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Can ADHD Cause Gender Dysphoria? An In-depth Study

Can ADHD Cause Gender Dysphoria? An In-depth Study

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Neurodevelopmental disorders, including ADHD and gender dysphoria, have become a point of controversy in both medical and social fields. ADHD is a learning disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that hampers a person’s emotional and social life. Gender dysphoria, in contrast, is the discomfort felt by people who are trapped in the wrong body; that is, gender does not align with the sex at birth.

In the last years, many investigations and clinician experiences have highlighted the possible association between ADHD and Gender Dysphoria. This overlap raises important questions: Does ADHD contribute to or worsen gender dysphoria? It may be interesting to know in what ways these two conditions might affect one another.

This article discusses how gender dysphoria and ADHD are connected and cognitive, psychological, social, and neurological components as well. Additionally, the most important concern is whether ADHD causes gender dysphoria or not.

Comprehending ADHD

To assess how ADHD can potentially be associated with gender dysphoria, it is necessary to get familiar with the features of ADHD. It is a global neurodevelopmental disorder that usually begins in childhood but continues through adolescence and adulthood. It is characterized by symptoms that fall into two broad categories:

  • Inattention: Inattention, forgetfulness, lack of organization, and making a lot of avoidable errors and mistakes.
  • Hyperactivity and Impulsivity: Fidgeting, speaking excessively, interrupting others, impulsiveness, and not considering the consequences of his actions.

ADHD is a global disorder that is estimated to affect 5-10 percent of school-going children, and boys are more affected than girls. Still, it is believed that girls are underdiagnosed because of different symptoms. ADHD can lead to inabilities concerning executive control, mood management, and interpersonal relationships in education or work as well as in interpersonal relationships.

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Gender Dysphoria: Definition and Symptoms

Gender dysphoria is the psychological distress caused by a mismatch between one’s assigned gender at birth, and one’s experienced or expressed gender.

Gender dysphoria is the distress resulting from the mismatch between a person’s assigned gender at birth and their expressed gender. For instance, an individual who was born with female biology might present themselves as a man or prefer to be called non-binary but will endure a lot of discomfort and unease if they are forced to live as a woman.

Symptoms of gender dysphoria include:

  • The need to feel like the other sex or the sex to which the person is not assigned at birth is a compelling wish.
  • Refusal of stereotyped gender roles or models.
  • Continuous dissatisfaction with the match between gender and physical characteristics.

Gender dysphoria is not the same thing as being transgender. Even though many transgender people endure Gender Dysphoria, some are not affected at all. In addition, it is also important to note that not everyone who has gender dysphoria is transsexual because gender can be complex and fluid.

The Intersection of ADHD and Gender Dysphoria

Recent studies pointed to the theory that ADHD sufferers have a higher prevalence rate of gender dysphoria than the average population. Strang’s work, published in 2014, showed that children diagnosed with ADHD were more likely to be gender variant at six times the rate of children without the disorder. Although it was not the aim of this research to establish cause and effect relationship, the research made a basis for further research on the link between ADHD and gender dysphoria.

Several possible explanations have been proposed to explain the connection between ADHD and gender identity:

