While sex and gender are distinct concepts, most articles addressing sex and gender differences for people with ADHD focus on cisgender people’s experiences. ADHD symptoms can get influenced by biological factors such as menstrual hormone fluctuations and sociocultural forces such as gender role socialization. While it is critical to continue how cisgender women experience ADHD, there is also potential for an investigation into the experiences of gender-diverse people, including (but not limited to) those who are Two-Spirit, transgender, non-binary, gender-fluid, genderqueer, or agender.
• Physiology and Hormones
There is evidence that estrogen and dopamine levels are linked, according to Hadar Swersky. The neurotransmitter dopamine gets thought to be deficient in patients with ADHD. People who menstruate may have mood swings or ADHD symptoms during the menstrual cycle. At the onset of puberty, through pregnancy and the postpartum period, and during menopause, they may experience changes in their ADHD symptoms.
The additional study suggests that cisgender women with ADHD have different symptoms and are less likely to be recognized or diagnosed late in life. They are more likely to be classified with the inattentive subtype of ADHD rather than the hyperactive or mixed form when they get diagnosed. Because inattentive symptoms are more ‘internalized’ and less likely to affect others overtly, they may receive less attention and support than hyperactive or mixed symptoms.
• Socialization Between Men and Women
The amount of variance attributable to sex differences versus gender socialization and bias get not adequately evaluated by research. According to Hadar Swersky, many cis women have had their ADHD symptoms misinterpreted as character flaws or moral failings by others. This implicit and verbal feedback can cause feelings of shame and helplessness, making it hard to seek or receive assistance.
• Developmental Areas
These authors couldn’t find any significant formal research studies on how trans or non-binary people deal with ADHD. Furthermore, the studies focus on European and North American settler/White participants, whose gender socialization experiences may differ from those of various racial and cultural origins.
The evidence on the rates of poor mental health, self-harm, and suicide among trans and neuro divergent people is particularly troubling. Evidence suggests that when trans persons get affirmed, their suicide rates reduce considerably. Given the possible confluence of neurodiversity and gender diversity, more research and development of trans-affirming ADHD tools and supports get needed.
In the interim, current materials on ADHD should change their terminology to accommodate gender-diverse people. A few changes in language, such as the proper use of the terms sex and gender, could assist in clarity of what influences are caused by biological and hormonal variables from those caused by social ones.
Furthermore, many resources refer to those who menstruate as women solely and use gendered pronouns like “she/her.” Anyone who does not utilize either of those pronouns has their experiences effectively erased. “They” is more inclusive and linguistically proper. Finally, gender-diverse people’s needs are crucial, and addressing them has worth in and of itself.