Complex ADHD in a Transgender Adolescent: Case Study and Clinical Implications

BackgroundAdolescents have increasingly been reported as identifying as transgender or gender-diverse and seeking gender-affirming care. Nonetheless, the proportion receiving gender-affirming medical treatment remains low; in the United States, fewer than 100 out of every 100,000 17-year-old adolescents assigned male at birth receive gender-affirming medical treatment. Attention-deficit hyperactivity disorder (ADHD), the most common childhood neurodevelopmental disorder, is a major public health concern and shows elevated prevalence among transgender and gender-diverse adolescents.Case PresentationThis case presents a 15-year-old adolescent with ADHD and co-morbidities, including gender dysphoria, harmful use of substances, and childhood mood disorders. After antipsychotic and antidepressant pharmacotherapy combined with psychological interventions, the patient demonstrated improved emotional regulation and diminished impulsive behaviors.ConclusionThis case underscores the need for life course-oriented care that addresses transgender-specific stressors and incorporates preventive substance abuse strategies. It also emphasises the urgent need for research into comorbidity-tailored pharmacotherapy to balance ADHD treatment efficacy with gender-affirming hormone safety.