  • Impulsivity and Self-Expression: One hypothesis is that individuals with ADHD, especially those with the impulsive-hyperactive subtype, may be less inhibited about exploring their gender identity. Impulsivity may lower the social barriers that often prevent neurotypical individuals from questioning or rejecting their assigned gender. The feeling of impulsiveness could reduce the level of social conditioning that denies people with neurotypical characteristics the right to question or reject their assigned gender. Those with ADHD may also be more likely to disobey traditional norms and participate in male/female nonconforming behaviors because they have poor impulse control and are fixated on individualities.
  • Executive Functioning and Identity Exploration: ADHD impacts executive abilities and higher mental activities, which include planning, decision-making, and self-control capability. This may be an issue for a person with ADHD in that their tendency to not conform can work against them regarding socially constructed gender roles of male and female. ADHD persons may be in a better position to come out indicating non-binary or fluid gender than others who feel boxed because of such norms.
  • Emotional Dysregulation and Distress: The inability to control emotions is part of the clinical picture of ADHD, and controlling feelings of anger, anxiety, and depression is nearly impossible. This emotional instability may heighten the feelings of gender dysphoria as people with ADHD may experience more emotional stress from not being able to conform to male or female roles. A study conducted to compare rates of depression and anxiety between the two conditions has revealed that both ADHD and gender dysphoria cause one to develop the other and, therefore, escalate the rates of depression and anxiety.
  • Social Rejection and Isolation: ADHD is associated with social challenges, as is gender dysphoria. Children with ADHD are rejected by their peers because of their impulsiveness, inability to follow rules, or academic problems. Likewise, gender-nonconforming people may face a situation of rejection or prejudice. The combination of social problems that may appear in patients with both ADHD and gender dysphoria can result in the aggravation of feelings of isolation and create a vicious circle involving low self-esteem and mental disorders.
  • Hyperfocus and Gender Exploration: Despite that, there are times when an ADHD person gets selectively attentive, or, as it is called, hypo-focused, or, in other words, gets obsessed with specific stimuli. As a form of hyperfocus, the case of some ADHD patients may experience unrelenting fixation with their gender identity. It can cause people to ask more questions about gender binary or more gender dysphoria; this is due to their higher preoccupation with gender issues.

Neurological Overlap

Another point that some researchers have advanced is that there might be some kind of neurological connection between ADHD and gender dysphoria. ADHD, in particular, is linked to the dysfunctional regulation of the dopaminergic system seen in the brain that provides for motivations, rewards, and emotions. Some researchers have argued that dopamine pathways are also engaged in response to other matters concerning self-image and personal identity, as well as social relationship structures. These neural circuits might be abnormal in children with ADHD and in those children who show signs of gender dysphoria.

Also, ADHD and gender dysphoria are said to have abnormalities in the gray matter density in specific regions of the brain, which include the prefrontal cortex and the anterior cingulate cortex, which are responsible for self-control, decision-making, and emotional regulation, respectively. Although further studies are required to characterize these relations between both disorders from a neurobiological perspective, there is enough evidence to consider that there may be a biological relation between both pathologies.

Read More: Bipolar Disorder Vs ADHD: Learn The Symptoms

Managing Co-occurring ADHD and Gender Dysphoria

ADHD self-esteem issues could be prevalent, and combined with frustration and anxiety in clients with ADHD, they could be further worsened by gender dysphoria.

  • Therapy: Both ADHD and gender dysphoria can be treated with Cognitive-behavioral therapy or CBT. In case a patient has both the mentioned conditions, the therapy can be aimed at developing impulse control together with addressing the issues of emotional dysregulation, that is, from one side, and affirmation of gender identity from the other. Gender-affirming therapy, especially, is effective in decreasing gender dysphoria distress caused by the disparity between the client’s gender identity and the assigned gender at birth.
  • Medication: ADHD medication includes stimulants, which include Adderall and Ritalin; they help with concentration and minimize impulsiveness. However, clinicians should also pay attention to how these medications affect gender dysphoria emotions since stimulants can, on occasion, precipitate anxiety or mood fluctuations.
  • Support Networks: Sufferers of ADHD and gender dysphoria should ensure that they have built a strong community. Neurodiverse people, as well as the LGBTQ+, can get support from the group, and this will reduce the feeling of loneliness.

Conclusion:

Seeking help for ADHD or gender dysphoria? Orange Coast Psychiatry can assist you.

ADHD and gender dysphoria may have numerous psychological, social, and neurological connections, though these connections are not yet very clear. Even though ADHD has never been linked to gender dysphoria, research indicates that gender-variant behavior is more persistent in the ADHD population. Impulsivity, mood swings, and loneliness may either cause or worsen gender dysphoria in people with ADHD. We still do not know much about these links, but people with both disorders should seek therapy and medication and turn to support groups.

