Autism Spectrum Disorder and ADHD: Understanding the Connection
- Bradley Melton
- May 22
- 5 min read
Updated: Jul 12
The Urgent Need for Research
The United States Health and Human Services (HHS) is focusing on researching the causes and treatments of various medical conditions. As a future mental health professional, I believe I can share valuable insights regarding neurological conditions. Specifically, I have an interest in autism spectrum disorder (ASD) and its connections with other issues, such as gender diversity.
Recently, a notable figure, RFK Jr., claimed we "will know the cause [of autism] by September." This assertion raises concerns because many scientists argue that ASD cannot be reduced to a single cause. It appears that these claims may be politically motivated rather than based on scientific evidence, especially considering the multifaceted nature of the condition.
Protecting Vulnerable Populations
The ongoing discourse often emphasizes protecting children and the "mentally feeble." While this may sound altruistic on the surface, it seems to reflect a more regressive cultural trend. For instance, there has been a growing push to ban gender-affirming care for youth and restrict research funding for LGBTQIA+ related topics.
I look forward to analyzing the upcoming report on ASD once it's released. In the meantime, I'm currently examining the research on Pediatric Gender Dysphoria care. Stay tuned for that!
While ASD remains a primary focus for HHS, I am concerned that attention deficit hyperactivity disorder (ADHD) may also come under scrutiny in this research. Studies have linked both conditions to gender variance, especially in transgender and gender-diverse (TGD) individuals.
ADHD has been recognized for a significantly longer time than ASD. Given my background, I intend to investigate its connection to TGD identities alongside recent, controversial journal articles exploring this relationship.
The World Federation of ADHD International Consensus Statement: Key Findings
A comprehensive document from the World Federation presents 208 evidence-based conclusions about ADHD. While this report contains substantial information, I will highlight the most relevant aspects here.
ADHD has been studied since a German physician first conceptualized attention deficits in 1775. That's nearly 250 years. However, stimulants, which are now commonly used to treat ADHD, were only introduced in 1937, 162 years later.
Understanding Symptoms
I will focus specifically on hyperactive-impulsive symptoms and how they affect individuals with ADHD. These symptoms often lead to increased aggression, risky behavior, and accidental injuries. Most notably, they can result in heightened peer rejection.
Peer rejection is a vital area to explore. It's estimated that 90% of individuals can recall a moment when they were ostracized by their peers. This experience can be particularly painful for those with ADHD.
While research on ADHD and gender variance is limited, it has suggested a correlation between peer rejection and the development of gender diversity.
Life Through Different Lenses
Here’s an analogy to illustrate how neurotypical individuals and those with ADHD navigate life: Life is like a wall one must travel through. Neurotypical individuals seem to intuitively fit through social norms, preserving the mold. In contrast, individuals with ADHD encounter variable deficits in this innate understanding. Each time they navigate this mold, it is altered.
This discrepancy challenges the underlying social norms. As a result, individuals with ADHD may come to see social roles, including gender roles, as arbitrary. Thus, they are more likely to question their gender identity.
Understanding ADHD and ASD as Biological Variations
Both ADHD and ASD can be seen as normal biological variations rather than "disorders." A condition is typically classified as a disorder if it causes noticeable distress or functional impairment. The paper mentioned earlier suggests that high-functioning individuals may not exhibit sufficient distress to be labeled as disordered.
Despite these good intentions, this perspective can be inherently ableist. High-functioning individuals often excel in specific fields. Society stands to gain from recognizing and utilizing the strengths of these individuals. However, this shift requires significant societal change.
The researchers appear to be leaning more toward the Neurodiversity Model rather than the Medical Model. This approach frames ADHD as a cognitive style rather than a deficit. Although this perspective recognizes ASD and ADHD as natural human variations, it is essential not to overlook the challenges faced by "high-functioning" individuals. Their distress may go unnoticed because it is not always outwardly observable.
The Impact of Neurotypical Standards
Neurodiverse individuals frequently experience heightened anxiety and depression due to communication issues arising from interactions with neurotypical peers. This struggle can be explained through the Minority Stress Model, which highlights the unique stressors faced by marginalized groups. While ASD is often characterized by social deficits, those with ADHD may experience similar challenges.
The ADHD and TGD Connection: A Systematic Review
Research exploring why TGD individuals are more likely to have ADHD is limited. Most studies thus far have focused on the connection between ASD and the TGD community. This inclination seems to be due to the noticeable impairments associated with ASD, which can create a more significant social divide.
A recent article presented as a systematic review delves into the ADHD and TGD connection. Here are some highlighted findings:
ADHD prevalence in TGD youth ranges from 2.4 to 12.6 times greater, doubling as they enter adolescence.
EMR (electronic medical record) data suggest that TGD adults have ADHD at a prevalence of 10 times higher than the general population.
Clinical studies show that between 6.8% and 21% of TGD youth meet the diagnostic criteria for ADHD.
Approximately 4.8% of ADHD youth self-report gender variance, nearly three times higher than neurodiverse controls.
The evidence suggests a strong correlation between ADHD and gender variance. Those with ADHD are found to be 6.64 times more likely to express a wish to be the other gender—a significant marker discussed in the World Professional Association of Transgender Healthcare's standards of care.
Future of Research and Advocacy
As I examine these intriguing findings, I worry about the future research landscape. The recent revocation of $800 million in LGBTQIA+ research grants by the National Institute of Health (NIH) and HHS poses a daunting challenge. Several states are also enacting policies making it increasingly difficult to access gender-affirming care.
One of my significant concerns is that research into the neurodiverse community could face increased scrutiny. While the UK is beginning to investigate ADHD and ASD as causes for gender diversity, equating neurodiversity with TGD status seems problematic.
In conclusion, I invite you to share your thoughts. Which aspects of TGD-ADHD research do you find most compelling? What gaps in understanding do you believe still need attention?
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