Trans, nonbinary & gender-diverse readers, page 20 of 84
Could I have ADHD?
Chapter 1 · You are welcome here
20. Trans, nonbinary & gender-diverse readers
Most ADHD writing talks only about men and women. For trans, nonbinary and gender-diverse adults, ADHD can be shaped by hormones, by masking, and by years of being seen as someone you are not. Healthcare can also make you choose which need to raise first.
What we know, and what we don't
The research base on ADHD in trans and gender-diverse adults is small but growing, and the picture so far is consistent. A large 2020 study in Nature Communications found that autism and other neurodevelopmental conditions, including ADHD, were more common among transgender and gender-diverse people, which means many of you arrive at an ADHD diagnosis after, or alongside, transition, and many clinicians have never thought carefully about how the two interact. The community has been doing this thinking for years and what is in this page is drawn directly from that community, not from a textbook.
1/6 Symptoms can shift, sometimes a lot.
Testosterone affects dopamine. Some trans men and trans masculine people with ADHD say their symptoms changed in their first year on testosterone. For some it got easier, for others harder. Research is limited, but if your ADHD changes alongside hormone treatment, tell whoever prescribes your ADHD medication.
2/6 The cyclical pattern can show up.
If you take oestrogen and progesterone in a cycle, the menstrual cycle page may apply to you too. Some trans women with ADHD notice their symptoms get worse at the same point each cycle. Tracking your symptoms for three cycles, as that page suggests, can show the pattern.
3/6 You may have been misread for years.
If you were assigned female at birth, the late-diagnosed women page may sound familiar: masking, quiet inattentive symptoms, and a diagnosis in your thirties. If you were assigned male at birth, your masking may look different. Tell your assessor about both.
4/6 The cumulative cost is real.
Hiding your ADHD and your gender at the same time is tiring. Many trans and nonbinary adults say their ADHD felt easier after coming out or transitioning, because they had more energy left over. If you are not out yet and feel exhausted, this may be part of the reason.
5/6 You can pursue both at once.
You do not have to finish a gender clinic referral before asking for an ADHD assessment, or the other way round. Different services run them and both have long waits, so it makes sense to start both at once. The Fast Track GP letter works alongside a gender clinic referral.
6/6 You can ask explicitly.
When you book, ask the Right to Choose provider whether their clinicians have worked with gender-diverse patients. It is a fair question. If they react badly, that tells you something before you commit. People in online communities have described Psychiatry UK and ProblemShared as generally trans-friendly, though experiences vary.
Communities and resources
1/4 Neuroqueer (online)
An online community for LGBTQIA+ neurodivergent adults, with an active Discord and many UK members.
2/4 r/adhdwomen
Explicitly welcomes "trans women, non-binary, agender, and genderqueer folks". The moderators enforce this.
3/4 Gendered Intelligence (UK)
UK charity supporting trans, nonbinary and gender-diverse people. It is not ADHD-specific, but its support workers can help when you are dealing with several health services at once.
4/4 ADHD UK forums
The main UK forum is generally inclusive. If you ask a question about your own situation, someone who has been through it will often reply.
If your GP misgenders you while you are also trying to get an ADHD referral. You can raise it. The two issues are separate, and you do not have to put up with one to get help with the other. A short, calm "could you use my correct name and pronouns, please, and then we can talk about the ADHD referral" usually works, and sets the tone with that practice.