Thursday, November 20, 2008

Why Feminism Is Still Relevant: Girls and Research and ADHD

As I've mentioned before, I listen to Talk of the Nation daily during my workday, along with a variety of other programs ranging from those I have to listen to with my earbuds in and those that I can listen to on my iPod's docking stereo without worry. Tuesday's Talk of the Nation, the second hour had Allison Stewart and her guest, Steven Hinshaw - Chair of the Department of Psychology at the University of California Berkley - tackling the issue of ADHD diagnosis in girls as opposed to boys. One of the interesting things the program brought into sharp focus for me was how ADHD is seen as a boys' illness. When girls have ADHD, they are less likely to be diagnosed because there is a widespread belief, among clinicians and parents, that ADHD does not effect girls. Before it is even available, ADHD is taken off of the table of potential culprits. Another issue Steven Hinshaw made mention of is the type of ADHD girls are more likely to have. According to Hinshaw,
"For some girls, the behaviors look pretty similar to the stereotypic boy. There's out of seat behavior and fidgeting; but often in girls, there isn't that overt behavior. There's a kind of spaciness... inability to focus, doesn't seem to hear or listen to things, real problems organizing, and the typical girl like this suffers in silence for all too many years."
One of the things not mentioned on the program but that immediately came to my mind is that some of that may be misdiagnosed or not diagnosed at all simply because it fits stereotypical girl behavior, and not girls with behavioral or psychiatric problems but regular girls. Girls, especially if one is blonde, are practically expected to be spacey. Girls have the airheaded stereotype fed to them so often it is a wonder any girl with ADHD even contemplates there being something wrong with her. We are fed those images of girls who can't, or don't, concentrate; girls who are more interested in boys and make up and the latest fashion trends than they are in school  - or, as in an episode of Burn Notice and separate but similar episode of Monk, almost certain death. A girl who felt odd about being so spacey could easily find 5 or 10 examples of how that was normal girl behavior simply by flicking through the television channels. And so would parents and teachers and doctors.

What Steven Hinshaw makes clear is that "all of the disorders of childhood that are behavioral or emotional or psychiatric appear more in boys", but what he also makes clear early and then often is this: "...boys with ADHD... are 99% of those studied... ...What we don't know very much at all yet is what are the long term outcomes in girls because there's only been literally a handful of longitudinal studies past childhood. And those studies - including ours here in Berkley, some on the East Coast, a couple in Europe - suggest that (a) girls can and do get ADHD and (b) when they do, in the adolescent years, as with all girls, there's a risk for anxiety, depression, and eating symptoms (A/N: I assume he means eating disorder symptoms). Girls with ADHD have more of that risk."  This is why feminism is still very much a viable movement, and why it is still very necessary. And this is what finally gets Allison worked up (sidenote: Crankosaur, if you're reading this, what do you think of Allison Stewart as a fill-in for Neal Conan? Because I think she's doing a terrific job). She says,
"I want to take off my host and journalist hat for a moment and put on my concerned citizen hat. When we were researching this story and talking about this story, I found myself just a little bit angry that there wasn't more research about girls, that there are all these young women and girls out there struggling with this problem and there hasn't been a whole lot of attention paid to it."
You and me both, Allison. Except in my case, I'm not just a little bit angry. I'm a lot angry. And more than part of that anger stems from the fact that men and boys, and white men and boys, are the default for humanity - always. Even when someone is anonymous, the general idea of them is as a man until it is proven otherwise. I can't even be incredibly angry at the researchers and the people funding these studies, because it isn't a personal myopic issue but a systemic one. This isn't just a bunch of idiot scientists who were too caught up in their own gender to recognize that there was a whole 51% of the population being left out in the cold; this goes to the very core of how we think and how we see the world and everyone in it.

And Hinsahw's reply, while emphasizing his own progressiveness and his own perspective of the inherent unfairness and inequality of this situation, doesn't do much to make my world view change very much at all. He contends,
"Well, I think this is a problem that has been noticed way beyond ADHD for some time now, maybe not long enough. Back in the early 90s, as I got research grants from the national institutes of health and press releases were put out and alerts to investigators, 'if you're studying heart disease, you've got to include females in your sample as well as males.' Females get afflicted by cardiovascular illness, but most of the research was on men, so we do have a sex or gender bias in a lot of areas of research. Now, as I mentioned in the outset, for the behavioral and emotional problems of childhood, boys are more at risk than girls, maybe 3 to 1 for ADHD, maybe 4 to 1 for autism; but the research was being done at 10 to 1, or 20 to 1, or 50 to 1. We need to raise our consciousness. We need to recognize that many of these conditions, both biomedical and psychiatric, are pretty much equal opportunity  - across races and ethnic groups, across the sexes - and we need to have researchers and clinicians and the citizenry realize and demand that attention is paid clinically and in terms of basic research so that we don't neglect a group really in need of treatment because of our stereotypes and our stigmas."
The thing that stands out for me is that although the ratios for most of these disorders is 3 to 1 or 4 to 1, the ratio for this research is out of this world and highly stacked against women. Those are abysmal odds. Those are depressing odds. And those are odds that make women seem insignificant in terms of interest and worth. This is why feminism is still very much needed. This is why we need more enlightened men working in these fields like Steven Hinshaw. But this is also why we need more women in these fields, and I would venture more minorities as well. In order for women to be a concern, perhaps we need to simply have more women be the ones doing the research. Perhaps one of the very real issues here is simply a lack of diversity at the upper levels of scientific research; and so when a man looks across a room and he is merely met with more men, his thoughts naturally do not drift beyond that homogeneous interest group. Either way, this is something that we need to recognize as being a valid issue, and cause for concern. Either way, this is something we need to highlight and point to, and bring as much attention to as possible. Because this is only one reason out of the many for why feminism is still a necessity in the lives of women, but it is a compelling one.


Anonymous said...

I haven't been listening to "Talk of the Nation" lately because I'm usually off doing important schooly-type thing (ie: getting coffee with my officemate or mooching candy off professors). I may have to look into this... I'm pretty into the sociology of mental illness. I think the fact that girls' attention problems get so little attention and really aren't particularly disruptive in the classroom really gives support to the theory of ADHD diagnoses being more about social control than actually helping children perform better in school.

MediaMaven said...

This reminded me of an article in the Times Magazine on girls and autism, how it's considered quite rare because the symptoms in girls are different.