if they're going to extreme lengths (such as getting ports or custom wheelchairs or service dogs) just for attention maybe they really need attention. Clearly something is wrong in their lives and they could be doing much worse things. Why is asking for attention, positive feedback, and peer acceptance such a bad thing?

• Paraphrased Reddit comment

Do you really think the statistically minimal group of people pretending to have illnesses are what is preventing people from getting medical care? The medical industry would refuse service anyways. Insurance has a direct incentive to think that people are malingerers by default. The general attitudes from doctors when it comes to chronic conditions is disbelief and gaslighting. If it wasn’t malingerers, it would be something else. The ableism in the industry is the issue, not random people it uses as scapegoats.

Hell, think of the term “malingerers”. People who pretend illness to get out of work. Is this not just a repeat of the usual,  complaint about lazy workers? Children, maybe not. Faking sickness to avoid school is a common trope for a reason. But do you really think adults who are being accused of faking illness are “malingerers”? If they need to fake illness to get out of work, and in the process lose a chance to get money, then they probably aren’t able to work in the first place. Healthy, neurotypical, able-bodied people don’t just pass up working opportunities for no reason. Even if it’s for attention, same issue. Healthy, able-bodied, neurotypical people don’t just spend thousands of dollars on surgeries and equipment and accommodations just to get attention. Healthy, able-bodied, neuro-typical people don’t need attention that much. There is clearly something going on there and whatever it is probably isn’t going to be prevented by some random strangers calling them fakers on the internet.

I know you have your own experiences that I could never even imagine when it comes to chronic illness, and I am mostly talking from a place of privilege. But I have been in the autistic community, which has similar issues with accusations of fakery, and it seems directly transferable to me. There is a reason that the autistic community has nearly universally agreed that self-diagnosis is valid. There is a reason that there are multiple complaints about “fake disorder cringe” subreddits on the Autism sub. There is a reason that “fake disorder cringe” was posted to r/againsthatesubreddits (and, by the way, was only prevented from getting a bad reputation because the actual Reddit site admins themselves came down from the heavens to protect ableism).

Accusing others of faking disorders is, at best, punching sideways. In situations where it is punching up, it’s pretty obvious that it’s punching up. Usually because it’s a rich person doing it.

I want to clarify that this is not about your emotions. Being frustrated at people for faking disorders is reasonable. You are experiencing hurt and, in a way, they have contributed to it. But consider the situation of a worker in a unionized workplace- It’s very similar. Yeah, it is frustrating that you aren’t getting your pay, and I sympathize with that, but the best way to get it is to join the union, not scab.