Frequently Asked Questions

Some of the symptoms of ADHD can worsen gender dysphoria, and this is not a shock to many professionals. For instance, using ADHD as an example, people have problems with their temper, which complicates the tasks of gender dysphoria.

ADHD and gender dysphoria cannot be cured. But, people with both these illnesses can have a better life and cope with the symptoms if treated properly.

Gender dysphoria can also moderate ADHD symptoms. For instance, people who suffer from gender dysphoria can also get worried easily and, therefore, find it hard to concentrate well.

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Shaheena Gazipura

PMHNP-BC

Richard Samedra, PMHNP-BC, is a Board Certified Psychiatric-Mental Health Nurse Practitioner. He brings over 12 years of experience in the mental health field, working with clients facing a wide range of acute and chronic mental health conditions. His journey began as a Licensed Vocational Nurse and Charge Nurse at Westminster Therapeutic Residential Treatment, where he supported clients dealing with anxiety, depression, schizophrenia, bipolar disorder, and substance use disorders. Richard’s dedication was centered on helping these individuals improve their mental health and transition to a lower level of care, whether that meant returning to their families, a board and care facility, or a sober-living environment.

Motivated by a growing passion for mental health care, Richard pursued his Registered Nurse (RN) education at Saddleback Community College and later transitioned to La Palma Intercommunity Hospital Behavioral Health. In this role, he specialized in geriatric psychiatry, working with older adults experiencing conditions such as Parkinson’s disease, dementia, depression, and anxiety. This experience solidified his commitment to mental health, leading him to work at Bellflower Community Hospital, where he provided care for patients experiencing severe psychiatric crises, including suicidal ideation, manic and depressive episodes, substance use disorders, and exacerbated schizophrenia symptoms.

Inspired by the impactful work of PMHNPs at Bellflower, Richard enrolled in the Psychiatric-Mental Health Nurse Practitioner program at Azusa Pacific University. To broaden his expertise, he worked full-time at College Hospital Costa Mesa while completing his studies. There, he gained comprehensive experience across various units, including adolescent, acute men’s and women’s, stabilization, and detox/med-surg. Now, as a PMHNP, Richard is committed to leveraging his diverse background and knowledge to provide compassionate, comprehensive care to those in need.

Richard currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where he is supervised by Dr. Montgomery.

 

Shaheena Gazipura

PMHNP-BC

Shaheena Gazipura is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) with over 9 years of dedicated experience in both inpatient and outpatient mental health care. She earned her Master of Science in Nursing from Western University of Health Sciences in Pomona, California.

Shaheena began her career working on an adult psychiatric inpatient unit before transitioning to the geriatric psychiatric inpatient unit at USC Verdugo Hills Hospital. In addition to her clinical work, Shaheena also serves as a Nursing Clinical Instructor, guiding the next generation of nurses through their mental health rotations at a large community college.

Shaheena is a passionate advocate for mental health, believing that it is a fundamental pillar of overall well-being. She is committed to reducing the stigma surrounding mental illness and strives to provide comprehensive, compassionate care that honors each individual’s unique experiences and challenges. Her goal is to create a supportive, nonjudgmental environment where patients feel empowered to work alongside her in achieving their mental health goals.

Outside of her professional life, Shaheena enjoys exploring new culinary experiences, staying active through exercise, and planning her next travel adventures.

Shaheena currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where she is supervised by Dr. Barrios.

