In medical settings, it is common for women’s pain to be ignored or dismissed. In other cases, it is not properly treated.

This phenomenon is particularly agonizing for women in some of their most vulnerable moments.

If you have been a gynecological patient, maybe you have felt unprepared for the pain of a procedure like an IUD insertion. Wondered why you were not offered a better option to control your pain before the HSG, a pelvic X-ray in which dye is shot into your uterus. Or been told, in any number of situations, that “you will feel pressure,” or “this will pinch,” or “take Tylenol.”

“To be honest, evidence suggests that Tylenol doesn’t likely work, even Advil doesn’t likely work, in many of those settings,” says Sara Whetstone, an obstetrician and gynecologist at the University of California, San Francisco. “So are we lying when we tell people ‘it’s just a cramp’?”

The pain that women experience in medical settings is common, often preventable and routinely ignored. I explored some of this in “The Retrievals,” a podcast series about recent events at the Yale Fertility Center.

The women I reported on experienced an extreme version of procedure pain. They underwent egg retrievals at a clinic where a nurse was stealing the fentanyl they should have been administered to manage the pain of the surgeries. Their pain control was missing entirely. Some of the women screamed out that they felt everything during their retrievals, in which a long needle is inserted through the vaginal wall and into the ovary.

For months, patient after patient complained about pain, and they say the clinic dismissed their complaints. One reason their complaints did not raise more alarm is that members of the medical staff expected that patients could feel pain with this procedure. Under the drug protocol the clinic had offered for years, some patients felt even severe pain. Pain had been normalized.

Not believing a patient is one way of dismissing pain. Offering inadequate pain control is another way of dismissing pain — another way of saying, this doesn’t matter.

Whetstone told me that she realized early in her career that pain control would be important in building trust with her patients, who include many women of color. Patients often tell her about past procedures in which their pain was not properly treated — and nobody listened to them. It’s a double trauma: pain being considered unworthy of adequate treatment in the first place, and then dismissed.

Why wouldn’t a doctor listen to a patient who complains about procedure pain? Whetstone had a reflective response. “I sometimes wonder if people internalize it as a failing that they as a provider did,” she told me. “That’s how I internalize it. When people have more pain than I want them to, I feel like I haven’t done a good job as the provider. So I wonder if not really engaging allows people to emotionally separate from their failure to control pain.”

Just because pain is acute also doesn’t mean it’s only a short-term problem. It can change health outcomes — alter the course of your life. You might avoid going back to the doctor for birth control. You might not get that endometrial biopsy. Or, like a patient I interviewed and others I have heard from since the series began, you might not go back for another egg retrieval and lose a chance to have a child.

All of the women in “The Retrievals” suffered lasting effects from their inadequately treated and unacknowledged pain. One of the most profound is a loss of trust in the medical system. One patient, Esha, who, for privacy, requested to be identified by only her first name, became pregnant with twins during her fertility treatment. She went into labor eight weeks early, and at the hospital, when it became clear that delivery was imminent, a provider approached Esha to talk about anesthesia.

Up until that moment, Esha had been calm. “The minute he said ‘anesthesia,’” she said, it was “pure panic.” Now the word raised a trauma. Esha looked at her husband and started crying.

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• A small group of lawmakers, led by a prominent Democrat, expanded the N.R.A.’s power over decades. Read this secret history of the gun lobby.

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TALK | FROM THE TIMES MAGAZINE

Alok Vaid-Menon is a gender-nonconforming activist and a prominent voice on issues of gender and sexuality. I spoke to them about new ways to think about transgender debates.

You write, “There is a shocking disconnect between the way the government and the media speak about gender-nonconforming people and the reality of our lives.” Tell me more.

There are no such thing as trans issues. There are issues that nontrans people have with themselves that they’re taking out on trans people. A great example is when they talk about our “agenda.” “The transgender agenda: It’s recruiting people.” My agenda is the ability to exist in public without the fear of being assaulted.

I think a lot of people have a sense that there is a true self inside them that gets boxed in by other people’s expectations. Do you have advice for people who might feel that way about how to be their true selves?

You’re pointing to exactly what’s behind all the anti-trans sentiment. The fundamental root of our problems is people living versions of who they’ve been told they should be, not who they are. The resentment that people have toward me and my community is because they’re looking at us saying, “What do you mean that we get to be free?”

But you don’t think people’s resentment is about their struggling to adapt to change more than feeling a comparative lack of freedom?

Of course. Things that are new are often jarring at first, but I want to tell you about the internet. I want to tell you about iPhones. These inventions fundamentally restructured how we related to one another, our self-conceptions, and there were not millions of people saying: “Abolish this! We are committed to our routine.”

Read more of the interview here.

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Transformation: A felon and former addict spun her background as a pet cemetery owner into a lucrative publishing career.

First Amendment battle: Booksellers are fighting a Texas law that would require them to rate books based on sexual content.

Our editors’ picks: Colson Whitehead’s sequel to “Harlem Shuffle” and eight other books.

Times best sellers: “Jackie,” a biography of the former first lady Jacqueline Kennedy Onassis by J. Randy Taraborrelli, is on the hardcover nonfiction list.

THE MORNING RECOMMENDS …

Try a 14-minute workout meant to help lower blood pressure.

Party in a hat you can make yourself.

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Play free video games you can download right now.

THE WEEK AHEAD

What to Watch For

• Washington State will hold a statewide primary on Tuesday.

• Pope Francis is scheduled to travel to Portugal on Wednesday to participate in World Youth Day.

• Monthly U.S. employment numbers will be released on Friday.

