Gender Bias and Over Diagnosing ADHD

            Attention-Deficit/Hyperactive Disorder (ADHD), according to the Centers for Disease Control and Prevention (CDC), “is one of the most common neurodevelopmental disorders of childhood”; In other words, this is a disorder that develops at an early age and has symptoms that are visual and set their occupants apart from others. With symptoms that are presented through actions and behaviors, it brings the question: why is it that many girls weren’t diagnosed with ADHD during childhood when they present clear symptoms, all while boys are being over diagnosed?  

            The same story is repeated by women who were diagnosed with ADHD late in life: not being diagnosed until it had already driven us into depression and anxiety. The thing about human nature is that when a person has no idea what is going on with themselves, no clarity as to why their behaviors compared to others aren’t on the same spectrum, one begins to question themselves. This often stems from remarks made by those around them, like teachers, family, and even friends. Those around them “are unaware of the symptoms of inattentive ADHD and may write them off as moodiness or laziness”. With no escape from the feeling of disappointment from those around you and at yourself, one may become depressed.This is a continuous cycle that negatively impacts the person’s life: their academic career, work-life, as well as their day-to-day life. This continues until a diagnosis is made and one gains clarity and is then able to practice methods of those struggling with ADHD (Attention-Deficit/Hyperactive Disorder).

The time and effort that America has put into the research of ADHD lead many to believe that it is a disorder that is more prevalent in America and less in other parts of the world. Because of this theory, many think that the debate on the disorder (late diagnoses of girls and over diagnosing of boys) are also prevalent to America. This is in fact, a global issue that is debated constantly by different groups of psychiatrists. There are even records of ADHD being over diagnosed in boys in Iran. Gender bias is the culprit behind the corruption of the diagnosis process of psychiatrists all over the world. A study was done in Iran that focused on the diagnosing process of Iranian doctors of both genders. It was found that psychiatrists were 2.45 times more likely to over-diagnose boys than girls. Furthermore, it is mentioned that the reason for this gap is the different symptoms that each gender displays; girls are found to display more inattentive symptoms while boys are found to be more disruptive. This is where the alignment to gender bias can be made. In the society that we live in and the norms of society, there is an expectation when it comes to the behaviors of both genders. Girls are taught to be quiet, obedient, and to hold themselves together while boys are even encouraged to be disruptive. Boys will be boys, they say. Is it a surprise that the boys are disruptive and hyperactive when in fact the society we have lived and raised boys in, acts as an enabler for them to continue to do so?

 With that in mind along with the statistics and other facts are given, one can conclude the stance and tone of this source. The authors: Beheshti, Mira-Lynn, and Christiansen, introduced the discussion topic with the same template as that of a lab report which gives it an official look. Include the multitude of statistics and specifics regarding control groups and whatnot, one can conclude that the authors chose to inform readers of the true numbers behind the diagnostics of ADHD. Readers were given evidence and the tone was not meant to be one of persuasion. Instead, the authors gave readers a more logical viewpoint, also known as logos.

It can be drawn that the over-diagnosing as well as the lack of diagnosing when it comes to girls, has devastating consequences. Women with ADHD, especially those not having been diagnosed and overlooked, tend to suffer from depression, anxiety, substance abuse, and even eating disorders. Many have opened the topic up for discussion on a multitude of platforms, from newspapers, to journals, websites, and even magazines. The Talk of the Nation did just that. A psychiatrist, a host, and calls from women who have in one way, or another dealt with ADHD. One by one, the women shared their stories and the relationship they had with ADHD. For some, it was their children who were diagnosed and some of these mothers were diagnosed during their adulthood. These are compelling stories that were shared to show the disproportionality when it comes to diagnosing girls in comparison to boys. The psychiatrist mentions girls getting overlooked. The symptoms are apparent and noticed, but the correlation to ADHD is not made because of the difference in symptoms.

