Autoimmunity and the Good Girls
How “good girl” roles may be igniting an epidemic of autoimmunity.
Posted May 26, 2026 | Reviewed by Monica Vilhauer Ph.D.
“Tell everyone about your book!” my producer, Fred, nudged me as we began a two- hour drive toward Telluride, Colorado, for a documentary shoot the next day.
“It’s okay,” I said. “Everyone’s tired! Long day of filming today.” Read: I’m the one who’s completely talked out, and I just want to doze up here in the front passenger seat.
“No way are you getting out of this!” shouted Jon, my thirty-five-year-old cinematographer.
“Agreed,” said Katrine, my friend and executive producer of the film project.
“You direct and write?” asked Darren, our confused driver.
I shared about how I had been diagnosed with shingles at eight, breast tumors began at 22, an autoimmune condition at 30, and melanoma, active Epstein-Barr, ovarian cysts, heavy metal poisoning, and more between the ages of 42 and 44.
“God, I’m so sorry,” they chorused one by one.
“Wait, what is an autoimmune?” asked Jon.
I shared the CDC definition, essentially, the immunity war the body wages against itself. I shared that there are more than a hundred autoimmune diseases on record, without a single cure for any, with women receiving 80 percent of the diagnoses.
I told them I had always found it fascinating that the majority of my friends had also been diagnosed with an autoimmune disease, and that all of them happened to be either the oldest or the only daughter in their family, as I was. I knew I wanted to explore more, but the birth order observation had been just a hunch. And not being a doctor or a scientist myself, I wanted to stay within my curious documentarian’s lane.
Why, I kept wondering, were all of my friends who grew up too fast, taking care of others more than we took care of ourselves, so sick?
In 2018, I decided to do a poll among 300 women who had an autoimmune disease in our Women Rising social networks to see if the question resonated outside of my personal circle. When the results came in, I was floored: nearly 70 percent of respondents were either the oldest or only daughter.
I knew from my own life that being the eldest daughter made me feel more responsible than the younger daughters I knew. I grew up not wanting to be trouble, or noisy, or needy because I felt punished by the results. I knew that feeling like a disappointment was so traumatizing that I would do self-sacrificing behavioral gymnastics to avoid it.
Dr. Jeffrey Rediger asserts in his book Cured: The Life-Changing Science of Spontaneous Healing , “There is a powerful link between our very identities and our immune systems. Perhaps what ultimately determines the health of the ‘soil’ of your body is how well you know who you really are at the most authentic level— beneath appearances, ‘shoulds,’ perceived expectations, and all the masks and roles that you assume for yourself and the world.”
As a documentary filmmaker, I knew I would need to prove out my theories of birth order and disempowerment at scale before anyone would listen. So I funded it myself.
Autoimmunity and the Good Girls became the first sociological survey exploring the intersection of empowerment and autoimmunity in American women . The survey was fielded by the independent research firm PROOF Insights in November 2023 to 1,000 women who had received at least one autoimmune disease diagnosis.
The results led me to the same conclusion as the instinct that spurred my self-exploration: 63 percent of women with autoimmune diseases said they were either the oldest or the only daughter.
Autoimmunity means our bodies cannot recognize or distinguish healthy cells from unhealthy cells. In other words, our immune systems are having an identity crisis.
But why should my own immune system know who it is and how to recognize itself? I have never known who I truly am or how to recognize myself. I never taught myself how to see myself or how to protect myself, only to abandon myself. Just like so many of us.
In my research for my book Autoimmunity and The Good Girls : How Permission to Put Ourselves First Has the Power to Keep Us Well, I interviewed Sharon, age thirty-five, eldest daughter and autoimmune-diagnosed executive turned Certified Nutrition Specialist (CNS) with a Master's in Human Clinical Nutrition for women with Hashimoto’s. She reflected in our interview, “As an eldest daughter and a caretaker for our parents and younger siblings, you want to grow up just being a normal child. But then parents and other authorities put all of these responsibilities on you.” When I asked Sharon about her own authenticity journey and who she is, who her truest self is after being raised as the consummate “good girl,” she confessed, “If I’m going to be honest, it might be no one. And that feels sad to me to say, but it’s just the truth.”
It is hard not to see that the conditioning of little girls to deprioritize themselves, to neglect themselves, to ignore their own needs, may be yielding an adult immune system that has simply followed directions to do the same.
Adapted from Autoimmunity And The Good Girls: How Permission to Put Ourselves First Has the Power to Keep Us Well (c) 2026 by Sara Hirsh Bordo. Used with permission of the publisher, HarperOne. All rights reserved.
Jeffrey Rediger, Cured: The Life-Changing Science of Spontaneous Healing (Penguin Life, 2021).
Autoimmunity and the Good Girls™ Proprietary Research, Women Rising®
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Sara Hirsh Bordo conducted the first quantitative research at the intersection of female empowerment and autoimmunity. She is the author of Autoimmunity and The Good Girls: How Permission to Put Ourselves First Has the Power to Keep Us Well (June 2026, HarperCollins).
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.