Two PSSD susceptibility patterns: inborn metabolic error, or stuck on-drug epigenetic adaptation
u/drwillpowers
r/PSSD2026-03-20T21:56:02Z
Dr Will Powers’ own statements and theorizing
Summary (paraphrased)
In the r/PSSD data-request thread, Powers states that most people recover from SSRI sexual dysfunction on stopping; those who don't likely carry an inborn metabolic error or genetic anomaly — e.g., HDAC dysfunction or methylation/demethylation problems — leaving them "stuck." A distinct subgroup adapted fine to the drug but cannot re-adapt after stopping: stuck in the on-drug epigenetic configuration. He also notes that clinical geneticists were unhelpful for his cases — panels ordered, "nothing wrong" reported — illustrating with a cisgender female patient with testosterone over 350 ng/dL whom a university genetics team cleared.
Key points (paraphrased)
- Two PSSD susceptibility patterns: inborn metabolic error, or stuck on-drug epigenetic adaptation.
- HDAC dysfunction and methylation/demethylation defects as candidate stuck-mechanisms.
- Clinical genetics dismissed his cases — a methods gap between panel testing and his WGS-based approach.
- Illustrative case: hyperandrogenic cis female cleared by a university genetics team.
Why it’s in the corpus
The PSSD susceptibility model in its early form: stuckness rather than ongoing toxicity. It also documents the clinical-genetics methods gap that motivates his whole-genome approach.
Context — the post Powers was replying toVerbatim third-party text, shown for context only — not Powers’ statement. Usernames removed.ShowHide
Powers' comment replies to [username removed], who asked how long-lasting epigenetic changes square with the fact that some people do recover, in the r/PSSD awareness thread (by [username removed]) spreading word of Powers' PFS/PSSD-sameness hypothesis and his request for PSSD patient data.
(Parent context recovered from the r.genit.al mirror on 2026-10-09; Powers' comment text itself is from John's user-provided export.)
Some fields on this page come from the release’s Markdown edition, which carries text the JSON edition omits.
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