A Case Series of Transgender and Gender-Nonconforming Patients in a Pediatric Functional Neurologic Disorder Clinic 2023 Wilkinson-Smith et al

Discussion in 'Other psychosomatic news and research' started by Andy, Sep 12, 2023.

  1. Andy

    Andy Committee Member

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    Youth who identify as transgender and gender nonconforming (TGNC) are at increased risk of anxiety, depression, bullying, and loss of social and family support. These factors may increase the risk of developing functional neurologic disorder (FND). If the risk of FND is increased in TGNC youth, then identifying which youth are at increased risk, and the particular times when risk is increased, may allow for earlier diagnosis and treatment of FND. Better awareness of functional symptoms among clinicians who care for TGNC youth may prevent disruption of gender-affirming care if FND symptoms emerge. Patients diagnosed with FND who are TGNC may require different forms of intervention than other youth with FND. We present 4 cases from our multidisciplinary pediatric FND program of TGNC youth who developed FND. In all individuals for whom follow-up information was available, access to gender-affirming health care was associated with marked improvement or resolution of FND symptoms.

    Paywall, https://journals.sagepub.com/doi/10.1177/08830738231200520
     
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  2. Hutan

    Hutan Moderator Staff Member

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    Those factors (bullying and so on) may increase the risk of FND. And they may not. It doesn't sound as though this paper sheds light on that.

    Well, yes, "If". But we still don't know if FND is more prevalent in these young people. Four cherry picked cases won't tell us much about epidemiology.

    It is difficult to imagine how BPS-based treatment for FND could safely be part of care for TGNC youth, given that, at its core, BPS FND treatment is instruction in the denial of one's own reality.

    That's the usual BPS difficulty with causation and correlation. A marked improvement over time doesn't mean that any intervention caused the improvement.

    Of course stressful situations can exacerbate symptoms in many diseases. We see that with Tourettes, which, as far as I know, is not regarded as an FND, and in Parkinsons. But, from the abstract, this paper is not evidence that stressful times are the cause of FND, or that FND is cured by removal of that stress. We could probably build just as compelling a case that the growth spurt of adolescence is a major stressor on the body and that increases the risk of neurological symptoms for a while, and that's why the symptoms eventually go with time, or become less troublesome. What is needed is good quality data, not self-serving speculation.
     
    Last edited: Sep 12, 2023
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  3. livinglighter

    livinglighter Senior Member (Voting Rights)

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    Unfortunately, they may also be at increased risk of sustaining attacks. Which can also cause plenty FND-like symptoms.
     
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  4. Ash

    Ash Senior Member (Voting Rights)

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    I don’t think FND is a process that exists outside of the researcher mind certainly not in the bodies and minds of their patients. So I don’t think Trans and gender non-conforming kids can be at risk from it anymore more than anyone else can.

    I do think it’s quite possible to stress a person so much to subject them to prejudice and hostility and abuse for a sustained period not allowing them escape or respite. That this likely would or could put a person at higher than otherwise risk, of all manner of biological disease processes as well as emotional and psychological harms, accidental and other injuries and preventable
    death.

    I do think nearly all of us probably have experienced some temporary sensory experiences direct mind to body, think of a lemon let your mouth water, or less pleasantly think of an important interview let your stomach clench, or think of your worst break up feel a pressure in your breast bone. For anyone who has a bad physical injury that sometimes aches, years later, thinking of the actual injury event will make it hurt a little extra. But all these sensations are just part of being alive. They are not a “neurological condition” in the sense of illness or disease or dysfunction.

    The FND researchers have taken a fact of life that applies to almost if not exactly everyone alive and weaponised it.

    @Hutan is right this framework for looking at neurological symptoms in this child population is obviously a very dangerous prospect.

    @livinglighter you’re sadly not mistaken there is a higher chance of these children experiencing violence than some others.

    The harm under guise of help
    is going strong.
     
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  5. rvallee

    rvallee Senior Member (Voting Rights)

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    They certainly increase the risk of being labeled as such. That is correct. Especially given how bigotry and prejudice intersect, and those are issues featuring both by the boatload. But that is not the same thing at all, what with there being no test for it, and applying a diagnostic process that consists basically of "no better explanation".

    Which is all very different from ME, which has actual criteria. The idea behind the conversion disorder is that it can create any and all symptoms, as long as they're felt that they're not explained by a known diagnosis. Felt, being the operating principle here. Which is a logical fallacy, the god of the gaps, also basically absurd. And when in doubt, they can simply apply the "overlay" BS. It's simply not a serious process.
     
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