Prevalence of Attention-Deficit/Hyperactivity Disorder Across Gender and Sexual Identity Groups in Youth: A Whole-of-Population Study.
Abstract
Purpose
To estimate attention-deficit/hyperactivity disorder (ADHD) prevalence across gender identity, transgender status, and sexual identity using whole-population linked data in Aotearoa New Zealand (NZ).
Methods
A nationwide cohort study using the 2023 NZ Census linked to administrative health data within Stats NZ's Integrated Data Infrastructure. Individuals aged 5 to 24 years were included. ADHD was identified from lifetime diagnosis and treatment records. Modified Poisson regression models estimated adjusted incident rate ratios (IRRs) by gender, transgender status, and sexual identity.
Results
Among 1,266,456 individuals, 43,095 (3.4%) had ADHD. ADHD prevalence was higher among those identifying with another gender (10.3%) than males (4.6%) or females (2.0%), and among transgender (9.9%) than non-transgender individuals (3.4%). Among those aged 15 to 24 years, ADHD prevalence was higher in non-heterosexual (8.0%) than heterosexual individuals (3.6%). Adjusted analyses showed similarly elevated rates.
Conclusion
ADHD prevalence was substantially higher among gender-diverse, transgender, and sexual diverse populations, highlighting the need for inclusive and equitable assessment and care pathways.