Women, according to a rapidly growing corner of the internet, have two choices: become a bitch or develop an autoimmune disease. It’s the kind of statement that sounds ridiculous enough to stop your scroll and apparently relatable enough to rack up hundreds of thousands of likes. While the exact origins of the trend are difficult to pin down, versions of it have exploded across Instagram, TikTok, and X over the past few months. Artist Alida Sun’s video declaring “You need to be a bitch or else you will develop an autoimmune disease” has amassed over a million views. Elsewhere, women are chiming in with testimonials that sound suspiciously like wellness-infused revenge fantasies: “Started being a bitch and my eczema was GONE,” wrote one X user. Another declared that “being a bitch is anti-inflammatory”.
The premise is simple. Women spend years people-pleasing, conflict-avoiding, over-functioning, and typing “No worries at all!” into emails that have, in fact, caused them considerable worry. All that suppressed stress eventually wreaks havoc on the body and, according to social media, can even pave the way for autoimmune disease. It’s also, to be clear, not a scientific theory. No doctor is handing out prescriptions that read “stand up to your rude flatmate” twice daily after meals. And yet, for a theory with very little evidence behind it, it has found an unusually enthusiastic audience.
“There is no question that prolonged stress, emotional suppression, and an inability to set boundaries can contribute to immune dysregulation,” says Dr Vishakha Shivdasani, a Mumbai-based longevity and disease reversal practitioner. “But I don’t think being a bitch is going to prevent autoimmune disease for anyone.” What the trend is really talking about, she says, is chronic self-sacrifice. “The goal isn’t really to become a bitch. It’s to develop healthy boundaries, reduce chronic stress, and learn to stand up for yourself.”
That’s admittedly less catchy than the TikTok soundbite.
Part of the reason the trend has resonated so widely is that it isn’t entirely detached from reality. Research has linked chronic stress to inflammation and immune-system dysfunction, but autoimmune diseases are influenced by a complicated cocktail of genetics, hormones, environment, and lifestyle factors. Women are also disproportionately affected: one review showed that women can have up to a fourfold risk of developing autoimmune diseases than men, although researchers are still trying to fully understand why. There is growing evidence that stress can worsen autoimmune conditions in people who are already susceptible. But that’s a far cry from saying that saying no to your needy coworker will cure your psoriasis.
Aryana Dalal, content creator and co-host of the podcast The Having Said That Show, immediately understood why the trend resonated. A self-described people pleaser, she recalls repeatedly developing stress-induced rashes during major life transitions. “It was more like suppressing my actual emotions,” she says. “I used to break into hives.”
Over time, Dalal began noticing a pattern. During stressful periods, particularly when she was swallowing anger rather than expressing it, her symptoms would flare up. Years later, after building a public persona centred largely around positivity, she uploaded a video where she openly vented her frustrations against men. “It was the first time that I’d ever been angry online,” she says. “And honestly, I’ve never been better.” What surprised her wasn’t the response from women who related to her anger. It was how uncomfortable everyone else seemed seeing it. “People were asking, ‘Why would you put this out into the world?’”
Which kind of gets us closer to why this trend is resonating more than any conversation about cortisol ever could. Women have long been rewarded for being agreeable, accommodating, and pleasant. We are encouraged to smooth things over, keep the peace, and be endlessly understanding. Anger, meanwhile, remains one of the least socially acceptable emotions for women to express. A man who stands his ground is assertive. A woman who does the same is often labelled difficult, dramatic or, yes, a bitch.
The problem, of course, is that this framing can get weird very quickly. Critics argue that it veers into ableist territory by reducing complex illnesses to personal behaviour. Women with autoimmune diseases already struggle to be taken seriously and often face delayed diagnoses. Suggesting that illness is the result of poor boundaries risks turning a medical condition into a moral failing. Sometimes bodies get sick because bodies are complicated, not because someone answered too many emails with smiley faces.
And yet, buried underneath the wellness hyperbole is a question worth asking: why do women need a medical justification to advocate for themselves in the first place? Why is “set boundaries because you deserve respect” somehow less persuasive than “set boundaries or your immune system will attack your thyroid”? The internet has wrapped a fairly ordinary piece of life advice in the language of disease because, consciously or not, many women still feel more comfortable defending their needs when they come with a doctor’s note.
And that’s probably the takeaway here. No, becoming a bitch won’t magically ward off autoimmune disease. There is no peer-reviewed study measuring the anti-inflammatory benefits of telling someone to get lost. But if this trend encourages women to look beyond a catchy statement and stop treating self-sacrifice as a virtue and start treating their own needs as important, it may be tapping into something real.
