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I'm wondering if it's explained by something like how likely you are to hear symptoms and think "that's something that describes me" rather than just kinda going with the default answer unless you are forced into picking the other.

I mean, suppose you've occasionally had sexual or sexualish thoughts about someone of the same gender (Iess sure if there is a standard answer effect if homosexual). One sort of person might not think much of that unless they feel them quite strongly while another might report they are bisexual. The same kind of attitude plausibly affects how you answer long COVID questions.

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