16.8 Million Disabled People, and poppy coburn Blamed Instagram

DisabilitiesChronic Illness
Written By Rheanna Nutter

Housekeeping before we get into it. This is not what I usually post here. I write about building a business that survives your worst health weeks, and I will be back to that shortly. But somebody with a national byline spent two thousand words telling my exact audience that we are performing our illnesses for attention, and I have a research habit that gets significantly worse when I'm angry.

So there are footnotes. Sorry in advance, but also not really.

On September 5, the Telegraph ran a couple thousand words by Associate Comment Editor Poppy Coburn explaining that women like me are not actually sick, we are having a moment. Chronic illness as a personality; disability as a look for autumn. Insert eyeroll here.

Or, more specifically, Poppy claims "Young women, nicknamed 'sickfluencers', are turning chronic illness into a lifestyle trend and entrenching a culture of economic inactivity".

Cute.

Oddly enough, however, the insult turned out to be the least interesting part of the article, because most of it is shitty opinion playing dress up as facts. But guess what, Poppy?! Doing so opens the door for your "opinions" to be fact-checked.

So that's exactly what I did.

Every source is at the bottom, cited and linked, because I am not walking into this one with vibes alone, unlike silly little Poppy.

One thing to note: I am American, so technically this is not my fight. Except the exact same arguments arrive on our doorstep daily as lived ableism, so yes it is.

The short version: Coburn's whole case rests on the number of British people counted as disabled going up. That number comes from a survey that started in October 1992 (yes, NINETEEN HUNDRED ninety two), using a legal definition written in 2010, asked through a set of questions that have been in their current form since 2012/13. She compares it to 1945. But silly Poppy, there was nothing in 1945 to compare it to.

Why do the disability numbers keep going up?

Because the way Britain counts disabled people has changed more than once since 1992, and because fewer of us in the world with chronic illness and disabilities are hiding. A survey of over 3,000 disabled people, run by YouGov for the accessible job board Evenbreak, found only 23% would disclose a disability when applying for work.

Sit in that 23% with me for a second - only twelve percent said they would disclose their disability at a job interview.

These are people who already know they are disabled, already know what accommodations they need, and are STILL deciding that saying it out loud in an interview costs them more than staying silent. In December 2022, under a legal framework that supposedly protects them.

That is what a century of being punished for admitting their disability does to a population.

Now let's run it backwards.

My grandmother's generation did not have the Equality Act, did not have the Americans with Disabilities Act, did not have a diagnostic category for most of the acronyms Coburn lists, and many were institutionalized for displaying any sort of disability.

People with epilepsy hid it. Mental illness either got you committed or got you extremely good at pretending, and disabled kids were sent away and quietly edited out of the family story, while the ones who stayed home learned to mask their illness, often before they even learned to read.

Side note, and I checked this twice because I did not believe it either: lobotomies were not some quaint pre-war horror that wrapped up by 1950. Walter Freeman performed 228 transorbital lobotomies in two weeks in West Virginia in July 1952. TIME covered it that September, so this is not some rediscovered footnote, it made the news at the time.

His last one was in February 1967, on a patient who died of a brain hemorrhage. He did roughly 2,500 transorbital lobotomies across 23 states before he died in 1972.

That is not ancient history, that is my mother's lifetime. WTF?!

Your grandparents did not know anyone with POTS because the label did not enter the literature until 1993, and anybody who felt like that had excellent reasons to keep it to themselves.

Coburn treats her own family's ignorance as a historical control group.

The niece, the marchers, the women on Instagram. That tells you where her attention went, but what it does not tell you is one single thing about how many of us there are.

Here is the part that should have stopped her, and I mean stopped her, mid-sentence, hands off the keyboard.

The DWP figure she quotes comes from the Family Resources Survey, launched October 1992. Its disability measure keys to the Equality Act 2010 definition. In 2012/13 the disability questions were rewritten to comply with the Government Statistical Service harmonised standards published in August 2011, which lined the survey up with that definition. DWP's own wording: "The impairment types respondents were asked about changed for the 2012/13 survey to reflect the new harmonised standards for social surveys published in August 2011."

