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Diagnosing Inequality: ADHD Diagnoses Showing Symptoms of Gender Inequality



Looking back on my behavior as a child, I realize two very important things.

One, that I was exceptionally hyperactive. I had no impulse control, no sense of boundaries, and the phrase “be quiet” (although I heard it often), was an insult to my five-year-old self.

The second thing I realize is how, despite all the times I randomly cut other kids’ hair, bolted out of school just because I felt like it, and threw temper tantrums over nap time, no one ever thought hey, maybe that crazy kindergartener who yells bad words to see what teachers do has ADHD?

Instead, I just got scolded, over and over again, all my teachers since pre-K yelling at me for being a “bad kid”. In fact, adults drilled that sentence, that declaration, “you are a bad kid” so far into my head that, by second grade, I accepted it as fact, as one of my defining characteristics.

My name is Elinor. I have brown hair and blue eyes. I like mac and cheese, my first chapter book was “Junie B. Jones”, and I am a bad kid.

Sometime during second grade, I discovered that there was a condition—a legitimate, medical condition—that could explain all my “bad” behavior. It was called Attention Deficit/Hyperactivity Disorder, or ADHD, and it was becoming quite common among boys in my class. It seemed like every other day another boy was pulled aside, their parents called, and a prescription for Ritalin handed to them.

I figured it was only a matter of time before the same happened to me. After all, I was far more hyper than most of the boys being diagnosed. But the days, then weeks, then months passed by, and I was stuck getting lectures about how I needed to “control myself”, while any boys refusing to sit for circle time got special treatment.

For a while I was just confused about the whole thing. While I knew I wasn’t a doctor and couldn’t be sure if I had ADHD, I did know that most of those boys had much milder symptoms than I did. On one occasion, I even went so far as to test my theory that I was invisible to any sort of medical concern. After observing a male classmate of mine be summoned by the Childhood Behavioral Disorder Gods after flipping out when he wasn’t allowed to stand during circle time, I decided to act up on purpose and see what happened. One afternoon, while my teacher read us some lame picture book, I began flapping my butterfly-positioned legs up and down. After maybe ten seconds, my teacher told me stop. I did, briefly, but then I started back up. Again, my teacher paused the story and asked me to stop flapping my leg-wings. But I was on a roll, putting on what I thought was the perfect performance of a hyperactive kid, and there was no way I could turn back now.

Once more I flapped, at a consistent-medium level speed. It was easy for me, since it was something I would actually do. I wasn’t going crazy with it, I wasn’t being overly disruptive. But yet again, my teacher addressed me, and told me to leave the classroom and wait for her in the hall.

I was ecstatic as I walked out of the room. This is it!, I thought. They’re finally going to admit that I’m not actually a bad kid, I just have ADHD! When my teacher came out into the hall, I fully expected her to hand me a phone and tell me to call my mom to set up a doctor’s appointment. Instead she just went off, telling me behavior was unacceptable, and that she would not tolerate any more of my “distractions”. Then—and I remember this part word for word—she said to me; “I know you always want to be the center of attention, but the world doesn’t revolve around you.”

That stung. I felt tears pool in my eyes, and because I hated for people to see me cry, and ran to the bathroom and hid in a stall.

I decided then that I didn’t have ADHD. I had no excuse for my behavior. I was just a bad kid. I annoyed my teachers and hurt other kids and zoned out during conversations because I was, at my core, a bad kid.

Obviously, when I was nine years old, I didn’t understand the whole “gender inequalities and expectations” thing. So while it struck me as odd that the only kids I knew to be diagnosed with ADHD and other behavioral disorders were boys, I didn’t put together the idea that our society had set unique expectations and standards for boys and girls, and that just by being the latter, my behavioral issues would be treated differently.

One day two years ago, when I was in the eighth grade, I was sitting in my therapist’s office, my leg tapping and my hands tearing (yes, tearing) apart a stress ball. My therapist made a remark about how hyperactive I was, and asked if I’d ever been identified as ADHD.

I told her no, no one had ever mentioned it, at least not to me. I did fill her in on my second grade behavioral crises, and upon hearing all the examples of ADHD-like things I did, she was shocked that after all these years I had never been diagnosed. She told me that from the first five minutes into meeting me, she knew I had moderate to severe ADHD. She had assumed it wasn’t on my medical records because my family had never gotten around to sending me to a doctor about it—which, by the way, is an apparently common things for girls’ families to do.

