Considerable attention has been given to the ways in which 'gender issues' make it onto the political agenda and successful strategies advocates have used to push for change. Nevertheless, less focus is given to the ways in which such policies are implemented once they become law, particularly in the context of privatisation where regulation of powerful business groups may be challenging. In this paper we examine the ways in which attempts to implement more gender-equitable health policies, particularly in the field of sexual and reproductive health (SRH), have been distorted by private sector actors in Chile. In particular we focus on the role of privately owned pharmacies and private health insurance companies, the ISAPRES, in distorting policy implementation following legal reform to promote more gender-equitable access to SRH services.