The transgender and gender diverse and attention deficit hyperactivity disorder nexus: A systematic review

Abstract

Introduction: Prior work suggests an increased prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among transgender and/or gender diverse (TGD) individuals. This systematic review summarizes primary literature on TGD/ADHD experience.

Methods: Texts from databases, reference lists, and referral were screened per PRISMA guidelines, with author consensus.

Results: Since 2014, 17 articles have been published on the TGD/ADHD nexus. Gender-affirming care specialists authored 65%. Seventy-one percent reported prevalence, per medical records. Only case reports discussed implications. None avoided deficit-framing, nor included explicit TGD/ADHD authorship.

Conclusions: The paucity of literature and lack of explicit TGD/ADHD community involvement are striking; each warrants increased attention.

Keywords:

• Transgender
• gender diverse
• neurodivergent
• ADHD
• literature review
• attention deficit hyperactivity disorder
• non-binary
• gender expansive

Ethics statement

This paper is a systematic review and therefore IRB approval was not required or relevant.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

All data are publicly available in the reviewed papers, as cited.

Notes

1 Neurodivergence, as coined by Kassiane Asasumasu in 2000, signifies “having a mind that functions in ways which diverge significantly from dominant societal standards of ‘normal’” (Walker, 2021, p. 38). Since its inception, neurodivergent (sometimes abbreviated “ND”) has evolved into most common use describing autistic individuals and/or those with Attention Deficit Hyperactivity Disorder (ADHD), though the broad term can include other experiences as well (e.g. depression, dyslexia, personality disorders).

2 Neurotypical, which can be abbreviated “NT” and used as an adjective or as a noun, means “having a style of neurocognitive functioning that falls within the dominant societal standards of ‘normal’” (Walker, 2021, p. 40). Neurotypical is a neutral descriptor counterpoint to neurodivergent, similar to how cisgender describes those who are not TGD.

Additional information

Funding

NA is supported in part by funding from the Social Sciences and Humanities Research Council’s Joseph-Armand Bombardier Canada Graduate Scholarship. TGG is supported in part by the NIH grant: R25MH119043 (University of Pennsylvania, Department of Psychiatry).