Clint Nacar

PMHNP-BC

Clint Nacar, PMHNP-BC is a Board Certified Psychiatric-Mental Health Nurse Practitioner. Mr. Nacar graduated from Charles R. Drew University of Medicine and Science. Currently Mr. Nacar works in an inpatient psychiatry unit at a leading academic medical center in Los Angeles, Renewed Mental Health Group, and Orange Coast Psychiatry

Mr. Nacar brings over 7+ years of experience with the mental health population. He works to help patients take control of their mental health through patient education, psychotherapy and medication management. Mr. Nacar’s areas of focus include: Depression, Anxiety, Adjustment Disorder, Bipolar disorder, Attention Deficit Hyperactivity Disorder (ADHD), and Post-Traumatic Stress Disorder (PTSD). Mr. Nacar treats children ages 6+, adolescents, and adults, offering both in-person services and telehealth at Renewed Mental Health Group.

With the collaboration of each patient, Mr. Nacar strives to develop individualized plans of care addressing each patient’s unique situation and concerns. He also encourages each patient to take charge of their mental health through a holistic approach while also employing the latest evidence based practices in treatment.

Clint is one of our most experienced Psychiatric-Mental Health Nurse Practitioners at Orange Coast Psychiatry and is 103NP Licensed in the State of California.

Cristian Cuevas

PMHNP-BC (Fluent in Spanish)

Cristian Cuevas, PMHNP-BC, is a highly skilled board-certified psychiatric mental health nurse practitioner with over seven years of experience in inpatient psychiatry and mental health.

A California State University Long Beach graduate, Cristian also earned recognition as a board-certified psychiatric mental health registered nurse. With a wealth of expertise in adult psychiatric care across the lifespan, Cristian has successfully diagnosed and treated a diverse range of mental health disorders.

Additionally, his specialized experience in child and adolescent inpatient populations further enhances his ability to provide comprehensive and compassionate mental health care.

Cristian Cuevas is the Lead Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry and is supervised by Dr Barrios.

Griselda Hernandez

PMHNP-BC (Fluent in Spanish)

As a licensed Psychiatric-Mental Health Nurse Practitioner (PMHNP) with a robust background in psychiatric and substance abuse nursing, Griselda provides compassionate, evidence-based care to individuals facing mental health and addiction challenges. The core of her practice focuses on promoting holistic wellness, fostering resilience, and empowering patients in their recovery journey. Specializing in the assessment, diagnosis, and treatment of adolescents with various mental health disorders, Griselda strives to create a therapeutic environment where patients feel valued, respected, and supported.
“My approach is grounded in years of diverse experience, including work in psychiatric units and medical detox units for both adults and adolescents. This extensive background has equipped me with the skills and knowledge to manage complex psychiatric and substance abuse conditions effectively. I am committed to staying updated with the latest advancements in psychiatric care, integrating cutting-edge therapies and best practices into my treatment plans. Collaboration is key to my practice; I work closely with multidisciplinary teams, families, and community resources to provide coordinated and comprehensive care tailored to each individual’s unique needs.”
Griselda holds a Master of Science in Nursing with a specialization in Psychiatric-Mental Health from West Coast University, and a Bachelor of Science in Nursing from The University of Alabama, Tuscaloosa. Additionally, she is fluent in the English and Spanish language, enhancing her ability to connect with a diverse patient population.
Griselda currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where she is supervised by Dr. Barrios.

Dr Barrios

Board-Certified Child and Adolescent Psychiatrist

Dr. Carlos Barrios is a Board-Certified Child and Adolescent Psychiatrist with over two decades of experience in mental health care. His expertise in telepsychiatry has allowed him to serve patients across California and beyond. In his practice, Dr Barrios integrates metabolic and functional methodologies, focusing on guiding patients toward medication independence and emphasizing the connection between physical and mental health.
Outside of his professional life, Dr Barrios is passionate about kettlebell training, which helps him maintain my physical and mental wellness. He cherishes visiting his family in Guatemala, to reconnecting with his cultural roots and rejuvenating his spirit. Dr Barrios is also deeply involved in transcendental meditation and rucking, practices that not only provide him with tranquility but also keep him grounded and connected to nature. These hobbies reflect his commitment to a holistic approach to health, both personally and professionally.