 Women are underrepresented in leadership roles in health systems in low and middle income countries despite making up the majority of the health workforce. Intersectional analysis shows that gender intersects with other social identities, creating unique positionalities of privilege and disadvantage. This can lead to barriers to career progression and leadership, such as lack of mentorship and sponsorship opportunities, reduced value, recognition and respective work, increased likelihood of taking on dual burdens of professional work and caregiving, and biases against effective leadership styles. By looking beyond gender and considering other intersecting social identities, we can better understand how gender intersects with other social identities and address the persistent barriers to career progression and leadership. This article was authored by Zara Zainali, Kuei Muraya, Sasi Malinu and others.