Being in pain every day, all day, is hard. But when you’re a woman, there’s a whole extra layer to the situation that makes everything that much harder.

It’s not just the expected stuff, like being told by a doctor that your bra is too tight and that’s probably what’s causing the excruciating pain in your right ribs that’s so awful that you literally want to jab a knife into your side and rip the bones out.

Or, after you change your bra, being told by the same doctor to just “calm down” because you’re probably just stressing yourself out, and that’s what’s causing pain so severe that you have to stop mid-conversation multiple times a day and lay flat down on the floor because you just can’t bear the agony of standing up.

No, it’s the other stuff too. It’s the things you don’t expect.

Like being accused of being a sexual assault victim, because that’s the only thing the doctor can think of to explain why it hurts like the end of the world when someone touches your ribs.

Or having a male doctor get uncomfortable examining your ribs because GASP! your boobs are right above them. Didn’t he go to medical school? Has he never seen a cadaver? Would he be so shy if it was a male patient with chest pain?

And then there’s stuff that you can’t even be sure of.

Like did that male doctor just give me Aleve for my level-10 pain because he really thinks that’s going to help? Or did he just think that, as a woman, I was probably exaggerating?

And, did that other male doctor accuse me of being an amazing actress just trying to score pain meds because he does that to every patient he sees on opioids? Or did he do that because I was a wee woman?

There’s also the stuff that bothers you, because you’re a Type A woman.

Like how you suddenly have to ask for help for everything. How you have to literally ask people to drive you to work, and do your laundry and even go over to the dining room table and grab your medication because you’re in too much pain to do any of it yourself.

And how asking for help means giving up control. So suddenly your towels aren’t folded the right way, and you have no idea where your favorite yoga pants are, and you have no say in what flavor yogurt you eat because you’re way too sick to go to the grocery store yourself. And it makes you crazy, but you have no other choice but to let it all go.

Except when you don’t let it go, and you try to do it all anyway. And so you work until you drop, and then you go home and do all the housework, and then you go on a date with your boyfriend and you end up screaming in pain in the ER because you really can’t do it all any more. You can’t even do some of it.

Then, there’s the stuff you hate.

Like when your boyfriend pretends like he understands how much pain you’re in, but then has a totally different reaction when one of his male friends tells him he endured the same thing and it was excruciating. And suddenly your boyfriend is way more sympathetic.

Or when you get genuinely upset about an emotionally abusive situation at work, and your boss tells you that it’s probably just because you’re so moody from all those pain meds you’re on.

There’s also the stuff you hate to admit.

Like how, as a woman, it’s especially hard to endure the most common side effect of medication — weight gain. And how, you hate that so much of your own self-worth is wrapped up in how you look, even when you’re in so much pain that you literally want to kill yourself to make it stop. And how you keep taking the meds and gaining the weight because you have no choice, but you also, simultaneously, fill up with shame knowing that you no longer come anywhere close to society’s definition of beauty.

Or how you can no longer stand up long enough to shower and blow dry your hair every day, and so suddenly you find yourself going a full seven days without a shower. And you know people are totally judging you for it. And they are judging you all the more harshly because you are a woman, and women are supposed to put an effort into their appearance at all times.

Or worse, how you finally decide one day to endure the shower, and hold the blow dryer, and sit on the toilet seat cover so you can do your makeup, and you take 30 minute breaks between each step so that you don’t wear yourself out. And then you put on a nice outfit and you go out to Steak & Shake and you run into someone you know and they say, “Wow! Well, you certainly LOOK great!” implying somehow that you can’t really be that sick if you’re wearing pink lipstick.

And there’s also the stuff you don’t even want to think about.

Like how you’re only 30 years old, but you’re in chronic pain every single day, which doesn’t exactly make you a great catch. So will you ever really be able to have children? And can you even think about having a kid when you can’t even take care of yourself most days? And anyway how would you even carry a baby when you need seven different medications just to survive?

So yeah, being in pain is awful. And being a woman in pain is also awful — but for a whole bunch of extra reasons.