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This study by Lee et al1 surveys female (assigned female at birth and those identifying as female) oncologists about the barriers they faced in pursuing their childbearing aspirations and most notably found that 1 in 3 of those surveyed experienced infertility, and 1 in 3 experienced discrimination during pregnancy and/or maternity leave. Lee et al1 recommend more education in, as well as access to, assisted reproductive technologies (ART) and paid pregnancy leave policies in medical school and residency. While both of these items would certainly be steps in the right direction, challenges to childbearing constitute a national problem that transcends women in medicine or any other profession. Large cultural changes, which physicians can and should lead, are necessary to offload the unreasonable burden placed on people who are attempting to conceive, are pregnant, and/or are raising children. There have been multiple reports of gender-based inequity in medicine with a focus on childbearing. Often cited is a delay in childbearing associated with medical training that leaves female physicians “involuntarily childless.”2,3 A study by Stack et al4 reported on a survey of 804 female medical residents in the US and found that 61% of those who were married or partnered were delaying childbearing, with most of their reasons including a busy work schedule, desire not to extend residency training, and fear of burdening their colleagues.4 Dishearteningly, only 38% of those delaying childbearing reported they were satisfied with that decision. A study by Rangel et al5 surveyed 850 surgeons and found that among 692 female surgeons, 42% had experienced a pregnancy loss, twice the rate of the general population. Furthermore, compared with male surgeons, female surgeons had fewer children, were more likely to delay having children due to training and were more likely to use ART.5 In a Society of Gynecologic Oncology (SGO) evidencebased review, Temkin et al6 report that parenting affects academic advancement opportunities more for women than it does for men and that perceived workplace pressures (such as those related to institutional productivity goals) as well as concern about retaliation lead to truncation of maternity leave. This segues into the study by Lee et al,1 in which one-third of survey respondents reported discrimination due to pregnancy or maternity leave. Female physicians who want, will soon have, or do have children do not have it easy. Lee et al1 advocate for early education on ART risks, benefits, and success rates, but this is not getting at the underlying issue: pregnancy discrimination and unfair distribution of childbearing responsibilities are a reflection of a larger problematic culture rather than an issue specific to women in medicine. These cultural values are so deeply pervasive (one could also say invasive) that they affect even these most educated and wealthy professional women, such as those who participated in this survey. Increased access to ART only delays the lack of support and discrimination women will face if and when they do ultimately bear children. Medical students are already taught that as women age, their fertility decreases. Encouraging formal and directed education regarding the infertility risks specifically toward female physicians (which Lee et al1 recommend) could be perceived as a blanket recommendation that it is best for women in medicine to delay childbearing and pursue ART. Medical schools and residency and fellowship training programs should instead focus their energy on creating a framework and culture that normalizes conception during these points in training while also subsidizing and supporting trainees and physicians who prefer to use ART and delay fertility until after training. Women medical students become women residents and fellows who become women + Related article