The issue with the disproportionality when it comes to the diagnosis of girls begins at an institutional level. The blame is on the healthcare system. Being that it is a healthcare system, one would expect that it should be used to spread knowledge on different disorders and be used to be aware/keep up to date on patients and changes in behavior and such. Instead, there is little to no research that has been done on women affected by ADHD and its long-term effects. If the healthcare system doesn’t spread awareness on the topic, or any topic for that matter, it’s not likely that many will be on the lookout for that specific circumstance. Take Covid-19 and Omicron as an example. The CDC keeps nd continues to keep the population and those around the world in touch and gives guidance on the disease and ways to stay safe. If not, many more people would have died and there wouldn’t be any awareness or information to protect yourself and those around you.

When it comes to bringing awareness and creating collaborations, the healthcare system and the education system should be creating many. With these collaborations comes the opportunity for the healthcare system to train teachers, administration, and even parents about disorders and things to be on the lookout for. According to Morning Sign Out, this is the primary issue. Parents and teachers have no clue what to be on the lookout for. Not only that, but even with doctor evaluations, boy diagnosis to girl diagnosis is 9:1. This is a huge gap.

The host of the broadcast Talk of the Nation is Allison Stewart, and she makes it a point to touch base on the lack of research that has been done. She even goes as far to mention someone needs to take the initiative: “I found myself just a little bit angry that there wasn’t more research about girls, and that all these young women and girls out there struggling with this problem, and there hasn’t been a whole lot of attention paid to it. What’s going to change that?”. As a host of a show, author, or anything where people look to you for information, it isn’t common to give opinions and stances on a topic; especially when there is a professional involved to inform and educate. In this case, Allison Stewart, the host, wasn’t afraid of voicing her take on the topic. Stewart uses persuasion (pathos) to get this point across and express the changes she feels should be made.

Looking at all the evidence found, one can conclude that there is in fact over diagnosing of boys for ADHD and very little diagnosing of girls. Within the different sources used for this topic, there are also different tones, stances, and methods being presented. From pathos to logos, the use of persuasion, and even statistics. All show the same point being made with different methods. With the language changes from source to source, one could tell that certain sources were meant for specific audiences. An example is the newspaper passage on the conversation between a psychiatrist, the host, and those affected by ADHD. This specific text pulling on the heartstrings of those reading is meant for those out in the world also affected by the disorder; to just let them know that they aren’t alone and that there is a safe space to talk and share their life with the disorder, and to also receive advice.

Through all the research found, there is a common theme: there is recognition that there is an issue in the health system regarding ADHD diagnosis in boys and girls. Boys are over-diagnosed, and girls underdiagnosed, and at a global scale at that. There are calls for change from those who have experience with this issue, as well as a call from people with platforms like Allison Stewart. Many have come out and shared their story bringing even more attention to ADHD. This attention can one day, hopefully, bring about the solution that traumatizes many women in their later stages of life.  

Work Cited

1. Beheshti, Ashkan, et al. “ADHD Overdiagnosis and the Role of Patient Gender among Iranian Psychiatrists.” BMC Psychiatry, vol. 21, no. 1, 2021, https://doi.org/10.1186/s12888-021-03525-3.
2. “Diagnosis Can Miss ADHD Symptoms In Girls.” Talk of the Nation, 18 Nov. 2008. Gale Academic OneFile, link.gale.com/apps/doc/A189231690/AONE?u=cuny_ccny&sid=bookmark-AONE&xid=f4029174. Accessed 25 Feb. 2022.
3. “Study Findings from University of Marburg Provide New Insights into Attention Deficit Hyperactivity Disorders (ADHD overdiagnosis and the role of patient gender among Iranian psychiatrists).” Women’s Health Weekly, 11 Nov. 2021, p. 631. Gale Academic OneFile, link.gale.com/apps/doc/A681529233/AONE?u=cuny_ccny&sid=bookmark-AONE&xid=ada84665. Accessed 25 Feb. 2022.
4. Ajith, Gouri. “Morning Sign out at UCI.” Morning Sign Out at UCI, 17 Mar. 2018, https://sites.uci.edu/morningsignout/2018/03/17/the-gender-gap-bias-in-adhd-diagnosis/.
5. Faraone, Stephen V et al. “The worldwide prevalence of ADHD: is it an American condition?.” World psychiatry : official journal of the World Psychiatric Association (WPA) vol. 2,2 (2003): 104-13.