In 2010, fifteen years after the Beijing declaration on women’s rights, the UN Commission on the Status of Women met to review progress in gender mainstreaming. Reports on gender equality by member states revealed differences in the degree of change achieved in this period, while highlighting common barriers to gender mainstreaming. The same barriers have long been identified by academics and activists, but prove remarkably resistant to strategies to address gender inequalities. This paper reviews approaches to gender mainstreaming in the context of health policy, and suggests that a model of the obstacles to gender mainstreaming, which identifies barriers as essentially pragmatic, conceptual, or political in origin, might enable a more explicit discussion of the factors underlying this resistance and the ways in which they might be challenged.