Gender Dysphoria & ADHD

Andrew Stewart
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Significant Ideas
● Gender identity exists on a wide spectrum
rather than a binary system
● Identity, expression, sex assiggnment at
birth, and physical/emotional attraction are
all interconnected, interdependent, and yet
independent variable fields of human
experience that do not by default co-
determine one another in their formation or
expression (i.e. being assigned the male sex
at birth does not dictate attraction to
members of a certain other group)
● Accommodations/protections for students
exploring their gender are described in the
RIDE Guidance Document “Guidance for
Rhode Island Schools on Transgender
and Gender Nonconforming Students:
Creating Safe and Supportive School
Environments” issued in June 2016
Gender Dysphoria Video

Video available at <https://youtu.be/ryV6lI1pawI>

Gender Dysphoria Supports in the Classroom
● Bullying, discrimination, and unconcious bias are major challenges
○ This can be further complicated in multicultural student
populations where conservative beliefs about
gender/sex/sexuality are strongly-held communal beliefs
● Suicidality in gender-minority students is extraordinarily high
(Thoma et al., Suicidality Disparities Between Transgender and
Cisgender Adolescents 2019)
Suicidality Rates

Thoma et al., Suicidality Disparities Between Transgender and Cisgender Adolescents 2019
Gender Dysphoria Supports in the Classroom
● In “'Here’s Your Anatomy...Good Luck': Transgender Individuals in Cisnormative Sex
Education" by Steven Hobaica, Kyle Schofield & Paul Kwon (American Journal of
Sexuality Education, April 2019), the authors identify how instructional practices
prejudiced against sexual/gender minorities manifest and impact students
○ Arguably sex education is most useful example in this matter because it
manifests as minority representation in the most direct and concrete fashion
possible i.e. it describes student population directly in the exact space-time
moment they developmentally occupy
○ Authors contrast impacts of cis-normative to inclusive sex ed upon students,
arguably useful for understanding impacts across multiple disciplines and
classroom subjects
Gender Dysphoria Supports in the Classroom
RIDE Gender Dysphoria Supports in the Classroom
● Confidentiality/Privacy
○ Gender identity is a sensitive matter. RIDE advises that faculty/staff/administration should be
cautious about disclosure to parents if the student risks physical or mental abuse as a result of
disclosure
● Gender Transition
○ Some students will opt for social and/or medical gender transition. Schools should work with
students and families to implement a process whereby concepts (i.e. correct pronouns) and a
timeline can introduce the process to the wider community in a fashion that is both welcoming
and integrative for the student while also maintaining privacy and safety (eg. bathroom and
locker room norms)
○ Dress codes and health/phys ed/school sports must be accomodating and universally applicable
to student gender identity, expressing no prejudice in enforcement of rules
Professional Organizations and Contemporary News Coverage

● Orgs
○ Trans Student Education Resources <https://TransStudent.org/>
○ Providence Youth Student Movement <http://PrYSM.US>
○ Youth Pride RI <https://www.youthprideri.org/>
● Major News Coverage
○ "
DeVos Vows to Withhold Desegregation Aid to Schools Over Transgender At
hletes
" by Luke Broadwater and Erica L. Green, 9/18/20 NY Times
○ "
Transgender Texas teen says she’s been banned from school until she adher
es to male dress code
Attention-deficit/hyperactivity disorder (ADHD)
● One of the most common mental disorders affecting children. ADHD also affects
many adults. Symptoms of ADHD include inattention (not being able to keep
focus), hyperactivity (excess movement that is not fitting to the setting) and
impulsivity (hasty acts that occur in the moment without thought).
● Many ADHD symptoms, such as high activity levels, difficulty remaining still for
long periods of time and limited attention spans, are common to young children
in general. The difference in children with ADHD is that their hyperactivity and
inattention are noticeably greater than expected for their age and cause distress
and/or problems functioning at home, at school or with friends.
○ DSM-V Definition
ADHD in Classroom Video

