported by evidence and many countries already have it
This change is long overdue.

4. Let Educators Talk About Sex and Vulvas on the Internet

This topic should not be controversial, yet it remains so.

Qualified educators are penalized, shadow-banned, or silenced for using anatomically correct language—while misinformation spreads freely.

Sex is not obscene.
Vulvas are not inappropriate.
Education is not pornography.

In 2026, we will actively oppose platforms and policies that suppress education and promote misinformation.

5. Menopause care is general health - not a niche or speciality

It shouldn’t require:

• A lucky social media algorithm

• A private-pay clinic (unless you want it)

• Or a months-long wait to find “the one good provider.”

All primary care clinicians, OB-GYNs, internists, psychiatrists, and cardiologists (oh, and the orthopedic surgeons and all other specialties) should be competent in menopause care.

This is not concierge medicine.
This is essential midlife healthcare.

6. Real Partnership in the Doctor’s Office and Improved Tort Reform

Here’s the harsh truth: clinicians cannot truly practice shared decision-making when fear of litigation dictates care.

Patients deserve partnership.
They deserve to ask for something.
They deserve to decline something.
They deserve to consider options as data evolves, even if not yet definitive.

However, physicians cannot genuinely collaborate with patients unless the legal environment supports it.

Defensive medicine kills collaboration.
Fear kills nuance.
The current tort system rewards rigidity rather than individualized care.

In 2026, we will advocate for:

• Real shared decision-making

• Respect for informed consent

• Tort reform that enables thoughtful, patient-centered care

This is uncomfortable to say—but it is essential to fix.

7. Insurance Coverage for Sexual Health

Desire, pain, arousal, and orgasm are fundamental aspects of health.

Yet sexual health treatments are often excluded, minimized, or dismissed. The system more reliably covers treatments for erectile dysfunction than for women’s pain, which highlights a significant disparity.

Coverage reflects values.
These values must change.

8. Real Research Funding for Women’s Midlife Health

We cannot continue to practice medicine based on:

• Outdated fears

• Underpowered studies

• Or data extrapolated from men.

Perimenopause and menopause deserve real funding, real trials, and real urgency—not as a niche interest, but as a public health priority.

Half the population will go through this. As the government fails in supporting established research - and let’s be honest, not much of it was going to midlife care in the first place - we will see private enterprise start to fund this. I hope I can start doing my part.

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Why This Matters

These goals are grounded in real clinical experiences, real patients, and the tangible harm caused by silence, fear, and outdated systems.

Education changes lives.
Access to care is a form of justice.
Women deserve significantly better than what they have received.

The year 2026 is about clarity.
It is also about courage.
It is about building the healthcare system that should already exist.

What did I miss? Please subscribe for regular 2026 inbox musings from me.

Love, Dr. Casperson