The House of Commons Library counts 16.8 million disabled people in the UK in 2023/24, and puts the rise at 5 percentage points between 2012/13 and 2023/24.

Read those two dates again, slowly, because I want you to enjoy this as much as I did.

The questions changed in 2012/13. The increase she is clutching her pearls about starts in 2012/13.

Now here is the part I am going to hand you myself, because I am not doing what she did, because I actually have integrity. That same briefing says prevalence stayed stable right after the questions changed. So the rewrite is not a switch somebody flipped that produced an instant jump, and I am not pretending it was.

Am I telling you the question change explains the whole thing? No, because I do not know that, and neither does she, and that distinction is the entire point of this post.

What I am telling you is that a comment editor at a national newspaper, writing a feature built on one number, could have spent ten minutes finding out how the number gets made. Ten minutes in the methodology and she would have found both the change and the caveat, which is more than she gave the women she wrote about. Silly Poppy.

Is Britain "sicker than it's ever been before"?

No, absolutely tf not. Britain in 2026 is not sicker than Britain was before antibiotics, before vaccines, or back when tuberculosis and polio were doing numbers.

What she means is that more people report disability on a survey.

Those are two completely different points, and she picked the more dramatic one, dropped it into the third paragraph where a fact should actually go, and never came back to defend it.

She's running with no source and no qualifier attached, which is a bold choice for a sentence carrying that much weight. Vibes, in a serif font. Silly Poppy.

Does POTS really have "no demonstrable pathology"?

POTS is diagnosed by a measured, reproducible sign: a sustained heart rate increase of at least 30 bpm within ten minutes of standing, with no drop in blood pressure. A machine actually records it.

A machine, in a clinic, printing out the results on paper. That is the definition of demonstrable.

Coburn quotes neurologist Suzanne O'Sullivan saying there is "no demonstrable pathology or proof of a nervous system disorder," and treats it as bible.

This opens up two problems, both of which are load-bearing.

First, that claim is slippery. Nobody seriously knowledgeable about it says POTS has ONLY ONE confirmed cause.

What actually exists is a pile of documented mechanisms showing up in different patients: low blood volume, damage to the peripheral nerves that control blood vessels, an overactive adrenaline response, and immune dysregulation.

The Cleveland Clinic Journal of Medicine review walks through all of it and is honest about what is unresolved, including that testing for the various autoantibodies found in POTS patients "has little clinical utility" in a patient who otherwise presents classically.

Somewhere between 16 and 20% of POTS patients have a coexisting autoimmune condition. "We have not settled on a single mechanism" and "there is nothing there" are not the same finding, and the swap between them is Coburn's move, not O'Sullivan's. Silly Poppy.

Second, she calls the 30 bpm threshold "arbitrary." Every clinical cutoff in medicine is a line a committee agreed to draw on a continuum, and I have a gorgeous example for you.

In November 2017, the American College of Cardiology and the American Heart Association moved the definition of high blood pressure from 140/90 down to 130/80.

Overnight, with no change to a single human body, the share of American adults classified as hypertensive went from 32% to 46%. Fourteen percentage points of the population woke up sick because a committee picked a different number.

Nobody wrote a trend piece about those people.

No one suggested they had made hypertension their personality, or that the increase revealed a culture going soft, or that Instagram was involved. A threshold moved, the numbers moved, and everyone understood exactly why.

That is the same logic Coburn refuses to apply to POTS, and it is the same logic she refuses to apply to the disability survey.

And O'Sullivan is not a consensus, she is one single person.

Dr Elke Hausmann, a GP in Derby who has Long Covid herself, published a direct critique in BJGP Life arguing that O'Sullivan "ignores the huge research literature that makes the case for Long Covid most definitely not being a psychosomatic condition, cherry picking some research that seems to support her view."

Coburn found tons of room for one single neurologist with a book to promote and gave the opposing side a single itty bitty quote she immediately talked right over.

Is that... lazy journalism I smell? Silly Poppy.

Because here is the thing.

That opposing voice was Professor Lesley Kavi, who chairs POTS UK, used to be a GP, and is a visiting professor at Birmingham City University. Coburn quoted her saying half of patients get told it is all in their heads, then moved straight past her to O'Sullivan.

