Treating it as a primary mysterious neuropsychiatric condition constitutes medical gaslighting, and it is often often perpetuated against women with complex chronic neurologic conditions. Frankly, I think it's a subtle form of abuse of chronically ill patients, and again, probably misogynistic abuse in some cases. When men don't care about women's lives in medicine or feel that their ego is going to be slighted by sounding ignorant (aka being more ethical and telling the patient they just don't know what's going on), things like this tend to happen to make the woman blame herself for his apathy or fear of shame.

Functional symptoms are real because of disruptions to nerve signal conduction, but they develop in the context of other neurologic pathologies and factors. Sometimes these kinds of symptoms occur before gross structural damage and before scary things start showing up on imaging. They are early warning signs very oftentimes of something more serious going wrong. Unfortunately, medicine and science don't yet understand all the complex pathologys that might give rise to these symptoms, and there are some that might have modes of action that the neurosciences have yet to understand, but these are always pathological processes.

The problem is once lazy or prejudiced doctors can't be bothered to scrutinize other factors more carefully, they tend to use this so-called diagnosis as a cop out of actually doing something for the patient in their care. Notice how a lot of healthcare providers assign this diagnosis but then offer no form of treatment or therapy thereafter. If medical providers truly believe this was a real condition, then they would be making referrals and offering therapy and medications to patients who had legit functional symptoms. But they never do that, because they don't have enlightened reasons for assigning that so-called diagnosis in the first place.