When Christa Lei As they struggle to conform to gender stereotypes, they find an unexpected ally in their neurodivergent brains.

The 32-year-old writer, who lives in Brooklyn, grew up in Hawaii as the youngest child of Filipino immigrants. Diagnosed at age 17 Attention deficit hyperactivity disorder (ADHD)– a developmental disorder that can lead to inattention, hyperactivity, and impulsivity just before senior year of high school. It took a decade before they figured out their gender identity, but they say living with and understanding ADHD gave them the tools to explore life outside the gender binary.

“The breadth of human experience is so vast that it cannot be contained in small sentences,” Lei said, reflecting on his journeys. “Life is so beautiful and comprehensive that it is hard for me to imagine putting myself in a small box.”

Although researchers have not found a direct cause-effect relationship between ADHD and gender diversity, An article from 2022 Psychology Center It reveals that those living with ADHD may question their gender or experience dysphoria more frequently than those without. One 2014 study On gender differences in people living together autism spectrum disorder (ASD) and when looking at ADHD, participants with ADHD were almost seven times more likely to express gender diversity.

Recent research also finds higher rates of ADHD among LGBTQ+ individuals compared to the general population:

• 2021 study Psychiatry Research Found LGBTQ+ adults three times more likely to be diagnosed with ADHD
• Gender diverse youth 6.6 times more likely Expressing gender differences if ADHD is present
• Among transgender and gender diverse individuals, 75 percent of those diagnosed with ADHD with gender dysphoria
• Between 2006 and 2014, a report found that transgender and nonbinary youth were three to 13 times more likely to have mental health conditions than their cisgender peers. mostly ADHD and depression

John F. StrangD., a neuropsychologist and director of the Gender and Autism Program at Children’s National Hospital in Washington, DC. a press release.

“In ADHD, difficulties in inhibiting impulses are at the heart of the disorder and can result in difficulty keeping gender impulses ‘hidden’ despite internal and external pressures against opposite gender expression.” he said.

Strang noted that neurodivergent children and adolescents may be less aware of social restrictions on expressing gender difference and less likely to avoid expressing these tendencies. “It can also be theorized that overly rigid or ‘black and white’ thinking may result in a more intense or absolutely rigid interpretation of such a child’s mild or moderate gender nonconforming tendencies,” he added.

Given the nature of Lei’s ADHD and their need to rely on creative ways to find personal structures that work for them, they view these two intersecting identities not only with curiosity but also humor.

“In ADHD, the mind is already (inherently) strange,” they said.

Expansion of studies on gender nonconformity and ADHD

Teddy G. Goetza non-binary psychiatry resident University of Pennsylvania and depends on it Eidos LGBTQ+ Health initiative, in Philadelphia, published a study Earlier this year, we sat down with neurodivergence and gender difference expert Noah Adams.

their work, “The Transgender and Gender Diversity and Attention Deficit Hyperactivity Disorder Nexus: A Systematic Review.” challenged the incomplete framework that often emerges in discussions of gender diversity and neurodivergence. Researchers have published 17 papers on the trans and non-binary and ADHD connection since 2014, but the main problem they found is that authorship from people in this intersectional community is still missing.

Emotional regulation is another big piece of the puzzle. Cate Osburnis an author, speaker, educator, and content creator specializing in the intersections of neurodivergence, gender, intimacy, and communication. Osburn, who uses both “he” and “they” pronouns on TikTok, gathered He has more than 1.6 million followers and more than 50 million likes.

osburn said guess basis It is stated that ADHD can cause emotions to intensify, making emotional management even more difficult. When combined with the stress or anxiety of social pressures around gender norms, feeling like an outsider can be overwhelming and damaging to self-esteem and confidence.

“If you struggle with forgetfulness or impulsivity due to ADHD and then face stigma for expressing your true gender identity, this can increase your feelings of self-doubt or inadequacy, especially when combined with common ADHD-related issues such as rejection sensitivity, perfectionism, and guilt or shame,” said Osburn, who falls outside the gender binary.