I left her office that day, sat in the car as my dad drove me home, and pondered this revelation. I was right, I thought. Second-grade me was right. And for the first time time since pre school, I didn’t feel like a bad kid.

I often wonder how things would’ve turned out if I had been diagnosed in elementary school. I wonder if I would still have the impulse control I worked so hard to learn, or if I’d be reliant on medication, unable to function normally without it. I don’t really know if things would have turned out different, but I today, I am totally fine with the way things went. Yes, it definitely sucked going through all of elementary and most of middle school believing I was a burden and a hazard to everyone I knew. And yes, it would have been nice to at least have an explanation for why focusing on only one thing at once was nearly impossible for me. But I’ve learned, for the most part, how to think before I speak, to take responsibility for my actions, and how pay attention to my teachers when they’re speaking. I’m not sure I would have gotten any of that if I had been given special treatment, if I had been branded as “DISORDERED” so my teachers could expect less of me.

Today, there is a discussion among doctors, parents, and teachers as to whether ADHD and other behavioral disorders are over-diagnosed. Some believe that disorders such as ADHD aren’t even real things, just a made-up classification for kids who have a lot of energy. Most, however, agree that while behavioral disorders are real and can be debilitating, there is a broad spectrum of severity, and at some point, it becomes unnecessary—and at another point, harmful—to give a mildly ADHD kid that official title.

I agree that ADHD and other behavioral disorders are over-diagnosed. This is a problem, as it gives kids would do find without the extra attention an excuse to not realize their full potential. More seriously, medications used to treat the disorder are not exactly gummy bear vitamins—they are powerful, and when overused, they can cause serious damage to someone’s body. Especially a child’s.

But while ADHD is over-diagnosed in boys, I believe that it is the opposite, under-diagnosed, in girls. And that this has a direct correlation with our society’s inclination to expect boys to be rowdy and disorderly, and therefore deserving of extra attention during childhood, while expecting girls to not act out, not make a fuss, and if they are having behavioral issues, to just deal with it on their own and learn to control themselves as to not create a disturbance.

Most statistics estimate that between five and ten percent of school-aged children in the U.S. have ADHD. Broken down by gender, approximately 13.5% of boys aged 3-17 have been diagnosed, in contrast to 5.4% of girls. This does not necessarily mean that ADHD is more prevalent in boys, just that boys are more commonly diagnosed. It is also agreed that boys are far more likely to be diagnosed with ADHD, with three to six more boys being diagnosed per girl, according to a study by Dr. Russell A. Barkley at the Medical University of South Carolina.

Some people speculate that boys are more likely to be diagnosed than girls because typical “boy symptoms” are more noticeable than “girl symptoms”. According to the Diagnostic and Statistical Manual of Mental Disorders, boys with ADHD are typically energetic, bouncing-off-the-walls types, while girls with ADHD are more likely to be withdrawn, with low self-esteem, and a tendency to become verbally aggressive when upset.

Most teachers and school counselors are educated on the symptoms of ADHD, and how to recognize signs that a student may be suffering. So why are so many more boys diagnosed than girls, if the prevalence rates are roughly the same? Reflecting on my experience with ADHD, I realize that I may have been a victim to our society’s gender binary mindset from the time I was seven years old. While boys with ADHD were given medicine and attention, I was told to sit on my hands. While boys with ADHD were pulled out of class to be examined by medical professionals, I was pulled out of class to be scolded. While the proverbial playing field was leveled for boys with extra time on tests, I was panicking because it was already twenty minutes into lunch and I still had an entire page of multiple choice questions left, and my teacher was getting annoyed.

Again, I don’t necessarily wish I had been diagnosed earlier, and had gotten the same attention as boys with ADHD. I’ve learned control my impulses, and have adopted techniques that help me to focus and succeed in school. But the gender biases displayed in our treatment of girls with ADHD is a part of a larger problem, a major flaw of society, that teaches little girls that they are less important and less worthy than boys.

ADHD is a complicated condition, as there are so many different levels of severity and varying methods of treating it. But we cannot attempt to reform the treatment of ADHD and other behavioral disorders without reforming the inequalities that exist between genders. Because until then, with only one gender succeeding with ADHD, we aren’t really succeeding at all.



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