Treatment options for ADHD are hindered by gendered assumptions

The ongoing Adderall shortage is an obvious threat to people with Attention Deficit/Hyperactivity disorder. What’s more alarming is the lack of alternative treatment options for ADHD, and how it disproportionately affects women and gender-nonconforming people. There are an estimated 1.2 million people who identify as nonbinary in the United States. So, why are they completely neglected in ADHD research?
Historically, ADHD research has focused primarily on boys and men, leaving people who identify otherwise without many resources or a variety of treatment options. ADHD presents differently in males and females, according to Children and Adults with Attention-Deficit/Hyperactivity Disorder. Without reliable research on how the disorder presents in nonbinary people, mental health providers are ill-equipped.
There are three different types of ADHD: hyperactive, inattentive and combined. Research suggests males are more likely to display external symptoms associated with hyperactive or combined ADHD types. Meanwhile, females typically exhibit internal symptoms indicative of inattentive ADHD.
In childhood, ADHD in boys is 2 to 2.5 times higher than its prevalence in girls, but the number is nearly equal by adulthood. The causes of ADHD are still unclear, but the ADHD brain does not develop neurotypically from birth and there is a link to genetics, according to ADDitude Magazine.
So, it’s not that women are suddenly developing the disorder — instead, symptoms are overlooked or misdiagnosed in childhood. Generally, women seek ADHD evaluation once their child is diagnosed. Other women do not receive a diagnosis until untreated symptoms have caused their life to spiral out of control.
ADHD symptoms prevail into adulthood for one-third of patients diagnosed in childhood, according to the Centers for Disease and Control Prevention. It is not something a person can develop from watching too many cartoons and eating too much sugar, nor is it a disorder people “grow out” of. However, the severity of symptoms can vary in different stages of life.
Access to a range of researched-backed and accessible treatment options is necessary to meet patients’ needs as symptoms fluctuate. Medication, skills, training, academic support, counseling, ADHD coaching and educational resources are among treatment options for ADHD. Employing a combination of treatments is most effective at easing symptoms, but they may not be as effective for nonbinary people and women.
Counselors and ADHD coaches are not prepared to support the needs of nonbinary people. Surely, there are some counselors who are knowledgeable about the unique challenges nonbinary people and women with ADHD face. Still, treatment options will not be sufficient until all mental health providers are sufficiently informed.
Furthermore, thorough research can allow educators to better recognize the disorder’s various presentations. I was diagnosed with primarily inattentive ADHD during my sophomore year of college. I sought an evaluation because engaging with everyday tasks has felt like an uphill battle my entire life.
In high school, teachers would sit talkative or disruptive students next to me because I was quiet and made good grades. Little did they know, my reserved nature was a coping strategy to disguise constant feelings of inadequacy. Educators can’t intervene and offer a student help if they do not have the knowledge to recognize when they are struggling.
A diagnosis and treatment allowed me to understand my brain function is different, not flawed. Finding an effective treatment plan took time and money many people do not have. Adequate mental health access is a human right and should not be determined by proximity to wealth.
Gender socialization is to blame, too. School-age girls may develop compensatory techniques to hide their symptoms. Disrupting conversations or being chronically late do not meet society’s standards of a well-mannered girl.
Pressure to be put together all the time eventually wears on a person, especially those with an untreated disability. In adulthood, compensatory techniques often fail and result in women with low self-esteem, anxiety and depression.
The situation is much worse for nonbinary people. Outdated gender stereotypes cause them to be completely neglected in mental health conversations. Despite the clear link between gender and ADHD presentation, there isn’t any reliable published research about how ADHD affects nonbinary folks. This has led to a lack of resources for nonbinary people with ADHD to reference when learning about their treatment options.
Nonbinary people face a variety of unique social pressures that impact their mental health. Conversations surrounding mental health and gender identity have become more common, but nonbinary and other underrepresented gender groups deserve more than ill-informed infographics on social media.
Improving resources and research is a necessary step the U.S. mental health field is already decades behind on. Additionally, more sound literature will allow parents and teachers to be informed on the variety of ways ADHD can present in people.
The Adderall shortage will eventually improve. Until mental health research and surrounding conversations become more diverse, treatment outlooks for ADHD and other disorders will continue to be insufficient.
If you or someone you know needs assistance managing mental health, https://speakout.unt.edu/how-get-help lists resources available on-campus, online and around Denton.
Featured Illustration by Erika Sevilla
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