Experiences of dyslexia in GP training in the UK: a qualitative study

Working as a doctor requires a variety of skills, and we do not all share these in equal measure. I therefore wonder why this article focuses specifically on dyslexia.

My concern is not with the experiences described by participants, which are clearly real and important. Rather, it is with how we understand those experiences. The article documents difficulties encountered by individuals who have received a diagnosis of dyslexia. I wonder whether these difficulties may, at least in part, reflect a mismatch between expectations and abilities.

My concern is that the term 'dyslexia' suggests pathology when it could instead be viewed as a mismatch between societal expectations and individual abilities. Human beings acquire spoken language naturally; reading and writing are cultural inventions. Unlike speech, literacy is not a universal feature across cultures, yet difficulties with literacy are often framed as disorders rather than variations in human capabilities.

Walking and speaking are species-typical developmental achievements. Reading and writing, by contrast, are cultural practices that must be explicitly taught. To define difficulty with literacy as a disorder risks pathologising a variation that becomes problematic primarily in societies that place a high value on written communication.

Although Western schools view writing, and therefore reading, through an 'evolutionary' lens, I suggest we might instead view them through a lens of adaptation. I question the tendency to treat human adaptations to their environments within concepts that imply superior and inferior adaptations when, in fact, there may simply be different ways of adapting. Climate, for example, may require different capacities, including different communication tools, according to what is sufficient for adaptation.

While labels may facilitate access to support, I wonder about their effect on self-esteem. As the authors note, dyslexia affected confidence. Perhaps greater attention could be given to helping individuals pursue educational and professional paths that align with what they wish to explore and develop, rather than defining children, young adults, and adults through perceived deficits.

Dr Fatou Mbow

GP and Founder of Attentive Medicine