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religion-is-a-mental-illness · 4 months

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My name is Dr Jill Simons. I'm a board-certified pediatrician and the executive director for the American College of Pediatricians. Today I'm here alongside my colleagues representing the Coalition of co-signers of the Doctors Protecting Children Declaration. Our coalition consists of physicians together with nurses, behavioral health clinicians, other health professionals, scientists, researchers and public health and policy professionals. And we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex.

This declaration was authored by the American College of Pediatricians, but really it was developed from the expertise of hundreds of doctors researchers and other healthcare workers and leaders wh, for years have been sounding the alarm on the harmful protocols that continue to be promoted by the medical organizations in the United States. Despite recent revelations from the leaked WPATH Files and the recent release of the final report from the Cass Review, these medical organizations have not changed course.

So, we are calling on these medical organizations of the United States, including the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, the American Medical Association, the American Psychological Association and the American Academy of Child and Adolescent Psychiatry to follow the science and their European colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex.

In our declaration, we affirm that sex is a dimorphic, innate trait defined in relation to an organism's biological role in reproduction: male and female this genetic signature is present in every nucleated somatic cell in the body and is not altered by drugs or surgical interventions. Consideration of these innate differences is critical to the practice of good medicine and to the development of sound policy for children and adults alike. Medical decision-making should be based upon an individual's biological sex. It should respect biological reality and the dignity of the person by compassionately addressing the whole person.

We are here defying the claims made by these medical organizations in the US that those of us who are concerned are a minority and that their protocols are consensus. They are not consensus, and we are speaking in a loud unified voice: enough.

[ Full press conference: https://youtu.be/C2tU90XPFlg ]

Doctors Protecting Children Declaration

As physicians, together with nurses, psychotherapists and behavioral health clinicians, other health professionals, scientists, researchers, and public health and policy professionals, we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex.

We affirm:

1. Sex is a dimorphic, innate trait defined in relation to an organism’s biological role in reproduction. In humans, primary sex determination occurs at fertilization and is directed by a complement of sex determining genes on the X and Y chromosomes. This genetic signature is present in every nucleated somatic cell in the body and is not altered by drugs or surgical interventions

2. Consideration of these innate differences is critical to the practice of good medicine and to the development of sound public policy for children and adults alike.

3. Gender ideology, the view that sex (male and female) is inadequate and that humans need to be further categorized based on an individual’s thoughts and feelings described as “gender identity” or “gender expression”, does not accommodate the reality of these innate sex differences. This leads to the inaccurate view that children can be born in the wrong body. Gender ideology seeks to affirm thoughts, feelings and beliefs, with puberty blockers, hormones, and surgeries that harm healthy bodies, rather than affirm biological reality.

4. Medical decision making should not be based upon an individual’s thoughts and feelings, as in “gender identity” or “gender expression”, but rather should be based upon an individual’s biological sex. Medical decision making should respect biological reality and the dignity of the person by compassionately addressing the whole person.

We recognize:

1. Most children and adolescents whose thoughts and feelings do not align with their biological sex will resolve those mental incongruencies after experiencing the normal developmental process of puberty.

Desistance is the norm without affirmation as documented by Zucker in his article “The Myth of Peristence”. (1) Zucker, KJ. The myth of persistence: Response to “A critical commentary on follow-up studies and ‘desistance’ theories about transgender and gender nonconforming children” by Temple Newhook et al. International Journal of Transgenderism. 2018: 19(2), 231–245. Published online May 29, 2018.http://doi.org/10.1080/15532739.2018.1468293 [1]

In the “largest sample to date of boys clinic-referred for gender dysphoria,” there was a desistance rate of 87.8%. (2) Singh D, Bradley SJ and Zucker KJ. A Follow-Up Study of Boys With Gender Identity Disorder. Front Psychiatry. 2021;12:632784. doi: 10.3389/fpsyt.2021.632784

The pro-affirmation Endocrine Society Guidelines (2017) admit: “…the GD/gender incongruence of a minority of prepubertal children appears to persist in adolescence.” (3) Hembree, W., Cohen-Kettenis PT, Gooren L, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline J Clin Endocrinol Metab. 2017; 102:1–35.

A longitudinal study from the University of Groningen in the Netherlands followed 2772 adolescents (recruited from a psychiatric clinic) from age 11 years through 22 – 26 years. “In early adolescence 11% of participants reported gender non- contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26).” Even in this psychiatric patient study group for which interventions were not addressed, but “gender affirmation” is most likely, gender non-contentedness (essentially gender noncongruence) decreased substantially from early adolescence to young adulthood.(4) Rawee P, Rosmalen JGM, Kalverdiijk L and Burke SM. Development of gender non-contentedness during adolescence and early adulthood. Archives of Sexual Behavior. 2024; https://doi.org/10.1007/s10508-024-02817-5

2. Responsible informed consent is not possible in light of extremely limited long-term follow-up studies of interventions, and the immature, often impulsive, nature of the adolescent brain. The adolescent brain’s prefrontal cortex is immature and is limited in its ability to strategize, problem solve and make emotionally laden decisions that have life-long consequences.[2]

3. Sex-trait modification or “Gender affirming” clinics in the United States base their treatments upon the “Standards of Care” developed by the World Professional Association for Transgender Health (WPATH). However, the foundation of WPATH guidelines is demonstrably flawed and pediatric patients can be harmed when subjected to those protocols.

The two Dutch studies that form the foundation for treatment guidelines as documented in the WPATH “Standards of Care” guidelines version 7 (SOC 7) had serious flaws.[3]

These studies did show that the appearance of secondary sex characteristics in adolescents and young adults could be changed by hormonal and surgical interventions, but they failed to demonstrate meaningful long-term improvement in psychological well-being.

Scientific concerns with these studies also include a lack of a control group, small sample sizes, significant numbers of patients lost to follow up, and the elimination of patients who experienced significant mental illness from entering the studies.

It is concerning that the Dutch studies did not address complications and adverse outcome in the adolescent cohort that underwent transition. These complications included new onset diabetes, obesity and one death.[4]

4. There is now sufficient research to further demonstrate the failure of the WPATH, American Academy of Pediatrics and Endocrine Society protocols.

The Cass Review was released on April 10, 2024, as an “independent review of gender identity services for children and young people”. The following points are from Cass’s final report:[5]

Commissioned by the National Health Service (NHS) England, and chaired by Dr. Hilary Cass, the 388-page report utilized systematic reviews, qualitative and quantitative research, as well as focus groups, roundtables and interviews with international clinicians and policy makers.

