The 10,000 Paper Cuts That Teach Women Not to Trust Themselves, with Melinda French Gates

Dr. Becky opens by arguing that self-trust can be worn down through repeated comments such as “You’re fine,” “Don’t be so sensitive,” and “You’re so dramatic.” A child may conclude that she overreacts and that other people understand her feelings better than she does. As an adult, she may minimize symptoms when a doctor says everything is normal, or dismiss her own distress after having a baby because exhaustion is considered expected. The episode’s central question is what happens when women learn to trust themselves again, and how parents can help daughters retain that authority.

Melinda French Gates tells Dr. Becky that her four-year-old daughter Jen once gave her the cold shoulder for hours when Melinda came home in a business suit after speaking at a work event. Melinda began changing into yoga pants and tennis shoes before entering the house; Jen would then meet her at the back door with a caregiver and a book, and Melinda would sit on the mudroom floor to read. Her youngest daughter later told her, “Mom, stop using your work voice.” Melinda says the clothing change represented a mindset shift: work was goal-oriented and efficient, while parenting required slowing down and entering the child’s world.

Melinda explains that she gets anxious during transitions and used to remain in an efficiency-driven “let’s go” mode while getting her younger children into the car. She created a rhyme and sing-song phrase telling them that “mommy’s in a transition time” and asking them to wait until they had gone partway up the hill before engaging with her. The children eventually asked from the back seat, “Are we done with transition mode?” Dr. Becky connects this to adults returning from work: someone’s first moments through the door may not represent how they are as a partner or friend, so quiet presence can be more helpful than immediate demands.

Melinda says Pivotal Ventures worked with Gallup on a survey of 5,000 U.S. adults after she repeatedly heard women describe mental-health difficulties during and after pregnancy. Half of respondents who had experienced pregnancy said they struggled with their mental health during pregnancy or afterward. Melinda argues that this cannot be left to individual parents; the healthcare system must be designed to notice and respond to it. Dr. Becky compares this with gestational diabetes, which affects roughly 8–10% of women and receives systematic screening, while mental-health problems affect a much larger share without comparable attention.

Melinda describes meeting Asia Brooks at an Alabama clinic. During her first pregnancy, Brooks was not screened for mental health and had a terrible experience. During her second, the clinic screened every woman as soon as she arrived, before proceeding with the other pregnancy tests. Melinda says this demonstrates that universal screening is feasible and that learning the scale of the problem creates a responsibility to act. Dr. Becky adds that perfectionistic people often believe effort should produce the desired result; becoming a parent exposes the limits of that belief because breastfeeding, sleep, development, and a baby’s schedule cannot be controlled through effort alone.

Melinda reports that one in three women in the survey said they had to push a healthcare provider to take their concerns seriously. She says this has happened even to her, including during perimenopause. After her last child was born at 37, she entered perimenopause in her early 40s without recognizing it. Chronic insomnia and anxiety emerged while she was traveling and meeting heads of state, and she began doubting herself in situations she had handled many times. She sought care from several professionals before someone identified perimenopause. Melinda says women should not carry the burden of educating the medical system about these symptoms.

Melinda says women and girls are repeatedly told they are too emotional or otherwise wrong, accumulating what she calls “10,000 paper cuts.” A person may notice that someone talked over her or repeated her idea in a meeting, then explain it away because the meeting continued. In a doctor’s office, she says, patients are already facing someone with greater formal knowledge and authority, making it easy not to ask questions. Both speakers argue that women should trust their observations while also fixing the system: doctors need better training in women’s health, and patients should ask for tests, seek another opinion, or find another doctor when dismissal persists.

Dr. Becky offers language that separates validating a child’s perception from granting every request: “I believe you,” “You’re right to notice that,” and “There’s something about this that doesn’t feel good.” She says a child can be right that ice cream is the only thing that sounds appealing while a parent still decides what is offered. Melinda embraces the idea that children should be taught they are the authority on what happens inside their bodies. She says this prepares them to tell a doctor, “I know something’s off,” even when they do not yet know the diagnosis. Melinda also supports asking, “I’ve noticed you seem to think this about me. Why might that be?”

Melinda argues that women’s health is connected to women’s power: women who are unwell may step back at work, take time away for care, or miss advancement. She has advocated for paid family and medical leave for both mothers and fathers for more than eight years. In Sweden and Norway, she says, men take leave at a child’s birth because policy has changed social expectations; more men and women work, and products adapt to families, including Norwegian bicycles with child carriers designed for snow. Dr. Becky adds that advice such as “sleep when the baby sleeps” ignores the many tasks a partner could handle if they were home.

Melinda says she trusts herself more at this stage of life than she did at 30, but rebuilding that trust required therapy and examining where it had been lost. A verbally abusive college relationship taught her to absorb someone else’s judgments about her looks and worth; later, Microsoft’s male-dominated, hard-charging culture led her to equate value with being smart. Her longtime friend noticed she had become curt and unlike herself, prompting Melinda to choose authenticity over fitting the culture. She also learned the idea of being a “good enough” parent, which reduced pressure on both her and her children. She and her children now joke, “Perfect is creepy.”

When Melinda visits her granddaughters, she sits on the floor and waits for them to approach. One may run to her while the other, especially after a nap, may be happy but reserved and need quiet. Melinda says this taught her that a child’s readiness is not a measure of love and that the adult’s role can be supportive rather than central. Dr. Becky connects this to bodily and emotional autonomy: children need to learn early that they may not be ready, rather than performing for adults who are ready. Melinda says grandparents should observe their adult children’s parenting with curiosity and forgiveness rather than assume there is one correct method.