 Up until the early 1990s, women were dramatically underrepresented in clinical research trials. Historically, the two most common reasons given for women's default exclusion were their purportedly more complicated and variable hormonal patterns and the possibility that they might be or become pregnant during the study, which could harm the fetus (DeBruin 1994, Little 1996, Giacomini and Baylis 2003). The National Institutes of Health solicited a report from the Institute of Medicine in 1992 on the effects upon women's health of these routine exclusions, and the report concluded that serious harms were being done to women. Women were disproportionately denied the direct benefits that might come from study participation. More importantly, their systematic exclusion from clinical trials meant that we did not know how to design appropriate treatment plans for women, whose different hormones and reproductive system, longer life span, and other medically relevant differences meant that treating them as smallish men for the purposes of dosing drugs and other treatment decisions was not a medically sound strategy. In 1993, the NIH changed its policies to make inclusion of women the default in all research, variation from which requires explicit justification. Constance Holden (2008) reported that as of 2006, women comprised 68.9% of participants in clinical trials. However, some argue that women continue to be significantly outnumbered by male subjects in biomedical research and clinical trials generally; these commentators suggest that women's inclusion rates were artificially inflated by a small number of single sex studies (Kim, Tingen, and Woodruff 2010). Moreover, disclosure of inclusion practices and rates in clinical trials is unreliable, and recent reviews fail to confirm reports of significant progress in diverse inclusion (Woodruff et al. 2015, Geller et al. 2011). 