As part of the evaluation, they reviewed the research on social transition, puberty blockers, and cross-sex hormones.

Social transition

“The systematic review showed no clear evidence that social transition in childhood has any positive or negative mental health outcomes, and relatively weak evidence for any effect in adolescence.

However, those who had socially transitioned at an earlier age and/or prior to being seen in clinic were more likely to proceed to a medical pathway.”

Puberty blockers

“The systematic review undertaken by the University of York found multiple studies demonstrating that puberty blockers exert their intended effect in suppressing puberty, and also that bone density is compromised during puberty suppression. However, no changes in gender dysphoria or body satisfaction were demonstrated [emphasis added].”

“There was insufficient/inconsistent evidence about the effects of puberty suppression on psychological or psychosocial wellbeing, cognitive development, cardio-metabolic risk or fertility.”

“Moreover, given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinizing/ feminizing hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.”

Cross-sex hormones

“The University of York carried out a systematic review of outcomes of masculinising/feminising hormones.” They concluded, “There is a lack of high-quality research assessing the outcomes of hormone interventions in adolescents with gender dysphoria/incongruence, and few studies that undertake long-term follow-up. No conclusions can be drawn about the effect on gender dysphoria, body satisfaction, psychosocial health, cognitive development, or fertility.”

“Uncertainty remains about the outcomes for height/growth, cardio-metabolic and bone health.”

The Cass Review further stated, “Assessing whether a hormone pathway is indicated is challenging. A formal diagnosis of gender dysphoria is frequently cited as a prerequisite for accessing hormone treatment. However, it is not reliably predictive of whether that young person will have longstanding gender incongruence in the future, or whether medical intervention will be the best option for them.”

A 2024 German systematic review on the evidence for use of puberty blockers (PB) and cross-sex hormones (CSH) in minors with gender dysphoria (GD) also found “The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn’t suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD.”[6]

5. There are serious long-term risks associated with the use of social transition, puberty blockers, masculinizing or feminizing hormones, and surgeries, not the least of which is potential sterility.

Youth who are socially affirmed are more likely to progress to using puberty blockers and cross-sex (masculinizing or feminizing) hormones.

“Social transition is associated with the persistence of gender dysphoria as a child progresses into adolescence.”[7]

“Gender social transition of prepubertal children will increase dramatically the rate of gender dysphoria persistence when compared to follow-up studies of children with gender dysphoria who did not receive this type of psychosocial intervention and, oddly enough, might be characterized as iatrogenic.”[8]

Puberty blockers permanently disrupt physical, cognitive, emotional and social development.

Side effects listed in the Lupron package insert include emotional lability, worsening psychological illness, low bone density, impaired memory, and the rare side-effect of pseudotumor cerebri (brain swelling).[9]

A coalition of physicians and medical organizations from around the world submitted a petition to the Commissioner of the U.S. Food and Drug Administration requesting urgent action be taken to eliminate the off-label use of GnRH (growth hormone) agonists in children.[10]

Testosterone use in females and estrogen use in males are associated with dangerous health risks across the lifespan including, but not limited to, cardiovascular disease, high blood pressure, heart attacks, blood clots, stroke, diabetes, and cancer.[xi],[12]

Genital surgeries affect future fertility and reproduction.

6. A report from Environmental Progress released on March 4, 2024, entitled “The WPATH Files” revealed “widespread medical malpractice on children and vulnerable adults at global transgender healthcare authority.”[13]

“The WPATH Files reveal that the organization does not meet the standards of evidence-based medicine, and members frequently discuss improvising treatments as they go along.”

“Members are fully aware that children and adolescents cannot comprehend the lifelong consequences of ‘gender-affirming care’ and, in some cases due to poor health literacy, neither can their parents.”

In addition, developmentally challenged and mentally ill individuals were being encouraged to “transition”, and treatments were often improvised.

7. Evidence-based medical research now demonstrates there is little to no benefit from any or all suggested “gender affirming” interventions for adolescents experiencing Gender Dysphoria. Social “affirmation”, puberty blockers, masculinizing or feminizing hormones, and surgeries, individually or in combination, do not appear to improve long-term mental health of the adolescents, including suicide risk.[14]

8. Psychotherapy for underlying mental health issues such as depression, anxiety, and autism, as well as prior emotional trauma or abuse should be the first line of treatment for these vulnerable children experiencing discomfort with their biological sex.

9. England, Scotland, Sweden, Denmark, and Finland have all recognized the scientific research demonstrating that the social, hormonal and surgical interventions are not only unhelpful but are harmful. So, these European countries have paused protocols and are instead focusing on evaluating and treating the underlying and preceding mental health concerns.

10. Other medical organizations are adhering to the evidence-based medicine documented in the Cass Review Final Report.

The constitution of the National Health Service in England will be updated to state, “We are defining sex as biological sex.”[15]

The European Society of Child and Adolescent Psychiatry issued a document titled “ESCAP statement on the care for children and adolescents with gender dysphoria: an urgent need for safeguarding clinical, scientific, and ethical standards.”

In this paper, they stated, “The standards of evidence-based medicine must ensure the best and safest possible care for each individual in this highly vulnerable group of children and adolescents. As such, ESCAP calls for healthcare providers not to promote experimental and unnecessarily invasive treatments with unproven psycho-social effects and, therefore, to adhere to the “primum-nil-nocere” (first, do no harm) principle”.[16]

11. Health care professionals around the world are also acknowledging the urgent need to protect children from harmful “gender-affirming” interventions.

In a letter to the British newspaper, The Guardian, sixteen psychologists, some of whom worked at the Tavistock Center for Gender Identity Development Service, acknowledged the role clinical psychologists played in placing children on an “irreversible medical pathway that in most cases was inappropriate.”[17]

In the United States, a group of psychiatrists, physicians and other health care workers wrote an open Letter to the American Psychiatric Association (APA), calling on the APA to explain why it glaringly ignored many scientific developments in gender-related care and to consider its responsibility to promote and protect patients’ safety, mental and physical health.[18]

12. Despite all the above evidence that gender affirming treatments are not only unhelpful, but are harmful, and despite the knowledge that the adolescent brain is immature, professional medical organizations in the United States continue to promote these interventions. Further, they state that legislation to protect children from harmful interventions is dangerous since it interferes with necessary medical care for children and adolescents.

