Conspiracy theories about Hillary Clinton’s health are nothing new. Most of them are vile. More of them are silly. And, until recently, mainstream culture has largely treated them as such.

But with Clinton’s recent diagnosis of walking pneumonia—along with a video of her stumbling as she left a 9/11 memorial event—speculation about her health has dominated the news cycle. That’s a shame, because the more attention we give to the matter, the more we play into longstanding stereotypes that use women’s supposed fragility to bar them from positions of power.

Consider: When Clinton had a silly, faux-startled reaction to a journalist’s question this past June, conspiracy theorists began posting overheated theories about her top-secret epilepsy. When she took a long bathroom break during a debate last fall (the women’s restroom, it turned out, was much further away from the stage than the men’s room), social media filled up with allegations that she had to wear adult diapers. And, ever since Clinton suffered a concussion in 2012, right-wing types have delighted in alleging that she has lasting brain damage.

All of the “concern” about Clinton’s health emerges from a desire to establish her as weak.

In light of pneumonia-gate, it’s worth scrutinizing the blatant sexism that underlies these particular accusations. The point of the epilepsy and brain damage rumors is to establish Clinton as cognitively deficient—essentially, to label one of the smartest and most accomplished women in the world as someone who can’t be relied upon to think clearly, and who’s therefore unfit for her job. (Of course, that’s not how epilepsy actually works, but the internet trolls spreading those rumors don’t care about the details.) The adult-diaper rumors are even clearer in their intent: We’re supposed to look at a woman who is applying for a traditionally male job and conclude that there’s something humiliating and disqualifying about her nether-regions and her control over her own body. All of the “concern” about Clinton’s health, from her brain to her lungs and all points south, emerges from a desire to establish her as weak.

It’s true that other male candidates have also had their age or their health invoked against them. Bob Dole, at age 73, famously fell off a stage during the 1996 presidential race, solidifying the perception of his frailty. John McCain, in 2008, was frequently depicted as “too old” to serve as president.

But McCain was in his early 70s and running against a 46-year-old man. Dole was was running against Bill Clinton, 20 years his junior. Clinton, at 68, is actually two years younger than her opponent, Republican candidate Donald Trump. Nor is she the first candidate to get sick on the campaign trail this election cycle. Last October, Democratic hopeful Bernie Sanders (age 75) had minor hernia surgery, without sparking any media panic. And so while presidential candidates’ health has often been a focus during election years, it seems we are uniquely concerned with Clinton’s body, and with establishing that body as weak, defective, and unfit to lead.

Female bodies engaged in traditionally male occupations are always suspect.

Then again: Why wouldn’t we be? Female bodies engaged in traditionally male occupations are always suspect, from Newt Gingrich’s infamously confusing assertion about women in the military (“females have biological problems staying in a ditch for thirty days because they get infections”) all the way back to Victorian claims that reading too much would make women insane and infertile. It wasn’t very long ago that employers could legally refuse to hire women for certain jobs or promote them because they might get pregnant. (Despite current legal protections, losing a job due to pregnancy is still something many women fear.) And any woman who’s been accused of being “on the rag” for asserting herself at work knows that her body’s basic settings are a source of speculation and distrust.

When it comes to leadership positions like the presidency, women’s fragility has routinely been invoked as a reason not to put a woman at the top. In 2008, when asked by TV presenter Bill O’Reilly to list the “downsides” of a female president, media personality Marc Rudov replied, “You mean besides the PMS and the mood swings, right?” In 2015, Cheryl Rios, CEO of Go Ape Marketing, declared that despite her own success as a businesswoman, she would never support a female president because “with the hormones [women] have, there is no way we should be able to start a war.”

Rios’s public self-sabotage aside, not all women have the same hormones. Nor do all women have periods, or get pregnant, or have the same genitals. (When it comes to unfair scrutiny of their bodies, transgender women get everything cisgender women get, and then some.) And it would truly be a medical marvel if Clinton, at 68, was still dealing with PMS. But it’s no accident that we scrutinize Clinton’s emotions just as harshly as her physical fitness, from the insistence that a hoarse New Hampshire speech in 2008 was actually a public crying fit, to the repeated complaints in 2016 that she yells too much and doesn’t smile.

This is particularly cruel, because the other main allegation against Clinton—and female leaders, more generally—is that they work too hard and have too few emotions. The stereotype of the cold, loveless career woman whose professional competence comes at the cost of a disastrous or empty personal life is everywhere in pop culture. Clinton herself is routinely said to be ruthless, overly ambitious, a workaholic, a woman whose entire life is aimed toward winning the presidency. Her pneumonia has been the occasion for copious handwringing about her failure to take time off from work. When she’s not portrayed as a sobbing, angry mess, she’s called a robot or an ice queen.

In order to prove their basic competence and sturdiness, women actually have to work harder than men do.

Yet in the lived reality of our focus on women’s “weakness,” our tendency to scrutinize female leaders both physically and emotionally for signs they’re breaking down or falling apart creates a double bind: In order to prove their basic competence and sturdiness, women actually have to work harder than men do. As it stands, Hillary Clinton can’t blink, cough, or go to the bathroom without causing speculation that she’s on death’s door.

In a sexist society, being female is, in itself, a pathology—the incurable defect of not being male. Women’s sexuality and emotions make them “crazy.” Their bodies—which, as it happens, tend to be longer-lived and more disease-resistant than men’s—are called weak, fragile, sickly, and lacking in the necessary strength and stamina to turn in long hours or apply the necessary willpower to a tough project or demanding job. And when they work themselves to the bone and run their health into the ground to prove everyone wrong, we pounce, claiming that their very commitment to the job is what’s destroying them.

As is so often the case, this isn’t just Hillary Clinton’s problem: It’s a problem for any woman who wants to prove herself, and finds herself working twice as hard as the men around her for half as much credit. But if we takes a close look at the evidence, it’s clear that Clinton, who has slogged through so much bias for a chance to serve the public, must be a lot stronger than we think.