This study explores the gendered experience of twenty senior women leaders within universities across the West and East Midland region. Semi-structured interviews were conducted to examine the women's perceptions of factors which influenced their characterisation of authenticity, the construct of their leadership identity, and the impact of leadership on their health and well being. Unlike earlier work in the field of educational leadership, here the key focus is on exploring the rhetoric and reality of authentic leadership constructed through the experiences of twenty senior women leaders in early twenty-first century Higher Education (HE), and the impact of the enactment of leadership on health and well being. This study gives a voice to women senior leaders in HE. It reveals the complex interplay of the personal and professional worlds, and the impact on leadership identity, and health and well being. These women strive for 'real' genuine leadership, however, they are not sufficiently positioned in the hierarchical structure to disrupt hegemonic structures and practices. The significance of the study for policy and practice is in its endorsement of an integrated approach, taking into account the personal and professional lives of women, to support their realisation of authenticity, and promote a work-life balance.