[Builder Notes Vol. 02] The Illusion of Demand: How Builders Fall for "Pseudo-Needs"
Users Complain in Words, But They Act on What They Actually Believe
Whether in my own builder journey or while co-teaching BIOS 438 at Stanford this spring, I keep seeing the exact same trap. It catches ambitious students, seasoned founders, and, more often than I’d like to admit, myself.
The problem was almost never technical execution. It was building a brilliant solution for something people don’t actually care enough to fix. So before writing a single line of code: how do you spot a pseudo-need?
The framework
We use a brutally simple tool adapted from the Stanford Startup Garage. One golden question: Have they taken ANY action to solve this need?
Based on the answer, every interview subject lands in one of five buckets:
Extreme User: intense pain, and they’ve already hacked together their own ad hoc solution (a gnarly spreadsheet, a manual workaround). Your strongest signal.
Solution User: paying for or using an existing solution, but it’s failing them. Need confirmed; the opportunity is the experience gap.
Solution Seeker: aware of the pain, hasn’t found anything that resonates. A real PMF gap.
Stuck in Status Quo: accepts the pain silently, blocked by systemic barriers. Worth exploring, but needs near-zero conversion friction.
Complainer: talks about the pain constantly, has never once acted on it. A time-sink dressed up as a market.
The most common pitfall for founders is over-investing in 'complainers.' Not all potential customers are equally important; in fact, only the top three segments deserve your focus and resources.
The PCOS Case Study
When I first started exploring consumer health, I set my sights on building a digital management tool for PCOS. The market is massive, the clinical need is undeniable, the patients are clearly frustrated. Our first interviews confirmed all of it, maybe too well. Women described in detail how the condition disrupted their metabolism, skin, emotional well-being. Stop at the 20-minute mark and I’d have rushed back to my laptop to build a symptom-tracking app. It felt like a goldmine.
Then I asked the golden question: “What have you actually done about this recently?” Often, nothing. Not because they didn’t care, but because they were paralyzed by the condition’s complexity and a total lack of systemic support. No sustained diet changes, no consistent exercise, just a loop of anxiety.
I checked this with a senior OB/GYN. She confirmed it: a significant share of diagnosed PCOS patients, even fully aware of the clinical stakes, can’t initiate or sustain any behavioral change. The friction is just too high. This is a textbook case of Stuck in the Status Quo.
Is PCOS a bad market? No. It’s chronically underserved with real potential. The framework just forces a pivot, and that pivot is the useful part. I believe two paths can pursue from here. Change the target: hunt for the Extreme Users already biohacking their diets, building spreadsheets, paying out of pocket for functional medicine. They have the action bias you need. Or change the modality: to reach the paralyzed majority, the product can’t demand willpower. It has to remove the friction entirely, through direct clinical intervention (care navigation, GLP-1s) or hardware that asks nothing extra of the user.
What this means for builders
Skip the digging, and you’ll spend months and real funding building for the loudest 20% of users, the group that will never convert. Need lives in what people do, not what they say. Chase the Extreme Users, the ones already duct-taping a solution together. That’s where the market actually is.