The American Psychological Association states it is the largest association of psychologists worldwide. The organization released a policy statement in February 2024 stating, “The APA opposes state bans on gender-affirming care, which are contrary to the principles of evidence-based healthcare, human rights, and social justice.”[19]

The Endocrine Society responded to the Cass Review by reaffirming their stance. “We stand firm in our support of gender-affirming care…. NHS England’s recent report, the Cass Review, does not contain any new research that would contradict the recommendations made in our Clinical Practice Guideline on gender-affirming care.”[20]

The American Academy of Pediatrics (AAP) Board of Directors in August 2023, voted to reaffirm their 2018 policy statement on gender-affirming care. They did decide to authorize a systematic review but only because they were concerned “about restrictions to access to health care with bans on gender-affirming care in more than 20 states.”[21]

Of note, Dr. Hilary Cass called out the AAP for “holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.”[22]

In Conclusion

Therefore, given the recent research and the revelations of the harmful approach advocated by WPATH and its followers in the United States, we, the undersigned, call upon the medical professional organizations of the United States, including the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to follow the science and their European professional colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex. Instead, these organizations should recommend comprehensive evaluations and therapies aimed at identifying and addressing underlying psychological co-morbidities and neurodiversity that often predispose to and accompany gender dysphoria. We also encourage the physicians who are members of these professional organizations to contact their leadership and urge them to adhere to the evidence-based research now available.

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therainbowwarrior4 · 10 months

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Why Transgender People Need Gender-Affirming Care (Essay I wrote for school)

According to the Human Rights Campaign, twenty-two states have passed laws that ban minors from receiving gender-affirming care. Gender-affirming care which includes, puberty blockers, synthetic hormones, and surgeries, are a safe and effective way to treat gender dysphoria, which is distress that results from having one’s gender identity not match their sex assigned at birth. The HRC states that, “Every single major medical organization, including the American Academy of Pediatrics, the American Medical Association and the American Psychiatric Association, supports the provision of age-appropriate, gender-affirming care for transgender and non-binary people.” It is essential for transgender people to receive gender-affirming care because it decreases the risk of substance abuse, improves mental health, and gives them the opportunity to be who they truly are.

It is evident that transgender people are at a higher risk of substance abuse and mental health conditions, such as depression and anxiety. According to one study, the use of any type of drug was 3.6 times more likely in transgender people than in cisgender people. Additionally, 47% of transgender adults reported binge-drinking in the last three months compared to 17% of the general population (Shannonhouse). However, a study also shows that gender-affirming surgeries can decrease the risk of substance abuse. A 35% decrease of past year tobacco smoking was found in transgender people who had one or more gender-affirming surgeries and a significant decrease in the odds of past-month binge alcohol abuse was observed when patients got all the surgeries they desired (“New Study Shows”). According to Columbia Psychiatry, “It is well documented that TGNB adolescents and young adults experience anxiety and depression, as well as suicidal ideation, at a much higher rate than their cisgender peers.” In 2020, the Trevor Project found that 54% of young people who identified as transgender seriously considered suicide, and 29% made an attempt on their lives. Despite this, numerous research studies have shown that gender-affirming care leads to improved mental health for transgender youth (Matouk and Wald). In addition to the numerous mental health benefits of letting transgender people access gender-affirming care, this care also allows transgender people to be who they really are. For example, Jaime Raines started testosterone when he was 17 years old. He describes how life was like before and after he started transitioning. “The two are incomparable really, life before transitioning felt like a struggle and I was constantly feeling uncomfortable and embarrassed about how I looked and how people perceived me. Life after, life now, is just me actually living my life as me” (“This transgender man”).

Opponents of gender-affirming care argue that sex change drugs, meaning synthetic versions of testosterone and estrogen, are radical and experimental treatments. They state that these treatments are mutilating people’s bodies and that teenagers are not capable of consenting to these treatments (Surgeons). Furthermore, they attest that hormones are given to minors too quickly without any formal procedures to make sure it is in the best interest of the patient and sometimes even surgeries, such as double mastectomies, are being performed (Denny). Challengers to gender-affirming care also allege that some patients have underlying mental health conditions, such as anxiety or depression, which are not being treated (Denny). They claim being transgender is a social contagion because of the amount of people now identifying that way. They also claim that it is mostly teenage girls that want this type of medical intervention because identifying this way is a collective behavior that is commonly seen in people who do not feel comfortable with their bodies (Surgeons). Lastly, they argue that many people regret transitioning and go on to detransition.

Proponents of gender-affirming care argue that hormones have been given to transgender people for decades. The first gender clinic in America was opened in 1966 and these hormones have been given to cisgender people long before that to help with certain conditions, such as menopause (Rosenthal). These hormones are safe for adolescents and adults as long as they are being monitored by a medical professional. Hormones are not usually prescribed until a patient turns eighteen. If they are prescribed in adolescence, it is with parental permission and support after going through the informed consent process (HRC Foundation). Double mastectomies are rarely performed on minors. If these surgeries are performed on 16- or 17-year-olds it is with parental support after talking to therapists, and surgeons. Surgeries involving genitalia are never performed on those under 18 (HRC Foundation). Anyone who wants to receive gender-affirming care is required to speak to a mental health professional before and during their transition. Dysphoria can worsen existing mental health conditions such as anxiety or depression. After talking to the patient, a doctor will make the decision regarding transitioning and if it will help the patient’s mental health (HRC Foundation). The idea that being transgender is a “social contagion” is called “Rapid Onset Gender Dysphoria.” GRD has been thoroughly debunked and over 120 medical associations have issued statements calling for the elimination of this term (HRC Foundation). A study done by the American Academy of Pediatrics found that youth assigned female at birth are no more likely to identify as transgender then those assigned male at birth. Lastly, several studies have shown that the percentage of someone de-transitioning is quite rare. The regret rate of transition is as low as 1 or 2 percent (HRC Foundation).

In conclusion, gender-affirming care is life-saving care for transgender individuals. This care is safe, effective, and can be life changing. It decreases the risk of substance abuse, suicide, anxiety, depression, and allows transgender people to be who they truly are. If “to shine your brightest light is to be who you truly are” (Bennett), then should not everyone have a chance to shine their brightest light?

Works Cited

Bennett, Roy T. “Be Who You Truly Are.” The Light in the Heart, 25 Nov. 2018, thelightintheheart.wordpress.com/2018/11/25/be-who-you-truly-are-2/. Accessed 9 Dec. 2023.