How does a gender-based approach to ADHD diagnoses miss non-binary people?

Even gender-affirming means of expression, such as bonding or tucking in, can be difficult for people with ADHD, according to Osburn. This can conflict with common methods of gender expression, as sensitivity to textures, temperature, or tight clothing can strain the senses. This makes it even more difficult to figure out what is “right” for a neurodivergent gender non-conforming person.

Medical ways to diagnose ADHD are deeply embedded in the gender binary.

2020 report, “Gender differences in adult ADHD” found that boys scored higher on a scale of childhood symptoms. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)found that there was a gender difference leaves women undiagnosed When it comes to timely diagnosis. They argue that untreated ADHD in women (presumably cisgender) persists for longer periods of time, while men (presumably cisgender) tend to receive diagnosis and treatment earlier.

Osburn’s ADHD diagnosis arose from a gender-based medical problem: The twisting and removal of her ovaries caused Osburn’s hormones to change so rapidly that ADHD medical experts overlooked Osburn’s entire life, it suddenly became clear. Although healthcare providers are often not trained to navigate conversations with nonbinary patients, Osburn sees the importance of nuance.

Osburn noted: female assigned at birth (AFAB) experience hyperactivity and impulsivity more internally, assigned male at birth (AMAB) Especially in childhood, they experience hyperactivity and impulsivity as external behavioral difficulties.

“If a post-male student is having difficulty in school, his ADHD may not be similar to that of his AMAD peers, but that does not make his experience any less valid or important,” Osburn said. People with ADHD who also menstruate are much more likely to experience premenstrual dysphoric disorder (PMDD), depression, anxiety, chronic pain, higher rates of eating disorders, self-harm, and orgasm difficulties, Osburn explained.

“The hormonal cycle of a person experiencing menstruation greatly and dramatically affects not only the severity of ADHD symptoms but also the effectiveness of medications. Individuals with ADHD who have a penis are more likely to experience emotional dysregulation, substance use disorder, erection problems, and even car accidents.” .

A keener awareness of perception

Jireh Deng getting ready before leaving the house “takes a really long time.” Deng is a nonbinary journalist and staff writer Los Angeles Times tells guess basis They say it took considerable effort to thoroughly consider how they presented their gender in the institutional setting, and that transitioning as someone diagnosed with ADHD during the pandemic was difficult.

Deng, who finds being misgendered by men more distressing, said: “I hate being perceived by men when I’m wearing a more feminine outfit outside, and I feel like my insides are being pushed out.” women. “I think part of this has to do with where I fit into the heteropatriarchy; Men have felt more entitled than women to touch or grab me in public spaces, and I think my intense aversion to being detected or worried about it has to do with my ADHD.

As the child of immigrants from Taiwan and Hong Kong, Deng feels additional pressure: the unique expectation of gender roles that they must fill as an excellent student, even though her brothers struggle just as much and are supported in taking medication. For Deng, expectations were compounded by gender and sexuality.

“My parents never brought up my ADHD, homosexuality, or gender presentation in the past because I did well in school and I guess for a long time I just hoped that my weird side would go away and I would eventually be back to factory settings. ”

Embracing Deng’s nonbinary and ADHD identities felt like a journey of self-acceptance, finding ways to ground themselves. These days, when they feel overwhelmed and overstimulated, they allow themselves to take a step back by stepping away from their phones and electronic devices and going surfing on the weekends.

“It’s really important to honor your feelings and show up as authentically as you can,” said Deng, whose confidence and self-acceptance has improved and she is happier since she stopped hiding. “I truly believe that accommodation is not just an option, but a necessity.”

Lei believes that being non-binary and having ADHD encourages them to remain emotionally open. At this intersection of experiences, it is crucial to embrace the unknown and maintain curiosity despite the lack of research and answers.

“People are so rigid. Stay curious because only you will know what works for you.