Gender Dysphoria and ADHD

Neurodivergent advocacy and advocacy for transgender and gender-diverse people are connected because both respond to systems that deny care, credibility, and autonomy to people who fall outside narrow norms. In both cases, harm comes not from identity or neurotype, but from institutions that try to suppress difference instead of supporting it.

This context matters when we read research about overlap, distress, and diagnosis.

Many clinicians and advocates have noticed that some adults seeking care for gender-related distress also describe lifelong attention or regulation challenges. Until recently, this overlap has been discussed more in clinical practice than in research.

A new clinical study helps clarify this pattern.

Researchers examined ADHD symptoms in adults who were newly diagnosed with gender dysphoria and looked at how those symptoms related to distress and daily functioning.

What the Study Looked At

The study focused on two questions:

  • How often ADHD symptoms were present in adults with gender dysphoria
  • Whether ADHD was linked to differences in distress or daily functioning

The purpose was to better understand patterns that may affect care and support.

How the Study Was Done

The study included 81 adults who were newly diagnosed with gender dysphoria at a specialized clinic.

Key details:

  • All participants were adults
  • None had started hormone treatment at the time of assessment
  • Gender dysphoria diagnoses were made by trained psychiatrists
  • ADHD symptoms were screened using a well-known self-report questionnaire
  • Participants were grouped into:
    • adults with gender dysphoria and ADHD symptoms
    • adults with gender dysphoria without ADHD symptoms

This was a cross-sectional study.

It looked at patterns at one point in time. It does not show cause and effect.

Concepts to Understand

Gender Dysphoria

Gender dysphoria refers to distress related to a mismatch between sex assigned at birth and gender identity. The diagnosis describes distress, not identity.

ADHD Screening

This study used a validated questionnaire to screen for ADHD symptoms in both childhood and adulthood. Screening is not the same as a full diagnostic evaluation.

What the Study Found

The findings showed clear patterns in how ADHD symptoms were linked to distress and daily functioning.

ADHD Was Common

About one-third of the adults in the study met criteria for ADHD symptoms in both childhood and adulthood.

This rate is higher than what is usually seen in the general adult population.

Takeaway:

ADHD symptoms were common in this clinical group and worth paying attention to.

ADHD Was Linked to More Distress

Adults with both gender dysphoria and ADHD symptoms showed:

  • higher levels of depression
  • higher levels of anxiety
  • more difficulty with daily functioning
  • more overall mental health diagnoses

These differences appeared even though gender dysphoria severity was similar across groups.

Takeaway:

When ADHD symptoms were present, daily life tended to feel harder.

ADHD Did Not Increase Gender Dysphoria Severity

The study found no meaningful difference in gender dysphoria severity between adults with and without ADHD symptoms.

Takeaway:

ADHD affected coping and functioning, not gender identity or the intensity of gender-related distress.

Diagnostic Complexity Was Higher in the ADHD Group

Adults with ADHD symptoms were more likely to have additional diagnoses related to emotional regulation and substance use.

The authors note that ADHD can overlap with other diagnostic categories, especially when emotional regulation is difficult.

Takeaway:

Without careful assessment, ADHD-related difficulties may be misunderstood.

A Key Pattern Worth Noticing

ADHD helped explain why distress and daily life challenges were greater for some adults.

ADHD was linked to:

  • higher emotional intensity
  • greater sensitivity to stress
  • more difficulty managing systems and expectations

Takeaway:

Identifying ADHD can change how distress is understood and how support is offered.

What This Means for ADHD Advocates

For ADHD advocates, this study highlights several important points:

  • ADHD may be common in adults seeking care for gender dysphoria
  • When ADHD is missed, people may appear more distressed or more complex than they are
  • ADHD affects follow-through, scheduling, and stress management, especially in healthcare settings
  • Screening can clarify support needs rather than increase stigma

Advocacy here is about better understanding and better support, not about labeling.

Strengths and Limits of the Study

What the Study Did Well

  • It was conducted in a real clinical setting
  • It used standardized tools to assess ADHD, anxiety, and depression
  • It compared adults with and without ADHD symptoms
  • The ADHD screening tool showed strong reliability, meaning it measured symptoms consistently

What the Study Could Not Answer

  • ADHD was identified through screening, not full diagnostic interviews for everyone
  • The study took place at a single clinic
  • The design does not show cause and effect
  • Trauma history was discussed but not measured using validated tools

These limits matter when applying the findings more broadly.

Key Insight to Leave With

In this clinical study, ADHD symptoms were common among adults with gender dysphoria and were linked to higher emotional and functional strain.

Recognizing ADHD helps explain why daily life may feel harder and where support can be better targeted.

Cecchelli, C., Moradei, C., Cocchetti, C., & Grassi, G. (2025). Gender dysphoria and neurodevelopmental disorders: Prevalence of attention-deficit/hyperactivity disorder (ADHD) among adults with gender dysphoria and their clinical phenotype. Clinical Neuropsychiatry, 22(6), 507–516.

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