Denny, Doreen. “Exposing the Lie of Gender-Affirming Care.” Restoring America, 13 Mar. 2023, www.washingtonexaminer.com/restoring-america/community-family/exposing-the-lie-of-gender-affirming-care?utm_source=google&utm_medium=cpc&utm_campaign=Pmax_USA_High-Intent-Audience-Signals&gad_source=1&gclid=CjwKCAiAmZGrBhAnEiwAo9qHiX8vNakZ_bQiz5rDsC-HxFlMyaTmQ2zs8cLde-oqFOfouZYQCoGxIxoCBo8QAvD_BwE. Accessed 9 Dec. 2023.

HRC Foundation. “Get the Facts on Gender-Affirming Care.” Human Rights Campaign, 22 Mar. 2023, www.hrc.org/resources/get-the-facts-on-gender-affirming-care. Accessed 6 Dec. 2023.

Matouk, Kareen, and Melina Wald. “Gender-Affirming Care Saves Lives.” Columbia University Department of Psychiatry, 30 Mar. 2022, www.columbiapsychiatry.org/news/gender-affirming-care-saves-lives. Accessed 27 Nov. 2023.

“New Study Shows Transgender People Who Receive Gender-Affirming Surgery Are Significantly Less Likely to Experience Psychological Distress or Suicidal Ideation - Fenway Health: Health Care Is a Right, Not a Privilege.” Fenway Health, 28 Apr. 2021, fenwayhealth.org/new-study-shows-transgender-people-who-receive-gender-affirming-surgery-are-significantly-less-likely-to-experience-psychological-distress-or-suicidal-ideation/. Accessed 27 Nov. 2023.

Rosenthal, G. Samantha. “Gender-Affirming Care Has a Long History in the US – and Not Just for Transgender People.” The Conversation, 27 Mar. 2023, theconversation.com/gender-affirming-care-has-a-long-history-in-the-us-and-not-just-for-transgender-people-201752. Accessed 6 Dec. 2023.

Shannonhouse, Rebecca. “Substance Use Disorder in Transgender and Nonbinary People.” WebMD, 21 Apr. 2022, www.webmd.com/mental-health/addiction/substance-use-disorder-transgender-nonbinary. Accessed 9 Dec. 2023.

Surgeons, Association of American Physicians &. “Transgenderism: The New Medical Standard?” AAPS | Association of American Physicians and Surgeons, 25 Feb. 2023, aapsonline.org/transgenderism-the-new-medical-standard/. Accessed 6 Dec. 2023.

“The Trevor Project National Survey 2020.” Www.thetrevorproject.org, 2020, www.thetrevorproject.org/survey-2020/?section=Suicide-Mental-Health. Accessed 27 Nov. 2023.

“This Transgender Man Documented His Amazing Journey on YouTube for over Five Years.” The Irish News, 8 July 2017, www.irishnews.com/magazine/daily/2017/07/08/news/this-transgender-man-documented-his-amazing-journey-on-youtube-for-over-five-years-1079578/. Accessed 9 Dec. 2023.

“Youth Assigned Female at Birth Are No More Likely to Identify as Transgender or Gender Diverse than Those Assigned Male at Birth: Study.” Www.aap.org, 3 Aug. 2022, www.aap.org/en/news-room/news-releases/pediatrics2/2022/youth-assigned-female-at-birth-are-no-more-likely-to-identify-as-transgender-or-gender-diverse-than-those-assigned-male-at-birth-study/. Accessed 9 Dec. 2023.

#lgbtqia+ rights #lgbtqia+ community #lgbtqia+#queer #queer community #transgender #lgbtq #lgbtqia #lgbt pride #lgbtq community #lgbtq rights #lgbtqia+ resources #lgbtqia rights #lgbtqiia+#lgbtqi community #lgbt #lgbtqplus #lgbtq+

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ladyalienist · 1 year

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What is your position on trauma-related conditions/personality disorders?

Hi! I’m really glad you asked because this is a thing I wanted to make a post about.

So, let’s first start with a bit of general context, shall we? I’ll try to make it as short as I can.

Psychologists and psychiatrists are different in many ways, but they both take care of the same kind of illnesses, distresses and problems, and hence need to communicate between themselves and create a taxonomy of the most common kinds of problems they face. In that taxonomy (DSM, PDM, you name it) it is understood, generally, that people might react to traumatic events in an acute way or in a persistent way (what we usually refer to as PTSD).

In that same taxonomy, personality disorders (PDs) are not seen as trauma responses per se: they are something different. Personality is defined as the unique and fairly consistent patterns of thoughts, feelings, and behaviours that distinguish a person from others. When something in the development of personality goes wrong and those patterns become consistently dysfunctional and hurtful to the person and/or to others, we have a PD. There’s currently about 10-15 of them that have a specific label, all with their specific characteristics: I’m not diving too deep into that because else this thing will become a whole essay and I’d have to charge you money to have you read it.

Now, one thing that seems intuitive but apparently was absolutely not to psychiatrists is that thought/feeling/behaviour patterns are not formed in a vacuum, and require a lot of interactions with external influences to be moulded into a specific shape: hence, a thing that isn’t that obvious is that personality disorders come usually (not always, but very often) from a deeply traumatic childhood.

Especially when it comes to the most (in)famous and debated personality disorder: the Borderline Personality Disorder (BPD), which many feminists (me included) view as an evolution of the so-called hysteria psychs would diagnose women with in the 1800s.

It is, on many levels, the very same situation: we have young women who react to horrifying and prolonged abuse by becoming “bad women”, “untamed women”, and hence need to be corrected with sedation and institutionalization.

Many ladies here on Radblr are unwaveringly anti-psychiatry, or at the very least critical of psychiatry and of the BPD diagnosis altogether: they think that it is a pathologisation of natural responses to the horrific treatment little girls go through in way too many cases, and a tool of oppression in the hands of a patriarchal paradigm of health and science.

Now let me be clear: I understand those critiques and they are in many ways grounded and valid. This is a diagnosis that gets often given without an understanding of the personal history of the woman who displays symptoms, or gets given way too soon (PDs should not get diagnosed before adulthood and many women receive a BPD diagnosis when they are still adolescents).

I am myself… not exactly enthusiastic about psychiatrists and colleagues alike, and I do not appreciate the modern paradigm of mental health, but you already know that, for you asked this specific question.

The fact is that in other ways it is a myopic view of a complex and nuanced issue. My first problem with the General-Radblr-Critique-of-Psychiatry is that many many people do not understand a simple fact: psych language is edulcorated as fuck and a competent psych keeps that in mind. When a psych writes “difficulties in keeping care of personal hygiene” (non-political random example of a typical consequence of severe depression) it doesn’t mean “eh, haven’t showered yesterday because I didn’t stink”, it means “this person hasn’t showered in months because they cannot find the energy/they do not want to see themselves naked/they are actively trying to rot while alive and are succeeding”.

