Achieving gender equality is a key component for improving global health, but how to do so remains a complex undertaking. Each community’s experiences with gender inequality and vision for equality are historically and culturally specific, while also fitting larger global patterns. This is the case in Chuuk, Federated States of Micronesia, a group of islands suffering from the impacts of a long history integrating coloniser and locally formed patriarchal values. Chuukese women often see their roles as powerless and silent except when acting through women’s groups. In recent decades, Chuukese women created an umbrella organisation for all women’s groups, yielding more power to effect change. Derived from an ethnographic study of the Chuuk Women’s Council (CWC), 1 focus group and 12 individual interviews were conducted with CWC members to explore women’s experiences advancing gender equality on their terms. Findings demonstrate how the CWC lobbied for legal change, replaced inadequate health and social services, and changed community conversations about gender. The CWC received national and international resources, which became both supportive and disruptive to their efforts. Findings from this study have implications for global support of grassroots efforts to achieve gender equality, with lasting implications for gender equity in health.