Headache disorders are often dismissed. Yet migraine is a serious problem for millions of people. Epidemiologists estimate that as many as 37 million adult Americans (or 12% of the adult population) have migraine. How is it that a disorder can disrupt so many lives, yet seem so banal, unimportant and, ultimately, difficult to believe? This book addresses the complex relationship between this legitimacy deficit and the cultural organization of pain, describing the multiple and often contradictory symbols, images, metaphors, patterns, and meanings that the word “headache” evokes and explaining how these social meanings circulate and contribute to rules and conventions about pain. How have developments in medicine shaped the cultural meaning of migraine and, conversely, how has the cultural meaning of migraine shaped what medicines are made, how medicine is practiced and what knowledge about head pain is and is not produced? Drawing on ethnography, interview, and archival data, this book examines the political economy of pain, taking a close look at how the politics of gender and health affect three distinct, but tightly interconnected groups of stakeholders-physicians who specialize in headache treatment, patient advocates, and the pharmaceutical industry. Each plays a central role in motivating a paradigm shift in understanding headache from a psychological imaginary to the neurobiological real. The conclusion describes the constituent components of legitimacy, with special emphasis on how the gendering of migraine may prevent it from being taken seriously as a disorder.