Another problem is that many people are not aware that PD diagnoses are actually… not that gendered: while it is true that BPD is more often female and Narcissistic PD is more often male, and socialization brings wildly different levels of destructiveness, there are men diagnosed with BPD and women with NPD, and they are not a statistical rarity!

The third and last problem is a direct consequence of the first: a thing many do not understand is that a PD diagnosis is not given because you’re a moody teen who is angry at misogyny.

It is mostly given when you are a fucking menace to yourself and people around you.

A person should get this diagnosis when they have a consistent pattern of destructive behaviour and uncontrolled emotional responses. These are people who self harm, who have risky behaviours (reckless driving, substance abuse and addiction, violent relationships) and who can and will treat others like shit with little to no reason.

Now, it should not be given to adolescents and this happens. It should not be given without addressing the causes, which often include sexual trauma or prolonged abuse, and this happens. Medication should be prescribed very, very carefully and this doesn’t happen. This is malpractice, and it is way too widespread. I will not deny that.

But here are just some funky tales of things people I know with that diagnosis did:

Set fire to the car of one of her ex BFs. Gleefully told me. The poor guy had done absolutely nothing wrong except leaving her, which was well within his rights. She absolutely could not understand why what she did was unacceptable.

Kept a merry-go-round between three different partners. Two of them were abusive pieces of shit. No amount of telling her that they were pieces of shit would have her convinced that they needed to be excluded from her life and that it wasn’t a good idea to keep fighting with A, calling B for sex and company, fighting with B, calling C for sex and company, fighting with C, calling A, and so on and so forth. This kept going on for years, I cannot stress this enough.

“I only like violent sex” (multiple people, on multiple occasions).

Cheating and then becoming flabbergasted at the partner’s anger, which was seen as cruelty towards them (multiple people, on multiple occasions).

Had a partner who absolutely loved and cherished her. Her response to compliments was, on average, “can you not?”. She would complain that she was ugly and no people would want to have sex with her: confronted with the fact that she did, actually, have at least one person wanting her, she blurted out “you don’t count”. Had the same reply for “I love you”.

Proceeded to find a partner whose opinion apparently counted: you guessed it, an abusive piece of shit. Could not wrap her head around the fact that the previous partner did not exactly want to stay friends.

All of this has to be added to the typical description: labile sense of identity, difficulty in understanding the limits in interactions, volatile emotions, black-and-white thinking, destructive rage, deep sense of void, self-harm and risky behaviour.

Does this look like something that should not be treated as pathological? Does this look like something that can go away with just some more compassion for trauma?

In conclusion: while I do agree that this is a diagnosis that can and does get used as a tool to silence the reality of gendered/sexual abuse on girls and women and it has an ugly stigma to it, I do not entirely discard it as useless either. What I’d like to see is a different paradigm in mental health, where people who have experienced earthly hell can find ways to heal (people can and do get a lot better!) and learn more constructive ways to deal with the world, but in order to do that we need to have a precise frame for the problem.

I hope I did explain myself, and if I didn’t please, let me know. I’ll try to be clearer.

#radblr #useless ramble #psychology cowardice #psychology rant #psychology sometimes feels so useless #thanks #thank you for asking this and also for reading

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shadowfromthestarlight · 11 months

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Dr. Riittakerttu Kaltiala, 58, is a Finnish-born and trained adolescent psychiatrist, the chief psychiatrist in the department of adolescent psychiatry at Finland’s Tampere University Hospital. She treats patients, teaches medical students, and conducts research in her field—publishing more than 230 scientific articles. In 2011, Dr. Kaltiala was assigned a new responsibility. She was to oversee the establishment of a gender identity service for minors, making her among the first physicians in the world to head a clinic devoted to the treatment of gender-distressed young people. Since then, she has personally participated in the assessments of more than 500 such adolescents. Earlier this year, The Free Press ran a whistleblower account by Jamie Reed, a former case manager at The Washington University Transgender Center at St. Louis Children’s Hospital. She recounted her growing alarm at the effects of treatments that sought to transition minors to the opposite sex, and her escalating conviction that patients were being harmed by their treatment. Although a recent New York Times investigation largely corroborated Reed’s account, many activists and members of the media continue to dismiss Reed’s claims because she is not a physician. Dr. Kaltiala is. And her concerns are likely to get more attention in the U.S. now that a young woman who medically transitioned as a teenager has just sued the doctors who supervised her treatment, along with the American Academy of Pediatrics. According to the suit, the AAP, in advocating for youth transition, has made “outright fraudulent statements” about evidence for “the radical new treatment model, and the known dangers and potential side effects of the medical interventions it advocates.” Here, Dr. Kaltiala tells her own story, describing her increasing worries about the treatment she approved for vulnerable patients, and her decision to speak out.

#healthcare #health #gender affirming care #trans #gender dysphoria

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nonbinaryresource · 2 years

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hmmmm not sure how to phrase this exactly, but I've been looking through the questioning tag and thought I could try just asking specifically. (Sorry it got quite long!)

I'm pretty sure watching too many trans tiktoks did not make me nonbinary, but it sure brought up questions. Mainly, what if relating to nonbinary/trans experiences in my case is just that, relating? I'm thinking I might be nonbinary or trans, all because I suck at almost everything considered my gender, from looks to skills and so my "disphoria" is me not liking how others see me, rather than it being my body. I don't want to be my body to people first and then my person, besides I get the feeling top surgery would make me look and feel aesthetically cooler lol but that's just me

Is that a thing or I'm just extremely in denial?

Not sure if you caught the study we were just reblogging on how dysphoria and transness is not caused by "social contagion" like tiktoks, but if not, it feels relevant to link.

Researchers from the Fenway Institute disproved the theory of "rapid-onset gender dysphoria" (RODG) and determined that "social contagion" does not influence gender identity in the largest study of its kind, published earlier this month in Pediatrics journal.

"The hypothesis that transgender and gender diverse youth assigned female at birth identify as transgender due to social contagion does not hold up to scrutiny and should not be used to argue against the provision of gender-affirming medical care for adolescents," Dr. Alex S. Keuroghlian, the study's senior author and director of Fenway's National LGBTQIA+ Health Education Center, and the Massachusetts General Hospital Psychiatry Gender Identity Program, said in a statement.

But I'm gonna focus on the idea of "what if I just relate to trans experiences but aren't trans?"

