This article examines gender discourses embedded in gender equality policies in the health sector. Gender mainstreaming was first adopted by a number of international and intergovernmental, regional and national actors some time ago, yet there is limited evidence of progress in addressing gender justice in health. Failures in gender equality policies have often been attributed to the lack of gender-disaggregated data, combined with a lack of resources, training and skills. In addition, studies have identified problems originating in the shift from participatory approaches to technocratic solutions, and the persistence of underlying gender relations of power. However, gender equality policies may also contribute to gender discourse in ways which reinforce and perpetuate inequalities between men and women. This article draws on Bacchi’s ‘what is the problem represented to be’ (WPR) approach to policy analysis, to explore responses of primary care organisations in England to legislation requiring public sector organisations to tackle gender discrimination and promote equality of opportunity between men and women. The article adopts a critical discourse approach to gender equality documents and suggests that such texts construct women and men as essentially different, reinforcing specific forms of masculinity and male performance and notions of male disadvantage in health systems.