Video available at <https://youtu.be/qfctBPLCc7E>

ADHD in the Classroom
● ADHD and ADD are no longer qualified as separate mental
health diagnoses; instead, the symptoms that used to define
ADD as a separate diagnosis are folded into the ADHD
diagnosis
○ Predominantly inattentive- memory, organization, focus issues,
previously called ADD.
○ Predominantly hyperactive-impulsive ADHD involves restless/impulsive
behavior but no attention issues.
○ Combined ADHD- both attention and restlessness
ADHD in the Classroom
● Manifestations
○ Distracted/off-task from assignments
○ Distraction of other students
○ Disruptive behavior
○ Incomplete assignments
○ Disparities in grading with subjects/classes student enjoys
versus those that are disinteresting
ADHD in the Classroom
ADHD in the Classroom
● Classroom supports include:
○ Setup of the physical space- Classroom design and layout of desks as well as
things like “wiggle chairs” or stress balls
○ Providing tools/devices for student use- Teach skills and methods as well as
items like highly-structured notebooks and graphic organizers
○ Accommodations for assignments and tests- Offer individualized
assignments/tests as well as 1-to-1 interventions
● Youths are also eligible for IEPs that formalize recognition and accomodations with
the school and family
Classroom Supports
Classroom Substance Use Disorder and ADHD
● A significant and concerning health
development is the illicit use of ADHD
medications
● A significant portion of ADHD diagnoses are
prescribed stimulants such as Methylphenidate
(Ritalin) or Amphetamine/Dextroamphetamine
salts (Adderall)
● Substance abuse of stimulants is a long-
standing problem in America that predates the
proliferation of Ritalin as the first ADHD
stimulant treatment
● Black market sale of stimulant medications has
emerged over the past two decades
● Stimulant abuse can cause impacts in
neurological, psychological, and cardiological
systems, including stroke and heart conditions
Professional Organizations and Contemporary News Coverage

● Orgs
○ American Academy for Child and Adolescent Psychiatry <https://www.aacap.org/>
○ Attention Deficit Disorder Association <https://www.add.org/>
○ National Resource Center on ADHD <https://www.help4adhd.org/>
● Major News Coverage
○ "Theresa Cerulli, MD: ADHD Students Struggling During COVID-19" by Kenny Walter,
9/21/20 HCP Live
○ "Penn State’s decision to end alternative grading is failing its neurodivergent students
" by Anonymous, 10/5/20 by The Daily Collegian
○ “Signs That You Are Self-Medicating Your ADHD” reviewed by Smitha Bhandari, MD,
7/20/2020 at WebMD
Additional Impairments
● Epilepsy- neurological tendency to have seizures, susceptibility exists on a spectrum
● Heart conditions
● Hemophilia- blood disorder preventing proper clotting, can lead to increased bleeds, bruising,
internal hemorrhaging
● Lead poisoning- infant/child consumption of lead in water or chipping paint causes brain
damage, learning impairments
● Leukemia- a group of blood cancers that usually begin in the bone marrow and result in high
numbers of abnormal blood cells
● Nephritis- kidney inflammation
● Rheumatic fever- inflammatory disease that can involve the heart, joints, skin, and brain,
typically develops two to four weeks after a strep throat infection.
Additional Impairments
● Sickle cell anemia- an abnormality in the red blood cells, leads to a rigid, sickle-like shape under
certain circumstances, health problems include attacks of pain ("sickle cell crisis"), anemia,
swelling in the hands and feet, bacterial infections and stroke
● Tourette syndrome- neurodevelopmental disorder characterized by multiple movement tics and
at least one vocal tic
● Fetal alcohol syndrome (FAS)- Symptoms including abnormal appearance, short height, low body
weight, small head size, poor coordination, low intelligence, behavior problems, learning
difficulties and problems with hearing or sight that can be attributed to prenatal alcohol
consumption
● Bipolar disorders- extreme changes in mood and behavior accompanying periods of depression
and periods manic or hypomanic episodes.
● Dysphagia- subdivided into four types of difficulty swallowing