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Janet Dafoe on FND: "Where the Sun Don’t Shine"

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Public-figure note: Janet Dafoe (@JanetDafoe) is a licensed child psychologist, long-time ME/CFS advocate, caregiver to her son Whitney Dafoe, who has extremely severe ME/CFS, and spouse of Stanford researcher Ron Davis. She has also been involved in published ME/CFS research. See also MEpedia: Janet Dafoe.


“Where the sun don’t shine”

At the September 2026 Stanford Community Symposium on the molecular basis of ME/CFS, a presentation included discussion of psychiatric and functional explanations around ME/CFS and dysautonomia. During the discussion, Dafoe was reported as saying that the FND diagnosis should be put “where the sun don’t shine.”

It was blunt, but Dafoe subsequently confirmed that she was the person who made the remark and explained what had prompted it. Her concern was not simply the terminology. She pointed directly to patients she believes have been harmed after receiving the diagnosis.

I was so moved by Brayden and Paige’s presentation that I cried. So many patients have been severely harmed because of that horrendous diagnosis. They need to be treated for what they actually have. I know there are no cures yet but there are treatments for the symptoms that help.

— Janet Dafoe, 12 September 2026

The important part is what Dafoe says happens after the diagnosis. Her criticism is that patients can end up being treated through the FND label rather than being investigated and treated for the conditions actually responsible for their symptoms.


“Neither is ME/CFS!”

Dafoe made her position even clearer over the same weekend. She shared the STAT article Long Covid is not functional neurological disorder and added:

Neither is ME/CFS!

— Janet Dafoe, 12 September 2026

ME/CFS, Long COVID, dysautonomia and FND can share descriptions such as fatigue, cognitive problems, dizziness, weakness, exercise intolerance and fluctuating disability. But symptom overlap does not establish a shared mechanism. Dafoe's objection is to moving ME/CFS and Long COVID into a functional framework because their biology remains incompletely understood.


This did not start with FND

Dafoe's objection to this kind of reasoning goes back much further than the Stanford exchange. The terminology has changed over the years, but her basic argument has remained remarkably consistent.

In 2018, during the controversy surrounding Netflix's Afflicted, Dafoe objected strongly to portraying poorly understood chronic illnesses as psychosomatic. Speaking about the programme, she said:

It's malpractice to say that it's psychosomatic.

— Janet Dafoe, quoted by Nylon, 2018

Her objection was not merely that the description was offensive. She pointed to biological abnormalities being investigated in these illnesses and argued that medicine should be trying to understand them rather than assuming a psychosomatic explanation.

Seen in that context, the 2026 Stanford comment was not a sudden change of position. Years before making her comments about FND, Dafoe was already arguing against turning incomplete biological knowledge into an explanation for why patients are ill.


From psychosomatic to functional

The terminology surrounding medically unexplained symptoms has changed considerably over the decades. Conversion disorder, somatoform disorders, psychosomatic explanations and functional disorders have occupied different places in that history and are not identical concepts.

For the patient who has been given one of these explanations while another disease remains unidentified, however, the practical problem can look remarkably similar: an unanswered medical question becomes an answered one.

That is particularly relevant to ME/CFS. Its mechanisms remain under active investigation. The fact that medicine does not yet have a complete explanation for the disease tells us very little about what that explanation will eventually be. Lack of an established mechanism is not positive evidence for a functional mechanism.


She has also been involved in the biological research

Dafoe is best known as an advocate and caregiver, but her involvement has not been limited to social media. In 2024 she was listed as a co-author on a published study examining longitudinal cytokine and other biological data in an extremely severe ME/CFS patient, with an affiliation to Stanford's ME/CFS Collaborative Research Center.

She has also written about attempts to investigate symptoms such as brain fog biologically, including metabolic hypotheses being explored by ME/CFS researchers. That background helps explain her response when the discussion moves towards functional explanations: her preference has consistently been to keep looking for mechanisms rather than treating the absence of a current explanation as an explanation in itself.

There is another detail worth noting. Dafoe is herself a psychologist. Her criticism therefore cannot easily be reduced to hostility towards psychology or psychological illness. Her objection is much narrower: psychological or functional explanations should not be substituted for biological knowledge that medicine does not yet possess.


The problem of turning uncertainty into certainty

This is where Dafoe's comments become particularly interesting. There is an important difference between saying “we do not yet know what is causing these symptoms” and saying “these symptoms are functional.”

The first statement acknowledges uncertainty. The second makes a claim about the nature of the symptoms. Moving from one to the other requires evidence. The absence of evidence for one explanation cannot simply become evidence for another.

This becomes especially important when dealing with illnesses whose biology is still being discovered. ME/CFS provides an obvious historical example. Patients experienced profound illness long before medicine understood even the limited biological abnormalities that can now be measured. What was unknown twenty or thirty years ago did not suddenly become biological when researchers discovered it. The biology was there; our knowledge was incomplete.

The same principle applies at the level of an individual patient. A normal scan, negative blood test or failure to identify a recognised disease does not tell us what is causing the symptoms. It tells us what those particular investigations did not demonstrate.


What happens after the label?

Dafoe's strongest criticism is therefore not really contained in the “sun don't shine” remark. It is contained in the explanation she gave afterwards: patients need to be treated for what they actually have.

That raises a more difficult question than whether the language she used was polite. What happens when an FND diagnosis enters the medical record and the patient continues to deteriorate, develops additional symptoms or later presents with evidence pointing elsewhere?

Does the diagnosis remain one hypothesis among others, or does it become the explanation through which subsequent symptoms are interpreted? Are new complaints investigated independently, or absorbed into the existing diagnosis? What evidence would be sufficient to reopen the original question?

Those questions become particularly important if the diagnosis is difficult to falsify in practice. If normal investigations support the diagnosis, fluctuating symptoms support it, unusual symptoms support it and later symptoms can also be incorporated into it, then the important question is not simply what evidence supports FND. It is what evidence could demonstrate that FND was the wrong explanation for that patient.


A position spanning years

Dafoe's comments are worth documenting because the September 2026 exchange is not an isolated attack on FND. At least as far back as 2018 she was publicly objecting to psychosomatic explanations being applied to poorly understood chronic illness. Years later, the terminology appearing in these debates increasingly includes functional disorders, but her underlying objection has barely changed.

Medicine encounters a patient whose illness it cannot adequately explain. There are two very different conclusions available: we do not know yet, or we know what kind of disorder this is.

The distance between those statements is evidence.

That is what makes Janet Dafoe's comments more interesting than the colourful line from the Stanford symposium. The real argument is not about where she thinks the FND diagnosis should be put. It is about whether medicine sometimes turns uncertainty into certainty before the evidence allows it.