Okay.

So.

What if you do?

What?

Then what?

You...find out more about yourself?

You...discover new things about your own feelings and comfort?

You...consider all of the options and come to decide on which label is best for you to adopt?

I'm not seeing a downside here. I'm not seeing anything to panic about. The transphobes have turned exploration and experimentation into the boogeyman. Life is about exploration and experimentation. Capitalism has absolutely ruined us. It's ridiculous to expect children who aren't even done psychologically developing yet to know and pick their life path and dedicate the rest of their life to it, including going thousands of dollars in debt to get a degree if necessary. It's ridiculous to expect people to not explore and experiment and have some damn fun in life, whether that's trying out 60 different jobs to find something that they want to do or discarding and picking up a new hobby each every single week to find what they actually find enjoyable or playing around with genders/sexualities/names/pronouns/clothes/etc. to figure out their feelings and better get to know who they are.

There is nothing - NOTHING - inherently wrong, bad, or immature about exploration and experimentation in life period.

So what if you relate to trans experiences but are actually cis? So what you identify as trans now for whatever length of time and change how you label later? So what?

I am so tired of the idea that anybody knows what they are doing ever. Nobody knows! We're all just making it up! The imposter syndrome we're putting everyone through for every aspect of their lives - from their jobs to their hobbies to their genders to their sexualities - is out of control. The society we have built is not meant for people. And that's incredibly, incredibly heartbreaking.

People should be allowed to play and explore and experiment!

People should be allowed to grow and change!

People should be allowed to be confused and unsure!

People should be allowed to not know!

People should be allowed to try on identities like we try on clothes at the store!

Fuck the self-gaslighting society is pressuring you to put yourself through.

I don't care what you know for sure. I don't care if you're going by a label you're unsure of. I don't care if you're going by a label you know is technically not the most accurate. I don't care if you stuck up a bunch of identity labels on a dart board, threw a dart, and decided to identify as that one. I'm here for you. The messy, confused, complex, hard to understand you. The real you.

Could it be a thing that you relate to trans experiences, don't really relate to cis experiences, and yet are cis? Sure. (Slightly tangential, but I think you might get some food for thought out of this piece of writing.)

But don't sit here thinking you have to identify as cis because you don't have "proof" of being trans. That's not a thing. It's just what the transphobes want you to think. You can identify as any damn thing you want (let's avoid cultural appropriation, though!), even if you're only 0.5% thinking you might be that thing.

If you think you might be nonbinary, practice not giving into the thoughts like "but I can't really be nonbinary because I'm only just now thinking about it". Practice letting yourself try out being nonbinary! For at least several months, unless it's just too terrible and you realize right away that it's not right for you. Don't debate on this or put yourself through a court of law or beat yourself down. Just let yourself be nonbinary. In a couple months, then come back to the questions of "is this right for me?".

And there is no "right" or "wrong" reason to identify with whatever identity. Some people identify as nonbinary because they have a very specific, pinpointable, non-binary gender. Others identify as nonbinary because they're not really sure but nonbinary makes them the most comfortable. Others identify as nonbinary because they want to be nonbinary. Others identify as nonbinary because they don't relate to or don't understand or don't want to identify with the binarily gendered structure of our society. Whatever your reasoning, it's both valid and nobody else's business (though ofc you can tell anybody why if it's what YOU want to do).

~Mod Pluto

P.S. If anything in this ask comes off as angry or frustrated, it is not with you. It is towards society and bigots who purport attitudes that harm people, even if in seemingly "little" ways like making them feel like they can't trust their own feelings.

#nonbinary #questioning #self doubt #self gaslighting #ask #trans #genderqueer #gender #mod pluto #experimentation #exploration #identity #labels

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nerdygaymormon · 1 year

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Given all the misinformation and political rhetoric, here's an article about gender-affirming care for minors written by Dr. Turban, who is director of the gender psychiatry program at the University of California, San Francisco

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Prepuberty - no medical or surgical interventions, but social transition may happen. One benefit for trans children who socially transition is their levels of anxiety and depression are similar to cisgender children

Attempts to force transgender people to be cisgender have been labeled unethical

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Puberty blockers are the earliest medical intervention that will be considered. Puberty blockers allow for a temporary pause of puberty, which can be especially helpful for adolescents who are having negative psychological reactions to the way their bodies are developing.

An adolescent must first undergo a comprehensive biopsychosocial mental health evaluation prior to starting puberty blockers. Consent is required from their legal guardian and the adolescent must assent to the treatment. If an individual is experiencing gender dysphoria, studies show that puberty blockers lead to improved mental health outcomes

As with all drugs, puberty blockers carry known side effects, such as falling behind on bone density (sex hormones are needed to mineralize bones). Adolescents on puberty blockers should have their bone density monitored during treatment, and pursue paths to improve bone health, such as exercise. In later adolescence, the body should have access to sex hormones, either from coming off of puberty blockers or by starting gender-affirming hormones.

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In later adolescence, transgender youth may be candidates for gender-affirming hormone treatment (for example, estrogen or testosterone) to create puberty changes that align with their gender identities.

A comprehensive mental health biopsychosocial evaluation must be conducted prior to initiation of these treatments. Part of this evaluation includes fertility counseling and consideration of fertility preservation.

Unlike with puberty blockers where the effects are reversible, several of the physical changes that occur from hormone therapy are not reversible, for example, voice changes from testosterone.

Studies link access to gender-affirming hormones with improved mental health for teens with gender dysphoria.

—————————

Most all gender-affirming surgeries are not considered until adulthood, with top surgery for trans masc & nonbinary adolescents being the primary exception. The other exception to gender-affirming surgeries being offered only to adults are situations like a 17-year-old who has graduated from high school getting surgery in the summer to avoid needing to take time off from college to recover.

Surgery is a major decision, and requires agreement from a mental health provider, a medical provider, and the surgeon. Regret rates for having gender-affirming surgeries are remarkably low.

#transgender

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accesshealthservices · 1 year

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Access Health Services | Why Adolescent Psychiatry Services are Important

Adolescence is a critical period of development where individuals experience significant physical, emotional, and social changes. It is also a time when many mental health conditions emerge or worsen.

According to the National Alliance on Mental Illness (NAMI), 1 in 6 youth aged 6-17 experience a mental health disorder each year. Untreated mental health conditions can have a significant impact on a teenager’s overall well-being, including their academic performance, relationships, and future opportunities.

As a parent or caregiver, it can be challenging to know when to seek help for your teenager’s mental health. Some common signs that may indicate a need for adolescent psychiatry services include.

