Objectives. This paper describes two experiments which develop a self-categorization theory (SCT) (Turner, Hogg, Oakes, Reicher & Wetherell, 1987) approach to the way people make sense of their symptoms. The first experiment builds upon a study by Levine & Reicher (1996) in which it is proposed that symptoms are evaluated, not against pre-existing illness representations, but by reference to their impact on situationally salient identities. The second experiment extends the SCT perspective on symptom evaluation to argue that the identities that are instrumental in assigning meaning to symptoms are themselves situationally constructed. Design and methods. In the first experiment, 40 female secretaries, defined either in terms of a ‘secretary’ identity or in terms of a ‘gender’ identity, were asked to evaluate a number of scenarios which describe different illnesses or injuries. In the second experiment 40 men from a rugby club were asked to evaluate a number of scenarios relating to illness and injuries. The identity from which scenarios were evaluated was held constant, but the comparison groups (or frame of reference) was manipulated. Results. Overall, the results of the first study provide clear evidence that the significance ascribed to scenarios depends on which identity is salient. The results from the second study provide clear evidence that the significance ascribed by the males to the scenarios was a function of the comparison groups they believed they were being compared to. Conclusions. Taken together, these two experiments provide strong evidence for the viability of an SCT approach to symptom evaluation.