Kavi has published on this. In the British Journal of General Practice, she lays out the actual mechanism: blood vessels fail to constrict properly on standing, blood pools, less returns to the heart, and the heart compensates by racing.

That is a described pathophysiology, in a peer-reviewed journal, by the person Coburn used as a literal speed bump on the way to her conclusion.

Two doctors. One gets to be the science and one gets to be the advocacy, and you can guess which one agreed with the thesis, right?

What did Covid actually do?

This is where things get interesting. Covid handed a lot of people measurable autonomic dysfunction, and the article half-admits this before sprinting away from it.

Kavi's paper again, and this one is from 2022, well before Coburn sat down to write: 41% of POTS patients report a viral infection preceding their symptoms.

Post-viral POTS is not a new theory somebody invented during lockdown.

It is the single most common trigger on record. Kavi also reports that Long Covid services were finding POTS in 15% to over 50% of patients with postural symptoms, and she flags that one as unpublished data, which is the kind of labeling I would have liked to see somewhere in Coburn's piece.

Then there is the harder testing. In a study in The American Journal of Medicine, first published online in 2023, researchers ran 99 people through beat-to-beat hemodynamic monitoring and a ten-minute active standing test. Of the 33 Long Covid patients, 79% met the international criteria for POTS.

Let me be careful here, since I am the one in this post accusing somebody else of sloppiness.

That is 33 people, which makes it a small and selected group rather than a population rate, and I am not going to inflate it into one. What it is not, however, is just vibes. That is objective measurement of exactly the thing O'Sullivan says leaves no trace.

Coburn has the pandemic in her hands twice and drops the ball both times.

She notes the UK's 130,000 POTS estimate predates it. She quotes Kavi saying cases rose sharply after it. She even uses the pandemic to explain the jump in Special Educational Needs support, because there it serves her argument.

Then the same event would explain the illness itself, right? But instead, it evaporates.

A virus that goes after the vascular and nervous systems tore through every country on the planet, the disabled population went up afterward, and she looked at that timeline and identified the culprit as... Instagram?!

El oh el. Silly Poppy.

Is having more than one of these "incredibly bad luck"?

No, it is a documented cluster that has been sitting in the literature for YEARS.

In one study of 91 POTS patients, 31% met clinical criteria for hypermobile Ehlers-Danlos syndrome, and another 24% had generalized joint hypermobility without meeting the full criteria.

This is where the article stops being sloppy and starts being wildly lazy.

Coburn writes that it "would require incredibly bad luck indeed" for the same woman to have several different conditions, decides luck has nothing to do with it, and lands on identity alone.

She arrived at that conclusion by….not looking.

Connective tissue that behaves differently changes how blood pools when you stand up, and the autonomic system spends all day compensating for it.

You do not have to take my word for any of this, because the researchers that studied it actually wrote it down and published it. It took me one search. One. I am not a doctor, I am a disabled woman with a laptop, and I found it with hardly any effort at all.

Worth saying, since I am in here demanding rigor: the mast cell piece of that cluster is genuinely contested.

A research abstract presented to the American Academy of Allergy, Asthma and Immunology is titled, flatly, "MCAS is not associated with hEDS and/or POTS."

It is a conference abstract rather than a peer-reviewed paper, so it carries less weight than everything else I have cited here, and I am telling you both halves of that because it cuts against the tidier version of my own argument. That is the standard. Coburn had the same internet I do and used it to conclude that we are simply unlucky. Silly Poppy.

What does she know about what I (or any other chronically sick or disabled person) want?

Nothing, and it does not slow her down for a second, because the article states its claims about our motives as fact and sources exactly none of them.

She writes that patients have "invariably" self-diagnosed before the appointment, that a chronic illness influencer "won't want to get better," and that the motive is "the desire to increase one's status through suffering."

Read those again and ask what evidence could exist for any of them.

None of it is observable. None of it is sourced. "Invariably" is a universal claim about every patient in Britain, made by a comment editor who surveyed a grand total of fucking nobody.

The Billie Eilish paragraph is the purest distillation of the method.

