I don't have empirical evidence for you. Just anecdotal (not nonsense.) Severe stutterer until my mid 20s. Never a fluent sentence. Blocks that would last until I ran out of breath. Cluttered speech due to all of the 'cheats' I had used for avoidance, all of which eventually integrated and compounded my disfluency. I had spent most of my life knowing I would always stutter. Went back to speech therapy of my own volition. I was ready to improve my fluency. I did the work. Every day I did my exercises. Every week I met with the speech pathologist. I progressed through the program. Within roughly six months I was using my new fluency outside of the therapist's office. I'll always be a stutterer, but I am fluent. I've worked with people for months and months before they ever heard a serious disfluency from me. e.g. Started a job in October. Spoke to the dispatcher daily and at length. Had a block one day in April and May. She made a joke. She was mortified when I told her I grew up with a stutter. I had to let her know it was OK and she didn't have to feel bad. If someone were to ask around my workplace, IDK if anyone other than the dispatcher knows that I stutter. ​ ​ >Is speech pathology pseudoscience? No. But I think it is still in its infancy. But there's a lot of good meaning people out there who aren't qualified to help people who stutter. These good intentions pave the road to hell. Failures breed doubt and resentment. Stuttering does a real number on one's psyche. I think treating it is difficult because its multifactorial nature. The individual has to be in the right frame of mind to improve fluency. They have to do the work. They require a competent speech pathologist who specializes in stuttering. Some people live in regions where the resources simply are there. I've heard horror stories about exposure therapy. (If anyone has been successful with exposure therapy, please chime in.) ​ >but nothing will ever fill the hole of not being able to communicate with others. You speak as if you've explored all of the options and you're resigned to the situation never changing. You're 23. Think about everything you knew to be true at 18 that you have since learned otherwise. I hope you're able to find improved fluency.