This invisible career ceiling is holding women back

On my last day at my old job, I couldn’t go in.

I’d been burning through sick days for months (more than I could explain to my manager) because I didn’t yet have words for what was happening to me. I was 25, running product at a tech company, trying to build a career while quietly unraveling. I’d been to the ER twice that year, seen a string of specialists, and been told by more than one doctor that my symptoms were probably psychological. I was terrified.

Eventually, I was diagnosed with autoimmune disease, a condition where the immune system attacks the body’s own tissue. An estimated 50 million Americans live with an autoimmune disease, and women make up 80% of those diagnosed. 

Caregiving, workplace bias, and motherhood are often cited as the barriers holding women back at work. Chronic illness almost never enters the conversation, even though more people in the workforce are managing it than most employers realize. For many women with autoimmune disease, there’s a different dynamic quietly shaping their careers.

I’ve come to think of it as an autoimmune “career ceiling.”

Unlike the traditional glass ceiling, this one doesn’t appear in a policy or a performance review. It shows up in small, private decisions women make alone, often without naming what’s driving them. Do you take the promotion with longer hours? Pursue the role that requires travel? Switch jobs and risk losing the insurance you can’t afford to lose?

To put numbers to what many women experience, WellTheory partnered with Wakefield Research and the Autoimmune Association to conduct a national survey of 250 working women in the U.S. living with autoimmune disease. What we found was clear: 70% said their disease had limited their career potential. Almost two in five (39%) have reduced their hours, and nearly a third have moved to less demanding roles to accommodate their condition. Two out of three, have stayed in a job they’d otherwise have left because they couldn’t afford to lose their health coverage.

Each of those is a decision made quietly, with no one around them knowing a health condition shaped it. A job with more stable benefits quietly takes priority over one with a higher salary. A promotion becomes unrealistic when it means longer hours and more travel and symptoms that don’t follow a schedule.

What makes this so hard to address is that autoimmune symptoms are largely invisible. Fatigue, chronic pain, and brain fog, and other symptoms don’t announce themselves in a meeting. The survey found that 61% of women say their symptoms interfere with their ability to function at work every day or most days. Yet 61% haven’t disclosed their diagnosis to their employer. Of those who haven’t, most worry about being judged, seen as unreliable, or passed over for opportunities, especially in competitive environments.

As more people manage chronic conditions during their working years, this has become a workplace problem, not just a personal one. Once we acknowledge these realities, we can work on designing workplaces where women don’t need to limit their professional future due to chronic conditions.

What employers can do isn’t complicated. Flexibility and remote work change the calculus for someone managing an unpredictable condition. So does a culture where disclosing a health challenge doesn’t feel risky. 

We’ve seen this in our work with employers at WellTheory: when people have access to care that actually helps them manage their condition, they’re far more able to stay engaged at work. Most report fewer symptoms interfering with their jobs.

But support only works if employees feel safe using it. More than a third of women in the survey who needed an accommodation either didn’t ask for one or didn’t get one. That’s a gap organizations can close.

For those willing to go further, investing in chronic care that treats root causes rather than just managing symptoms pays off in both directions. Better employee health and lower claims tend to move together. It’s one of the few places in benefits where doing right by people and managing costs aren’t in tension.

I think about the woman who called in sick on her last day, alone with something she couldn’t explain. That was me. She is everywhere, quietly adjusting her professional future to fit a body the people around her can’t see struggling.

Until we name that, we can’t change it. The data is a start.

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