Perspectives on gender and identity that emphasise variability of performance, local context and individual agency have displaced earlier paradigms. These are now perceived to have supported gender stereotypes and language ideologies by emphasising gender difference and homogeneity within genders. In a secondary analysis of health and illness narratives we explore the interaction of class and gender in individuals' constructions of gendered identity. High social class men perform gender in particularly varied ways and we speculate that this variable repertoire, including the use of what was once termed 'women's language', is linked to a capacity to maintain social distinction and authority. Men's performance of conventional masculinity is often threatened both by the experience of illness and being interviewed about personal experience. Lower social class women in particular demonstrate an intensification of a pre-existing informal family and support group culture, marking successful members by awarding them the accolade of being 'lovely'.