Adolescent Psychiatry Services: Click Now

#Adolescent Psychiatry Services #Adolescent Psychiatry Care #Adolescent Psychiatry Service #Telehealth Therapist Clinic #Telehealth Companies Washington #Telehealth Psychiatrist Near Me #Telehealth Therapy Washington #Medication Therapy Management Services #Weight Management Medication

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womented · 1 year

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"transitioning helps alleviate suicidality and improve quality of life" DEBOONKED

Source: Zucker, K.J., Lawrence, A.A., Kreukels, B.P. (2016). Gender Dysphoria in Adults. Annu Rev Clin Psychol. [Link]

More sources:

An Australian paper stating that most available evidence indicating positive outcomes for gender reassignment is of poor quality. (D’Angelo, R. (2018). Psychiatry’s ethical involvement in gender-affirming care. Australasian Psychiatry 26 (5): 460-463. [Link])

A prominent study claiming that medical transition alleviated suicidality had to be corrected, to clarify that it proved “no advantage of surgery” in this regard. (American Journal of Psychiatry (2020). Correction to Bränström and Pachankis. Published online: 1 August 2020. [Link])

A long-term study in the European Journal of Endocrinology demonstrating that suicide rates among transgender "male-to-females" were 51% higher than the general population. (Asscheman, H., Giltay, E. J., Megens, J. A. J., de Ronde, W., van Trotsenburg, M. A. A. & Gooren, L. J. G. (2011). [Link])

British review conducted by the National Institute for Health and Care Excellence (NICE) graded certainty of evidence for puberty blocker use as “very low” in every category, including impact on gender dysphoria, mental health, body image, global functioning, psychosocial functioning, cognitive functioning, bone density and adverse effects. (National Institute for Health and Care Excellence (2021). Evidence review: Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria. National Institute for Health and Care Excellence (NICE); NHS England; NHS Improvement. [Link])

A German study “found insufficient evidence to determine the efficacy or safety of hormonal treatment approaches for transgender women in transition”, adding that “[t]his lack of studies shows a gap between current clinical practice and clinical research.” (Haupt, C., Henke, M., Kutschmar, A., Hauser, B., Baldinger, S., Saenz, S.R. & Schreiber, G. (2020). Antiandrogen or estradiol treatment or both during hormone therapy in transitioning transgender women. Cochrane Database of Systematic Reviews 11. [Link])

When it comes to gender dysphoric children, there is little evidence that medical transition decreases suicide rates. There is little evidence to assert that puberty blockers are necessary to prevent suicide. (Biggs, M. (2020). Puberty Blockers and Suicidality in Adolescents Suffering from Gender Dysphoria. Archives of Sexual Behavior (49): 2227–2229. [Link])

#now imagine how many more studies we would have if #research like this wasnt suppressed or shunned #radfem safe #radfems please interact #terfs do touch #terfs do interact #radical feminism #radfem sources

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tallmantall · 5 months

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James Donaldson on Mental Health - Study looks at teens who deny suicidal thoughts, but later die by suicide

By Erin Blakemore A previous version of this article incorrectly said a new study had found that nearly 1 in 3 teens with depression who deny having thoughts of suicide or self-harm on a commonly used mental health screening questionnaire go on to kill or harm themselves in the following months. The study found that among teens with depression who go on to die by suicide or harm themselves, about 1 in 3 reported not having such thoughts in the screening questionnaire. About 1 in 3 teens with depression who self-harm or die by suicide denied having such thoughts when completing a commonly used mental health screening questionnaire in the preceding days or weeks, a new analysis suggests. The study, published in JAMA Psychiatry, looked at 13-to-17-year-olds with depression diagnoses who answered Question 9 of the Personal Health Questionnaire (PHQ), which is used to screen for depression severity, before intentionally harming or killing themselves between 2009 and 2017. The researchers split the teens into two groups: a cohort of 691 who completed the questionnaire within 30 days before self-harm or suicide and 1,024 who completed the questionnaire within 90 days of self-harm or suicide. In the 30-day cohort, adolescents who gave themselves a score of 0 on the question about thoughts of suicide and self-harm were “significantly” less likely to have depression than those who said they were experiencing thoughts of suicide and self-harm. However, those with a history of inpatient mental health treatment were twice as likely to deny such thoughts as those with no history of mental health hospitalization. Among the 90-day cohort, teens were less likely to report thoughts of death or self-harm if they had less severe depression, were older or were screened at a primary care provider’s office. Those with eating disorders were 60 percent less likely to deny thoughts of suicide or self-harm, however. Teens with a previous mental health inpatient stay, substance use disorder or a diagnosis of ADHD were likelier to score 0 on the questionnaire. Overall, the researchers found, 30 percent of teens screened with the PHQ-9 who later intentionally self-harmed or died by suicide had reported they had no thoughts of suicide or self-harm on the questionnaire within the previous 30 or 90 days. The researchers note that the questionnaire is used to screen for depression, not suicide specifically, and that the questionnaire became more common during the study period, which could account for some of the findings. #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space. #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy www.celebratingyourgiftoflife.com Link for 40 Habits Signupbit.ly/40HabitsofMentalHealth If you'd like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here's the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub To better address surging suicides and self-harm among teens, they write, it’s important to figure out why adolescents deny having such thoughts. Adolescents with a history of mental health hospitalization may be reluctant because they fear re-hospitalization, the researchers note, or are afraid that caregivers will overreact. The same fears could explain why older teens were less likely to disclose. “Understanding reasons why many at-risk adolescents do not endorse thoughts of death and self-harm should be given high priority,” the researchers conclude. According to the Centers for Disease Control and Prevention, youths and young adults make up 15 percent of all suicides, and suicide is the second-leading cause of death among 10-to-24-year-olds. Read the full article

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neurodiversitysci · 2 years

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Are You Interested in ADHD Research? Here’s Where to Start

A reader recently asked me, in reply to a recent blog post about Russell Barkley, what important research is being done on ADHD, and who is doing it.

The best place to start exploring ADHD research is with the World Federation of ADHD International Consensus Statement (open access PDF here). This 2021 meta-analysis lists 208 evidence-based conclusions about ADHD.

It makes an excellent introduction to ADHD research because it spans a variety of topics, including:

Who has ADHD and how common it is worldwide

Genetic and environmental causes,

How the brain differs in ADHD,

How ADHD affects skills in cognitive and academic areas,

What treatments are safe and effective,

What life outcomes affect people with ADHD -- including educational achievement, peer relationships, health problems, rates of accidents and substance abuse, quality of life, and more.

