Gender Dysphoria and Neurodevelopmental Disorders: Prevalence of Attention Deficit Hyperactivity Disorder (ADHD) Among Adults with Gender Dysphoria and Their Clinical Phenotype.

Objective: Despite the increasing amount of data showing the presence of high association between gender dysphoria (GD) and autism spectrum disorders, less is known on the association between GD and other neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD). The aim of this study was to examine the prevalence and clinical features of ADHD in a group of adults with a primary diagnosis of GD. Method: A sample of 81 consecutive adults newly diagnosed with GD were assessed using standardized self-report measures evaluating GD severity, mood and anxiety symptoms, and ADHD. GD participants with associated ADHD were compared to participants without ADHD regarding gender dysphoria symptoms, mood and anxiety symptoms, and functional impairment. Results: We found a 33.3% prevalence of ADHD among GD individuals. Those with GD and ADHD had a significantly higher lifetime prevalence of psychiatric co-occurrence-particularly borderline personality disorder and cannabis use disorder- along with greater mood (U = 3.805, p < .001) and anxiety symptoms (U = 3.717, p < .001), and more severe functional impairment (U = -3.233, p = .001) compared with GD individuals without ADHD. No group differences emerged in GD symptom severity. Conclusions: Findings indicate that GD individuals show high prevalence of ADHD and that individuals with both GD and ADHD appear to represent a more complex subpopulation with heightened depressive and anxiety symptoms and increased functional impairment. These results underscore that the presence of ADHD is frequent and appears to exert an important clinical impact on individuals with GD; therefore, ADHD should be routinely screened for in this population.