Functional Neurological Disorder Among Sexual and Gender Minority People

SGM community members may face unique minority stressors, which put them at risk for developing neuropsychiatric disorders, potentially including FND. FND and SGM identities are more prevalent in younger age demographics. In some patients, case reports suggest a potential temporal association between FND symptom onset and concealment of a SGM identity with symptom resolution through disclosing the identity and receiving affirming care. Larger cohorts of patients with FND suggest an increased prevalence of FND in the SGM population compared with the general population. Gaining a sense of agency, reframing threat assessment, and resiliency building are all protective factors that buffer against damaging neural changes in response to overwhelming stressors. More research is required to better characterize FND in SGM people. Treatment approaches for FND in SGM communities should be biopsychosocialfocused, multidisciplinary, and involve local community agencies to help the patient build supports and find appropriate affirming services and resources. They should be informed by minority stress models and what is known regarding intersectionality.Creating inclusive clinical and research environments is critical to the therapeutic alliance and healing process for SGM patients with FND. Neurologists should potentially expect an increasing number of patients with SGM patients with FND to present to their clinics, given that a higher proportion of younger persons identify as members of these communities. More research and clinical sup-port are required to better address the needs of SGM patients with FND.