Every August, South Africa celebrates the strength and resilience of women. We speak proudly of women who persevere, carry families, lead organisations and hold communities together despite enormous pressure.
But resilience can become a dan- gerous compliment when it allows institutions to avoid changing.
For many women living with chronic illness, being described as "strong" often means continuing to work while in pain, concealing exhaustion and protecting others from the discomfort of seeing that they are unwell. Their resilience might be admired precisely because the conditions forcing them to be resilient remain unchallenged.
This Women's Day, 9 August, and Women's Month, we should ask a more pointed question: What does it cost women to keep appearing well enough to be taken seriously at work?
Our research explored the work- ing lives of eight professional South African women living with systemic lupus erythematosus, commonly known as lupus. Lupus is a chronic autoimmune disease that can affect different parts of the body.
Its symptoms can include pain, profound fatigue, cognitive difficul- ties, swelling and skin changes. The condition is episodic, meaning that a person might appear well at one moment and experience a serious flare-up at another.
The unpredictability sits uneas- ily with the way most workplaces are designed. Organisations tend to reward consistency, visibility and uninterrupted productivity. The ideal employee is expected to arrive, perform and progress along a pre- dictable path. Bodies, however, do not always cooperate with organisa- tional calendars.
For women with lupus, the chal- lenge is therefore not only managing the illness. It is managing how the illness is interpreted by other people. Because many symptoms are invis- ible, women may be told that they "look fine". This seemingly reassur- ing observation can become a form of dismissal. If there is no visible evidence of illness, fatigue can be mistaken for disengagement, cog- nitive fog for poor preparation and the need for flexibility for a lack of commitment.
The women in our study described having to per- form wellness: maintaining a composed professional appearance while privately manag- ing pain, uncertainty and exhaus- tion. This performance protected their credibility but it came at a cost.
They were effectively doing two jobs. The first was the work for which they were employed.
The second was the largely invis- ible work of managing symptoms, deciding whether to disclose their condition, educating others about lupus and anticipating how col- leagues or managers might respond.
The burden is profoundly gen- dered. Women are expected to remain composed, dependable and attentive to the needs of others. Professional women must often work harder to establish their competence and authority. Illness introduces another layer of scrutiny. A woman might worry that disclosure will change how her ambition, reliability or leadership potential is perceived.
She must decide whether to explain what is happening or remain silent. Neither choice is without risk. Disclosure could open the door to flexibility and support. It could also invite pity, scepticism or exclu- sion from future opportunities.
Concealment might preserve a pro- fessional identity in the short term but it could require a woman to con- tinue working beyond what is physi- cally sustainable.
Some participants resisted describ- ing themselves as disabled, even when lupus substantially affected their functioning. This was not nec- essarily a denial of their physical realities. It reflected the social mean- ing attached to disability: depend- ence, incapacity and diminished pro- fessional worth.
The workplace therefore placed them in a contradiction. To access support, they might need to identify themselves through a category they feared could be used to question their competence.
Our findings led us to develop what we call the Continuum of Embodied Challenges. It shows how women might move repeatedly between medical uncertainty, bodily disrup- tion, identity negotiation and work- place adaptation. This is not a neat journey from diagnosis to recovery. A flare-up, a change in manager or a new role can reopen questions that a woman believed she had resolved.
Inclusion must therefore be equally responsive. A one-off accom- modation or disclosure conversation is not sufficient for a condition that changes over time.
There were also stories of work- places responding differently. Compassionate managers offered flexibility, adjusted physically demanding responsibilities and trusted employees to communicate what they needed. Colleagues some- times became active participants in care and return-to-work support.
The accounts demonstrate that inclusion does not require organisations to abandon standards or over- look performance. It requires them to question unnecessarily rigid assumptions about how good perfor- mance must look.
A person can be highly capable without having the same capacity every day. She can remain ambitious while making decisions that protect her health. She can need flexibility without lacking commitment. She can lead effectively without pretend- ing that her body is endlessly avail- available to the organisation.
Workplaces can begin by training managers to understand invisible and episodic conditions. Employees should have confidential and cred- ible routes through which to request support. Flexibility should be informed by what a person needs to perform her work, rather than by whether colleagues can see evidence of illness. Organisations should also examine whether presenteeism is being confused with commitment. An employee who remains at her desk while unwell might be cel- ebrated as dedicated, while another who manages her health responsibly might be viewed as less dependable. This is not a meaningful measure of contribution.
Most importantly, employees liv- ing with chronic illness should be included in designing workplace practices. Policies written without lived experience often look progres- sive on paper but remain inaccessible in practice. Inclusion is relational: it is created through trust, responsive- ness and the everyday conduct of managers and colleagues.
Women's Month should certainly honour courage. But it should not romanticise suffering or turn silent endurance into the standard against which women are measured.
Women living with lupus do not need to be praised for hiding their pain successfully. They need work places in which their credibility does not depend on concealment.
The real test of an inclusive organi- sation is not how it treats employees when they are consistently well. It is whether they remain trusted, valued and able to participate when their bodies become unpredictable.
If Women's Month is to mean more than ceremonial recognition, we must stop asking women to dem- onstrate their strength by surviving workplaces that were never designed with them in mind. The responsibil- ity for adaptation cannot continue to rest on women alone. Sometimes the most meaningful way to honour women's resilience is to ensure that they no longer need so much of it.
Armand Bam is an associate profes- sor at Stellenbosch Business School at Stellenbosch University. Joy Lulema is a management consult- ant. This article is based on their paper 'Performing wellness, con- cealing pain: a gendered continuum of challenges for women with lupus in the workplace', published in Frontiers in Psychology (2025).