Coburn notes that Eilish showed tics in one interview four years ago and has not visibly ticced at concerts since, and offers that up as evidence of performance.

Tic suppression is one of the most studied features of Tourette's.

People with tics can suppress them for stretches, especially when focused or performing. Suppressibility is in fact what separates tic disorders from other movement disorders, and it is the entire basis of the standard behavioral treatment.

That is not a loophole I went looking for, it is the clinical description of the condition.

Coburn did not check. She looked, saw nothing of interest to her, and filed the nothing as proof about a named woman's honesty, in a national newspaper, under her own byline. Silly Poppy.

And then there's the "won't want to get better" line. I want that one printed, framed, and mounted above my desk.

I run a business teaching chronically ill and disabled entrepreneurs how to build sustainable businesses that survive their worst health weeks. You know what my clients ask me for? Systems that still run at low capacity. Workflows that keep going on the days where they can't even get out of bed.

Not one human being has ever hired me to help them stay sick more efficiently.

If somebody walked out with a cure tomorrow, the line would wrap around the block seventy eleven times, and I would be in it at 4am with a camping chair and a thermos, sporting a TShirt that says SILLY POPPY.

Here is the structural problem with her argument, and it is fatal. She wants it both ways.

We are not really sick, and also our pain is real via the nocebo effect. Sick means sick. Not sick also means sick. Nothing counts as evidence against her position in either direction, which means nothing she wrote can be wrong, and nothing that cannot be wrong is an argument.

So what is the article actually for?

Welfare cuts. That is the purpose of the preceding two thousand words. The piece finally lands on benefit caseloads, school budgets, and Reform's pledge to push a quarter of a million people back into work for up to £50bn in savings, and every section before it is aimed at that ending like a damn runway.

The pastel infographics, the compression socks, the Billie Eilish paragraph, her mother's appendicitis scar. All of it is there to get you comfortable enough to nod along at the closing stretch, where a party's savings figure gets quoted like a lab result.

Now let's talk about that £50bn, because the timeline is absolutely delicious.

Reform trailed the plan on August 16, 2026 and launched it properly on the 17th, when Robert Jenrick presented it in London under the title Making Welfare Work. While we are here, the actual numbers, since Coburn did not print them: 241,000 people, all of them specifically British nationals, and around £50bn a year rather than a one-off "up to."

The Institute for Fiscal Studies, the UK's leading independent economics research institute, published its response the same day.

On the disability benefits piece specifically, the IFS said there is "relatively little detail on what the new assessment would actually entail or on how they would avoid the experience of previous attempts to toughen up the system, which saw savings falling significantly short of government's expectations."

Translation: we have tried this before, the money did not show up, and nobody has explained what is different this time.

Coburn published on September 5. That is nineteen days after the country's most credible fiscal referee said the number was soft, and she printed it anyway, no caveat, inside an article that spent its entire length scolding women for believing things without "proof."

She demanded biomarkers from us and took a press release at face value. The call is coming from inside the house. Silly Poppy.

The part she almost saw

Coburn's own opening tells on her. A niece nobody knew was sick, marchers with walking sticks, women online with acronyms in their bios, and instead of having compassion or empathy, she read all of it as a social outbreak.

What she was watching was a century of hiding coming to an end.

People are now saying what my grandmother's generation was taught to hide, and now we have a national newspaper calling it a lifestyle trend.

The autism numbers she finds so suspicious follow the identical shape. Diagnostic criteria widened in 1987, in 1994, and again with DSM-5 in 2013. Universal screening in the US started in 2006. Intellectual disability diagnoses fell as autism diagnoses rose, which is called reclassification. Scientific American, summarizing the research, puts it this way: "Awareness and changing criteria probably account for the bulk of the rise in prevalence, but biological factors might also contribute." Coburn looks at that same jump and sees a culture going soft.

She is not wrong that something changed, she just got the direction backwards. What changed is that we stopped hiding, and now we are being counted, and it turns out being counted is expensive for the people who preferred us to be completely invisible.

I am not going back. And silly people like Poppy need to read up on Ableism.

May her coffee always be cold, her pillow always hot, and may she fuck right off into oblivion.

Sources

Rheanna Nutter
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