That question is at the heart of a research study by two academics from Nelson Mandela University who are using fashion design to explore the lived experience of endometriosis, a chronic condition affecting an estimated 190 million women worldwide according World Health Organisation.
Micaela Scholtz and Mieke Janse van Rensburg
Mieke Janse van Rensburg and Micaela Scholtz , from the Department of Visual Arts recently presented their collaborative research at the 12th World Women's Studies Conference, held in Chiang Mai, Thailand, under the theme "The Power of Dialogue: Abolishing the Conditions of Voicelessness,” an endeavour which earned them the prestigious Superlative Presenter Award.
Their paper, "Unveiling the Unseen: Intersection of Fashion Design and Artmaking to Enhance an Autoethnographic Narrative Through Dialogue and Trauma-Informed Design", investigates how fashion might function as a tool for representing the lived experience of endometriosis.
While fashion is often viewed primarily as clothing, the researchers argue that it can also serve as a powerful form of communication and self-expression.
"Fashion holds a compelling duality: it's deeply personal, yet inherently social. It operates as a visual language that people instinctively decode, making it a powerful vehicle for identity, representation” said Janse van Rensburg.
The project emerged from a long-standing desire by the two colleagues to collaborate across their respective disciplines. Janse van Rensburg, a fashion designer, approached Scholtz, a designer-artist who was diagnosed with endometriosis in 2012, after identifying an opportunity to respond to a conference call for papers.
The result is an interdisciplinary study combining fashion design, artmaking and autoethnography – a research method that draws on personal lived experience.
Unlike many studies that examine endometriosis through a clinical lens, this project centres the voice of someone living with the condition.
"Research indicates that women with endometriosis frequently face significant delays in diagnosis, often feeling dismissed, disbelieved and having their symptoms normalised. It impacts the physical body, has an emotional toll, and affects the complex evolution of self-perception,” said Scholtz.
The researchers describe endometriosis as an example of what they term "invisible trauma". Although the condition may not leave visible external marks, it can profoundly affect identity, relationships, daily functioning and psychological wellbeing.
Their research asks a simple but important question: How might fashion be used to unveil invisible trauma?
Through ongoing dialogue, Scholtz's lived experiences informed the development of a conceptual fashion collection that translates physical symptoms, emotional experiences and evolving self-perception into garment designs and textile surfaces.
Original artworks created by Scholtz, including visual representations of endometriotic lesions, informed the collection's colour palette, textile prints and aesthetic language.
Rather than allowing illness to define identity, the researchers sought to create designs that acknowledge the condition as part of a person's story without allowing it to become the whole story.
"This research offers an alternative perspective, one that acknowledges the condition as part of the self, without allowing it to become the whole of it," Scholtz explained.
The project also challenges assumptions about fashion's role in society.
"Fashion is often dismissed as superficial, but I've always seen it differently. When you stop seeing clothing as purely material and start seeing it as an act of agency, something shifts. That's where fashion becomes genuinely powerful,” said Janse van Rensburg.
The collection remains a work in progress, with the duo hoping to move beyond conceptual sketches toward the production of physical garments and a future exhibition.
For both Micaela and Mieke, the project demonstrates how creative practice can contribute to broader conversations around women's health, representation and social awareness.
Ultimately, the work seeks to ensure that experiences often overlooked or misunderstood are not only acknowledged but seen.