Functional neurological disorder and functional somatic syndromes among sexual and gender minority people: A scoping review.

J Psychosom Res

Department of Neurology, University of California San Francisco, San Francisco, CA, United States of America; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States of America. Electronic address:

Published: November 2023

AI Article Synopsis

  • This text reviews existing research on functional neurological disorders and somatic syndromes specifically among sexual and gender minority (SGM) individuals.
  • The literature search resulted in 26 relevant studies, mostly consisting of case or cross-sectional analyses, with significant representation of gender minority individuals and various diagnoses noted, including fibromyalgia and functional neurological disorders.
  • The conclusion highlights a scarcity of comprehensive data in this area and suggests the need for more observational studies to better understand the prevalence and clinical characteristics of these conditions in SGM populations.

Article Abstract

Objective: To describe the current literature on functional neurological disorder and functional somatic syndromes among sexual and gender minority people (SGM).

Methods: A search string with descriptors of SGM identity and functional disorders was entered into PubMed, Embase, Web of Science, PsycInfo, and CINAHL for articles published before May 24, 2022, yielding 3121 items entered into Covidence, where 835 duplicates were removed. A neurologist and neuropsychiatrist screened titles and abstracts based on predefined criteria, followed by full-text review. A third neurologist adjudicated discrepancies. Eligible publications underwent systematic data extraction and statistical description.

Results: Our search identified 26 articles on functional disorders among SGM people. Most articles were case (13/26, 46%) or cross-sectional (4/26, 15%) studies. Gender minority people were represented in 50% of studies. Reported diagnoses included fibromyalgia (n = 8), functional neurological disorder (n = 8), somatic symptom disorder (n = 5), chronic fatigue syndrome (n = 3), irritable bowel syndrome (n = 2), and other functional conditions (n = 3). Three cohort studies of fibromyalgia or somatic symptom disorder reported an overrepresentation of gender minority people compared to cisgender cohorts or general population measures. Approximately half of case studies reported pediatric or adolescent onset (7/13, 54%), functional neurological disorder diagnosis (7/13, 54%), and symptom improvement coinciding with identity-affirming therapeutic interventions (7/13, 58%).

Conclusion: Despite a methodologically rigorous literature search, there are limited data on functional neurological disorder and functional somatic syndromes among SGM people. Several studies reported increased prevalence of select conditions among transgender people. More observational studies are needed regarding the epidemiology and clinical course of functional disorders among SGM people.

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http://dx.doi.org/10.1016/j.jpsychores.2023.111491DOI Listing

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