‘The Bachelor’ Shines A Rare Spotlight On Endometriosis In Crucial Conversation

Grand romantic TV moments aside, The Bachelor franchise is at its best when it dares to air vulnerable, relatable, real-life conversations between cast members. In other words, the reality show thrives when it leans into reality; a truth Bachelor Nation was reminded of during Lexi Young and Joey Graziadei’s one-on-one date in Season 28, Episode 4.

As noted in Decider’s Week 4 recap, for his first date in Malta, Joey invited Lexi to explore the capital city, Valletta. Though Lexi enjoyed the day, the knowledge that she had to have a “tough conversation” about a “very sensitive topic” with Joey was admittedly weighing on her.

At dinner, the 30-year-old digital strategist from Atlanta, Georgia opened up to Joey about falling ill after she moved to New York, getting surgery, and being diagnosed with Stage 5 endometriosis. What followed was a crucial, refreshingly honest conversation that helped raise awareness and educate people on a common — but still misunderstood — health condition, its impact on fertility, and the toll it can take on a person’s quality of life.

When Lexi first mentioned her endometriosis to Joey, the Season 28 lead openly admitted he was unaware of the condition, further emphasizing the importance of airing the eye-opening conversation on prime-time ABC.

Lexi went on to explain that endometriosis is “a reproductive condition where tissue that’s supposed to grow inside of your uterus grows on other organs.” In her case, she said, tissue covered her reproductive organs and went all the way up to her lungs, and though it was successfully removed, her doctor sat her down and told her she might not be able to have her own kids.

Since Lexi’s intro video on Night 1, she’s been transparent with viewers about the very real fear that her condition and potential inability to birth her own children would be a dealbreaker for Joey. Ahead of their dinner conversation, Lexi reiterated to cameras, “I worry that sharing the vulnerable part of me will make him not want to pursue a relationship with me.” After telling Joey she’s wanted to be a mother her whole life and “definitely” wants to have a family one day, Lexi revealed she’s only opened up about her fertility issues to one other person, her ex, who “ultimately came to the decision that he can’t be with someone who might not be able to have his children.”

Before we get to Joey’s response, let’s take a moment to acknowledge just how huge it is that The Bachelor devoted significant airtime to such a substantial conversation that has the potential to inform viewers and make those who also have endometriosis feel less alone. Back in 2023, Netflix’s Virgin River introduced an endometriosis storyline that struck a similar chord with viewers, but the medical condition remains a rare topic of conversation on television that’s still being learned about and stigmatized in the real world today.

Per John’s Hopkins, endometriosis affects up to 10% of women between ages 15 and 44 and can lead to incredibly painful period cramps, pelvic pain, pain during or after sex, and other symptoms. Though the cause of the condition is still unknown (and it doesn’t yet have a cure), experts learned that it’s linked to infertility, which is why it can have such an impact on romantic relationships.

Lexi’s vulnerability, along with producers’ decision to shine a rare spotlight on the health issue, helped the franchise take an important step in the right direction. But also of note and worthy of celebration was Joey’s reaction to the news.

Respectful, patient, and accepting as ever, the Bachelor lead thanked Lexi for sharing with him. He didn’t shy away from admitting “the idea of someone having complications with having kids” was never something he had to deal with, but he also assured her, “I don’t want you to think in any way that’s something that I hear and it makes me want to run away. That doesn’t scare me in any sense, and there are a lot of other ways to be able to create a family…”

“Things happen for a reason, they make you stronger, and they define who you are. You need to know how special you are and how much you deserve everything, because I understand from any type of past experience, when something like that comes out you think there’s something wrong with you. There isn’t,” Joey continued. “It shouldn’t ever make someone run away or be afraid of being in a relationship with Lexi, cause there’s so much more to Lexi than just that.”

Joey’s empathy and desire to gain a greater understanding of the condition brought Lexi (and me!) to tears. The overwhelming sense of emotional relief led her to admit that she’d nearly made peace with the thought of being alone forever because it seemed easier than finding a partner who could look beyond her imperfections, and as someone who also has a relationship-impacting health issue, I can’t tell you how relatable and moving these scenes were to watch.

As we saw earlier in the season when contestant Daisy Kent opened up about her battle with Lyme disease, her hearing loss, and her cochlear implant, on-screen representation of all sorts is vital for change, acceptance, and inclusion. At the end of Episode 4, Lexi happily accepted Joey rose, and The Bachelor Season 28 earned some serious points in my book.

New episodes of The Bachelor air Mondays from 8:00 p.m. to 10:00 p.m. ET on ABC with next-day streaming on Hulu.