I'm confused!!!
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HELP!!!

We need to sort something out straight away...
These statements are all true.
Yes, I admit, it is very confusing. For those who haven't had time to sit and have a thorough read of this site I will say that I have argued for all these "causes" somewhere.
I think it needs to be simplified:
Genes "cause" a lot in life. For example; your height.
'Sue' has a genetic height of 156cm-178cm
Environment "causes" a lot in life. For example; your height.

'Sue1' lived in Bangladesh, was malnourished, and is 157cm tall
'Sue2' lived in America, was well fed, and is 170cm tall
'Sue3' lived in America, was well fed, but contracted polio as a child, and is 140cm tall.

So here, nutrition has an effect on the range that the genes suggest. BUT an illness (not genetic) can "cause" a height outside of that range.

What happens in TS is that there is one "main" gene.
That is, those who have the GTS gene will most likely have TS. But behind that one gene are hundreds, maybe even thousands or millions, of other genes that can misbehave in TS.
While 'Bob1' may have gene XqY which means he has one more dopamine receptor than normal in each ganglion, 'Bob2' may have gene WqZ which causes 2 extra dopamine receptors in each ganglion. 'Bob1' may have AqB which causes small Corpus callosum size, and so might 'Bob2'...etc...
The problem is that TS is a name given to a set of symptoms without any reference to what causes those symptoms

At the most basic level:

'Sue' was hit in the eye with a cricket ball, and got a bruise.
'Bob' was bitten by a mosquito next to the eye, and it bruised.
If DSM IV-TR was used, these people would both have "Black-eye syndrome", even though the cause is completely different!

For those who strive for the perfect medication or a "cure for TS" this is bad news. After all, in Black-eye syndrome, 'Sue' should get an ice pack, while 'Bob' would have more luck with an antihistamine!