From Symptoms to Stigma: A Conceptual Review of Endometriosis and Workplace Bullying

Endometriosis is a chronic and often debilitating condition whose symptoms extend beyond pelvic pain to include fatigue, gastrointestinal and urinary complaints, menstrual irregularities, and reduced work capacity. These symptoms are typically framed within medical or occupational health discourse, yet little attention has been paid to how they are socially interpreted within workplace relationships. Drawing on the workplace bullying literature alongside qualitative research on the lived experience of endometriosis, this conceptual review proposes that endometriosis-related symptoms are minimized through two interconnected mechanisms: symptom fragmentation, in which the disease’s varied and cyclical presentations are perceived as unrelated complaints rather than expressions of one chronic illness, and identity pathologization, in which the resulting pattern of absence and reduced capacity is reattributed to the worker’s character rather than her condition. The review further situates these mechanisms within the broader literature on women-to-women workplace bullying and examines how humor may function as a socially deniable vehicle for mistreatment. Three anonymized vignettes drawn from clinical practice illustrate each mechanism in isolation and in combination, tracing the self-reinforcing loop through which fragmentation and pathologization sustain one another over time. Practical implications are offered for occupational health practice, managerial training, anti-bullying policy, and clinical care. The aim is not to psychologize endometriosis, but to contextualize suffering that currently falls between medical, organizational, and psychological frameworks—and to prevent the gradual transformation of illness into stigma and of symptoms into moral judgment.