• Thailand’s parliament is scheduled to pick a new prime minister on Friday.

What to Cook This Week

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Faris Ajluni (left) and Jose Nazario pose in their vests in downtown San Francisco. Bobby Allyn hide caption

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Bobby Allyn

Faris Ajluni (left) and Jose Nazario pose in their vests in downtown San Francisco.

Bobby Allyn

Long associated with Wall Street and Silicon Valley, the Patagonia vest has endured as a tribal symbol of finance and tech. But those who’ve dared in recent weeks to put on their vests in San Francisco have been the target of a resistance of sorts.

“Urgent: Stop wearing vests,” implore flyers plastered around the city. “You live in San Francisco now. It’s time to start acting like it.”

It’s the latest show of frustration from city residents against the tech workers that many blame for making the city one of the nation’s most expensive. NPR tried but was unable to track down the creator of the flyers.

Not everyone who sports a Patagonia vest is a “tech bro,” says proud Patagonia vest-wearer Sam Runkle.

“The kind of people who wear Patagonia are maybe raising rents and maybe are the kind of people that these other groups are trying to push back on,” he said on a recent afternoon, as he played fetch with his golden retriever with a lacrosse stick and ball in a grassy field overlooking the San Francisco Bay. “But there’s another cohort of people who do wear Patagonia who are not at all part of that.”

For instance, Runkle, who works in sales at the software startup Paylode, said of his digs in the city’s trendy Marina neighborhood: “I live in a four-bedroom that’s really a two-bedroom with a plywood wall, so I don’t think I’m raising any rents.”

And, he notes, a Patagonia vest is practical in San Francisco: the perfect wind shield for a city on the tip of a peninsula.

“It’s comfy,” Runkle says. It gets the job done.”

Indeed, plenty of women and non-tech workers adore the vests in the Bay Area for the same reason, but Runkle admits it’s most often sported by bros. In particular, bros who know something about venture capital or software engineering.

“It’s true,” he says.

Sam Runkle with his golden retriever sporting a blue Patagonia vest in San Francisco’s Marina neighborhood. Bobby Allyn hide caption

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Bobby Allyn

Sam Runkle with his golden retriever sporting a blue Patagonia vest in San Francisco’s Marina neighborhood.

Bobby Allyn

The vest ‘hits the right sweet spot between East Coast money and West Coast casual’

The tension fueled by the vests comes as no surprise to historian Margaret O’Mara at the University of Washington and author of the book, “The Code: Silicon Valley and the Remaking of America.”

She said the rise of the fleece vest in tech circles coincided with the throng of new investors piling into flashy startups in the early 2000s.

“In a way, it has its roots in the marriage of Silicon Valley and Wall Street that started with the dot-com boom,” she said.

As the finance and tech industries became closer over the years, venture capitalists ditched preppy sweater vests for Wall Street’s favorite garment: the Patagonia vest.

“You can wear your pressed khakis and your collared shirt and you put on a fleece vest and it just hits the right sweet spot between East Coast money and West Coast casual,” O’Mara said.

‘VC Starter packs’ offer Patagonia vests, a Twitter feed audit and a Peter Thiel book

It became a status symbol to waltz around the Bay Area rocking a vest with the name of a venture capital firm you recently closed a deal with, or one with the embroidered logo of your new job at a Big Tech company. Elite tech conferences used to hand them out as swag. The vests carried cache.

Sumukh Sridhara remembers walking to his tech job one day shortly after moving to San Francisco and seeing person after person wearing the same exact vest.

“It just seemed like something that didn’t necessary fit in San Francisco,” he said. “In a place that’s usually known for its diversity of types of people and types of things that people work on, everybody just ends up wearing the same outfit in this one industry.”

So, in jest, he began selling a so-called “VC Starter Pack.” It included a gray Patagonia fleece vest, the book “Zero to One” by entrepreneur Peter Thiel and a personalized Twitter feed audit, among other things.

He did find some takers at $699 a pop, and he donated the proceeds to charity. Then, as part of the joke, he redirected the website he created for the VC Startup Pack to job listings at the prominent venture capital firm Andreessen Horowitz.

“It seems like nowadays the way to work in VC is to just work there,” he said.

Of late, Sridhara said he has seen fewer vests with the names of companies and tech conferences around town. That’s in part because of Patagonia. Last year, it announced it would stop selling vests with corporate logos. (Patagonia declined to comment for this story and Andreessen Horowitz did not respond to multiple emails.)

Still, walk around the windy streets of San Francisco and you’ll find plenty of people wearing the vest.

On a recent afternoon in the city’s financial district, a group of colleages at a fintech firm strolled out of their office building, some in their vests. Among them: Jose Nazario, who says he started just two weeks ago.

“In preparation, because I knew I wasn’t wearing a suit, I bought three vests,” he said. “I made sure not to get a Patagonia one. I didn’t want to get stereotyped, so I got non-labeled vests for that reason.”

He acknowledges that, yes, he might look like a tech or finance bro, but so what?

“It’s part of the uniform. And it fits. I like the way vests look on me. They make your shoulders look big. I’m a guy so big shoulders help,” he said.

The fleece vest does not add flare to one’s look in every city.

Sridhara, who made the VC starter kit website, recently launched a new kit for techies moving to Miami. Among the items: An appointment with a fashion consultant, so tech workers don’t look ridiculous wearing their fleece vests while holding their piña coladas along South Beach.

“You can’t tan in a fleece jacket,” the site instructs. “A local stylist will acquire palm prints, Versace jungle prints, and guayaberas for you.”

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