Okay, I’ve thought about this question for most of a day, because the obvious answer is “….why would I?”, but it’s clearly not obvious to you.

Now, I know exactly what you’re thinking. They’re a doctor. They’re a professional you’ve gone to for help. And pain and fatigue are, like, medical things, right? Going to a doctor about medical stuff and then saying “LOL NOPE” to what the doctor says is like hiring a plumber and then arguing about how to fix your sink, right? If you’re so smart, why’d you call the plumber over?

Okay.

But now imagine your basement is flooding and you call the plumber. While on the phone, the plumber asks you what the problem is and you say that there’s a pipe in your basement that’s burst and it’s now flooded.

And the plumber—still on the phone—says “LOL NOPE.”

And you say, “Excuse me?”

The plumber says, “Look, a flooded basement is a really severe problem, okay? Usually, these calls, they’re a clogged toilet or a leaky u-bend under the sink. Trust me, this is better. Those are a lot cheaper to fix.”

And you say, “I’m sure they are, but I’m telling you, my basement is flooded. I’m looking down the stairs and I can see the water.”

“I’m just saying, there are other things it could be. It won’t hurt anything to eliminate them first,” the plumber says.

And you say, “But I need my basement fixed! Look, I can’t go down in my basement and do laundry right now, and I have important keepsakes down there in boxes… some of them are already ruined, but maybe I can salvage some if we can just fix the problem.”

“Well, then it will be in your interest for me to check your toilets and your u-bends,” the plumber says.

“The problem is not in my toilets or my sinks,” you say. “I am looking at the problem. I called you because my basement is flooded, and I need you to help me fix that.”

And then… now, I’m not assuming you’re female, but I just want to emphasize that this is a starkly though not exclusively gendered phenomenon, so if you’re not female then imagine you are.

“MA’AM,” the plumber says, in a way you recognize. It’s the voice of putting you in your place, the voice of unearned authority, and with this voice, this word, ma’am, is not a title of respect, it’s a reminder and a command. “MA’AM, if you’ll just calm down. I’m sure what you’re experiencing seems terrible to you, but the truth is, it’s probably not as bad as it looks from where you’re standing. And that’s a good thing! Trust me, have been a plumber for 27 years. Now, when can I come over to check your u-bends?”

“It’s not my u-bends!” you say.

“Ma’am, if you don’t want to be helped, I’ll start to think you’re calling for attention.”

You see?

(Now for bonus points, imagine the plumber refuses to help you until you lose a statistically improbable amount of weight just to rule out that this might be flooding your basement, or is acting on the subconscious but deeply entrenched idea that people with your skin color are less susceptible to flooding and in less need of help, or believes that as a feeeemale you’re more likely to be suffering from emotional distress than a physical problem and suggests the preferable course of action would be for you to take a nap every time the supposed flooding in your basement bothers you.)

As I said in that post, pain and fatigue — like dysphoria — are qualitative experiences. This means they happen in your head and they cannot be directly observed or measured by anyone else (which would make them quantitative phenomena). 

The doctor talking to you about dysphoria —or pain or fatigue — is not a plumber in your house, they are a plumber on the phone. The only input they receive about the problem is your account of it. 

Me, a counselor: “Your daughter kicked you out of the house, changed her phone number, and blocked you on social media.”

NP: [dismissive] “Yes, yes, but when she was a little girl there was no problem.”