This chapter discusses inequities in involving women in water management processes and integrating a gendered approach to water conflict transformation. This is illustrated in two case studies in the Global North and Global South: the Deschutes River Basin in central Oregon, USA, and the transboundary Ferghana Valley in Central Asia. The Deschutes River Basin study identifies few women in leadership positions within water management and governance organizations, particularly in traditionally male-dominated professions. The Ferghana Valley study demonstrates that development and aid projects in a transboundary setting can fail if they do not incorporate intersecting dimensions of gender, history, religion, and culture. Both cases point out that gender-inclusive approaches are beneficial to analyzing and transforming water conflicts at any scale, geographical location, or level of development. Ultimately, in order to achieve true gender equality in water management and governance, systemic change that challenges traditional masculinized norms and practices is vital.