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Paper short abstract

This paper analyzes how physicians interpret persistent symptoms in endometriosis and other controversial illnesses. Thus, psychologization and medical hierarchies can shift certain complaints to the margins of medicine, where complementary and alternative medicine becomes a tolerated resource.

Paper long abstract

This paper examines how healthcare professionals interpret persistent symptoms in controversial illnesses and how these interpretations shape the boundaries of medical legitimacy. Following sociological analyses of medicalization (Zola, 1972; Conrad, 1975), medicine can be understood as a profession that defines and controls what counts as disease and legitimate treatment. However, some conditions occupy ambiguous positions within this jurisdiction, particularly when persistent symptoms remain difficult to objectify biomedically.

Drawing on observations at an expert endometriosis center and interviews with healthcare professionals, this study explores how physicians interpret persistent symptoms in endometriosis and other controversial illnesses, particularly when biomedical explanations remain uncertain.

Research on conditions such as endometriosis, chronic fatigue syndrome, or fibromyalgia shows that persistent symptoms often challenge biomedical frameworks. In such situations, physicians may reinterpret complaints through processes of trivialization, psychologization, or normalization, thereby reshaping their status within the medical field. When symptoms remain difficult to objectify or alleviate, they are increasingly interpreted through psychological, behavioral, or lifestyle-related explanations. These shifts reflect hierarchies of legitimacy within medicine, in which conditions lacking objective markers or reliable treatments tend to hold lower status.

The paper argues that these processes create margins of legitimacy in which complementary and alternative medicine (CAM) can emerge as a tolerated resource, supporting patient self-management and addressing suffering that biomedicine struggles to fully integrate. More broadly, recourse to CAM should not only be understood solely as patient-driven, but also as partly shaped by professional interpretations that relocate certain complaints to the boundaries of medical legitimacy.