The paper is well organized, with the conclusions placed under clear, useful topic headings.

The writing style seems clear, and fairly easy to read. There’s not much jargon, as research papers go. However, I’m a former cognitive neuroscientist who has probably read thousands of research papers, so your mileage may vary, depending on your experience reading psychology and neuroscience research papers.

Who:

There were 80 authors from 27 countries and 6 continents, led by prolific researcher Stephen V. Faraone.

Authors were representatives of national and international ADHD organizations, such as the World Federation of ADHD, EUropean NETwork for Hyperkinetic DisorderS (Eunethydis), the Latin American League of ADHD, the Chinese Society of Child and Adolescent Psychiatry, etc.

What they Did:

1. The authors reviewed studies that had at least 2,000 participants, meta-analyses of five or more studies, and meta-analyses with at least 2,000 participants.

2. Based on this research, the authors created 208 evidence-based statements about ADHD.

3. Finally, 403 people read the manuscript and agreed with its contents.

Why:

This was the second international consensus statement written about ADHD. It updates the original statement by “cataloging important scientific discoveries from the last 20 years.”

“Nearly 2 decades ago, an international team of scientists published the first International Consensus Statement on ADHD. They sought to present the wealth of scientific data attesting to the validity of ADHD as a mental disorder and to correct misconceptions about the disorder that stigmatized affected people, reduced the credibility of health care providers, and prevented or delayed treatment of individuals challenged by the disorder.” [bold added by me].

Keep in mind that not every interesting topic in ADHD research is covered:

“If a topic is not included in this document, it does not mean the topic is unimportant; rather, it means the evidence found was insufficient to allow firm conclusions. This could be because there were insufficient studies of quality, because no attempt was made to assess publication bias, or because the data available did not support the claims made.”

What they Found:

Here are some of the conclusions I think will be most interesting and important to ADHD people and their supporters:

ADHD is not new. Signs and symptoms have been recognized as clinically significant for over 200 years.

The diagnosis of ADHD is valid, based on standard criteria for the validity of a mental disorder.

ADHD occurs throughout the world. It affects about 6% of youth and 3% of adults, and is more common in males than females.

ADHD has not become more common in the past 30 years.

There are many genetic and environmental causes for ADHD.

Environmental causes typically affect fetuses and newborns. Environmental causes include: exposure to toxins; nutrient deficiencies; very/extremely preterm birth or low birthweight; extreme deprivation, stress, infection, poverty, or trauma early in life; or traumatic brain injury early in life.

There are differences in the brain between groups of people with and without ADHD. However, these are not useful for diagnosing ADHD. First, these differences are typically small. Second, they do not differ between ADHD and other disabilities.

Differences in the brain are structural (such as cortical surface area, gray matter volume, white matter integrity) and functional (activation in specific areas in general and while doing specific tasks, as measured by fMRI and electroencephalogram activity).

ADHD medications do not change brain structure. They do affect brain function, especially in inferior frontal and striatal areas that are atypical in ADHD.

As a group, people with ADHD have deficits in a variety of abilities measured with psychological/neuropsychological tests, including: academic achievement (reading, spelling, arithmetic); working memory; various forms of attention; planning and organization; impulsive decision making; and a preference for small immediate rewards over large delayed rewards.

Some medical problems are more common in ADHD, including allergies and asthma; obesity; sleep disorders; somatic disorders; and more.

ADHD can reduce quality of life for young people and their parents, relative to typically developing young people and their parents.

Children and youth with ADHD are more emotionally disregulated. They may be more emotionally reactive to novel or stressful events.

Children and youth with ADHD are more likely to have emotional problems, conduct problems, or peer problems/difficulty socializing with and rejection by peers, and to engage in bullying.

Children and youth with ADHD have higher rates of accidental injuries and traumatic brain injury (TBI), substance use disorders, risky behavior, and premature death.

Children and youth with ADHD have higher rates of suicide.

People with ADHD are more likely to be both perpetrators and victims of crime. However, they are also more likely to make false confessions.

People with ADHD are more likely to experience educational underachievement, such as lower achievement, needing special education services, dropping out of school, or not graduating high school on time.

Several medications are safe and effective for treating ADHD symptoms, including both stimulant and non-stimulant medications. These medications have specific adverse effects, including on sleep and children’s height gain.

Some non-medication treatments for ADHD are safe and effective, including “behavioral and cognitive-behavioral therapies,” computer-based cognitive training and neurofeedback, omega-3 fatty acid supplements, and exercise.

What’s Next?

Remember that not every research finding about ADHD was included in the paper. The Discussion section lists things we still need to learn more about. Here are some of my favorites:

How culture affects the way ADHD manifests and responds to treatment

How ADHD affects older adults

Effects of stigma on people with ADHD

The nature of emotional regulation symptoms of ADHD, and whether they should be added to the diagnostic criteria

In addition, I noticed some topics were missing despite a large body of research exploring them, and in my opinion, good evidence (at least from studies with fewer than 2,000 participants):

The overlap between ADHD and other developmental disabilities, such as autism, dyslexia, dyscalculia, and developmental coordination disorder (DCD)/dyspraxia.

The role of dopamine in ADHD.

The rates of anxiety and depression in people with ADHD.

Variability in performance (especially response time) from moment to moment, which researchers call “intra-individual variability,” and which I’ve read is perhaps the best-supported symptom of ADHD -- is mentioned as part of the findings of one meta-analysis (#67), but not as a fact about ADHD in its own right.

How can I use the paper to learn more?

Here are some ways you can use this paper as a jumping-off-point to learn more about research findings that interest you. These suggestions are aimed mostly at people who don’t read a lot of research papers, so feel free to ignore them if you have more experience.

1. First, see Table 1 for the summary of findings. You can follow links from the table to whichever findings most interest you.

2. Read the introduction, discussion, and the sections that interest you.

3. Look at the references for claims that seem interesting or surprising.

Who wrote these papers? Check out the authors’ websites, and see what they’re studying. Search Google scholar for their names, and you will find a list of their papers, which you can sort by date.

4. Follow up by reading interesting cited papers: The easiest way to find specific papers is to search Google scholar for the titles. You can always find the abstracts free at the publisher’s website. On Google Scholar, you can often find a free pdf of the full text on the right-hand margin of the page. (If you don’t see one there, click the button “See x versions” next to the link to “Related articles”).

Have you read the International Consensus Statement? What did you think? Did anything in it, or not included, surprise you?

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