As Gypsy grows older, the series shifts from a medical mystery into a dark coming-of-age story. The True Story Behind Hulu's 'The Act' - Time Magazine
The show illustrates this rare form of abuse where a caregiver fabricates or induces illness in another to gain sympathy and attention.
To maintain this facade, Dee Dee subjects Gypsy to unnecessary surgeries, medications that rot her teeth, and a wheelchair she doesn't actually need. Themes of Control and Awakening