The “tough it out” remark in the Tylenol-autism controversy did more than set a narrative about pregnancy and medication. It echoed a deep, persistent pattern in medicine: the dismissal of women’s pain. For centuries, women’s experiences of pain and discomfort have been minimised, trivialised, explained away or normalised as “just part of life”. This article situates the recent controversy within that broader history, showing how many women’s symptoms of pain and discomfort have not been medicalised until very recently while there has been a historical expectation that women should endure pain and how this reinforces a gendered knowledge gap.

A historical pattern of dismissal

The idea that women should endure pain without complaint reaches far back in history:

·       Hysteria and wandering womb theories: In antiquity and through the 19th century, women’s pain and psychological distress were attributed to the uterus, pathologising their bodies while trivialising their symptoms.

·       Period pain: Dysmenorrhea has often been dismissed as a normal part of menstruation rather than recognised as a medical issue. Many women were told to endure cramps, even when they indicated conditions like endometriosis.

·       Endometriosis: For decades, the condition was under-researched and under-funded, not taken seriously by the medical establishment, framed as a natural by-product of menstruation rather than a debilitating chronic illness.

·       Menopause and perimenopause: Rather than being approached as stages requiring nuanced care, menopause was either ignored as “just part of ageing” or narrowly medicalised through debates over hormone replacement. Women’s wider symptoms and pain were often minimised as psychological or inevitable.

Each of these examples shows how women’s embodied experiences have been deliberately categorised as “normal” stages rather than legitimate medical concerns requiring treatment, support and empathy.

…Even in sociological textbooks

In contemporary sociology, critiques of “medicalisation” have highlighted the creep of pharmaceutical and clinical frameworks into parts of life that may not need medical solutions. Typical examples that they cite are anything relating to medicating children for conditions like Attention Deficit Syndrome or hyperactivity. But, strikingly, a number of prominent 21st century textbooks listed women’s cycles and life stages: menstruation, menopause, endometriosis, perimenopause, as areas that perhaps should not be medicalised, that they should be left as “normal”. And who were the authors of such statements? Male sociologists! They were implicitly echoing President Trump’s “tough it out” line: that pain in women’s lives is to be endured rather than addressed.

This is upsetting for two reasons:

1.       It shows how even progressive disciplines can reproduce dismissive attitudes towards women’s health.

2.       It underscores the absence of parallel critiques about men’s health. There was no suggestion, in these texts, that erectile dysfunction, prostate enlargement, low testosterone or even male pattern baldness should be seen as “normal life stages” that did not merit medical intervention. Conditions affecting males are very thoroughly medicalised.

The building blocks of sociology

This disappointment is magnified by the very promise of sociology. Sociology is often associated with leftist movements and for good cause. It is a discipline that exposes inequalities and concentrations of power and wealth. It deconstructs the building blocks of society and holds a mirror up to what society is, what culture is, what social life is. Its power lies in its ability to show how social structures, such as class, race, gender, power and wealth are not natural givens but constructed arrangements. Once exposed, these blocks can, at least theoretically, be rearranged to build back something greater and more equitable. This is what terrifies those in power about sociology.

But it doesn’t have to be a tool of sociopolitical revolution. Medical sociology, for example, has been particularly important in revealing the social determinants of health, the unequal distribution of care and the ways in which professional authority shape patients’ experiences. It is what we use to illuminate how the “knowledge gap” between healthcare professional and patient is not a fact of nature but a product of institutional choices, a structure that can be deconstructed and rebuilt in a far better way.

For this reason, it is particularly jarring to read in some of the most prominent sociology textbooks of the 21st century passages that mirror Trump’s “tough it out” message. To suggest that women’s health issues such as period pain, menopause or endometriosis should not be medicalised is to accept the endurance of suffering as normal. Rather than deconstructing power, it reinforces it. Rather than rearranging the blocks towards equity, it uses them to fan inequality.

The gendered double standard

Trump’s “tough it out” line reflects this same double standard: women are expected to endure suffering because it is supposedly natural. There is a by now well-established pattern: men’s conditions are medicalised, monetised and treated as requiring urgent solutions; women’s conditions are normalised, trivialised and framed as requiring stoicism.

The paradox for women is that even when life stages are medicalised, the framing often serves institutions more than patients:

·       Pregnancy: Over-medicalised in terms of monitoring and risk management, yet women’s own accounts of pain and discomfort are often sidelined.

·       Childbirth: Historically pathologised as a medical event rather than a physiological process, yet women’s reports of labour pain are still frequently undertreated.

·       Menopause: Framed as a hormonal deficiency to be correct rather than a stage of life requiring holistic support.

This approach widens the empowerment gap: professionals control the narrative while women’s lived experiences remain marginalised.

Why “tough it out” stings so much

The phrase “tough it out” is not new advice; it is the latest echo of a long history where women’s pain is:

·       Dismissed: Seen as exaggerated or imagined.

·       Normalised: Cast as a natural burden of womanhood.

·       De-prioritised: Placed behind institutional interests, cultural scripts and male health priorities.

Our reframing of the knowledge gap as a choice applies sharply here. Institutions and disciplines, whether medicine or sociology, choose whether to validate women’s pain or to dismiss it. When they default to dismissiveness, they widen the gap between authority and patient experience. That gap is gendered: women learn that their voices and symptoms carry less weight and their trust in institutions erodes.

One way forward could be to consider the following:

1.       Acknowledging women’s pain as real: normalise listening to women’s accounts as valid evidence, not exaggerations.

2.       Challenge the double standard: Question why male-only conditions are medicalised while women are told to endure.

3.       Reframe life stages: Treat menstruation, endometriosis and menopause as legitimate areas for care, not as naturalised burdens.

4.       Close the gendered gap: Use clear, empathetic communication that affirms women’s experiences rather than dismissing them.

Conclusion

“Tough it out” is not just a populist throwaway line. It is the most recent expression of a long tradition in which women’s pain is minimised and normalised, while male health issues are medicalised and prioritised. The phrase condenses centuries of dismissal into three words. To counter it, institutions must do more than issue clinical corrections. They must confront the gendered knowledge and empowerment gap directly, reject the double standards that shape health communication and speak to women not only with facts but with recognition, empathy and respect. And disciplines like sociology, which pride themselves on exposing inequality, must ensure they are not replicating the very dismissals they exist to critique.

Thank you for reading,

Nur Ferrante Morales, Bonilla de la Sierra, Spain

Mark Gibson, Leeds, United Kingdom

September 2025