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Gender identity

For some people the sex they were assigned at birth might feel wrong. Others may feel that their identity is fluid and that the binary description traditionally used to define gender does not tell the full story. Questioning gender may lead a person to transition, but it might also make more room for fluidity and self-acceptance. A therapist with a firm understanding of gender identity is well-placed to explore such issues.
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How do I know if I have ADHD? Does my child have ADHD?

Many people with ADHD aren't aware they have it. They will be aware however that everyday tasks seem more difficult for them than for others. Typical symptoms are finding it hard to focus, missing deadlines and trouble controlling impulses, ranging from impatience to mood swings and outbursts of anger. Other symptoms include:

  • Trouble multitasking.
  • Excessive activity or restlessness.
  • Poor planning.
  • Hot temper.
  • Trouble coping with stress.

What ADHD is not

The above list may be familiar to most people at different times in their lives. If these symptoms occur only occasionally, they probably don't have ADHD. A doctor usually diagnoses when someone’s symptoms cause problems that stop a person working, finding stable housing, or living normally and safely.

Diagnosis of ADHD in adults is often trickier because the same symptoms also occur in mental health conditions, such as anxiety or mood disorders. Many adults with ADHD also have at least one other mental health condition (depression and anxiety are the most common).

At what age do ADHD symptoms appear?

Symptoms usually start before the age of 12 and continue into adulthood.

How long does ADHD last?

ADHD is a lifelong condition, though it often becomes less marked in adulthood. But it can be effectively managed. The first step is to see a doctor and start seeking a diagnosis.

How many people have ADHD?

In the UK, the incidence of ADHD in school-aged children is thought to be between 3 and 5%. In adults it is between 3 and 4%.

What causes ADHD?

We still don’t know for sure. An enormous amount of research is focused on finding the causes of ADHD. Factors that may be involved include:

  • Genetics.
  • Environment.
  • Problems during development.

What are the risk factors for ADHD?

The risk of a person developing ADHD may increase if:

  • Family members suffer from ADHD.
  • During pregnancy the mother smokes, drinks, or uses drugs.
  • A child is premature.

What are the impacts of delayed diagnosis of ADHD?

ADHD has been linked to:

  • Poor school or work performance.
  • Unemployment.
  • Financial problems.
  • Trouble with the police.
  • Alcohol or drug misuse.
  • Unstable relationships.
  • Poor self-esteem.

How is ADHD diagnosed?

Making the diagnosis normally includes:

  • Asking questions about symptoms and family medical history.
  • ADHD tests to measure symptoms.

What are the treatments for ADHD?

ADHD is normally treated through a two-pronged approach:

  • Medication.
  • Therapy.

ADHD medication

Doctors might prescribe stimulants for ADHD – which might seem counterintuitive, but has a strong evidence basis for regulating brain activity.

Some ADHD patients might also benefit from antidepressants or other medication, but in every case a doctor is best placed to advise on what to take.

Therapy for ADHD

Psychotherapy is indicated for people with ADHD but behavioural therapies can also help manage traits that make people with ADHD disorganised, and teach useful skills as well.

Help and information about ADHD

ADHD (NHS Choices)

NHS Choices provides information about the signs, symptoms and treatment for depression.

ADHD Foundation

For people with an ADHD diagnoses, this charity provides resources and advocacy.

Young Minds

Aimed at young people, this profile of ADHD explains what it is, how to seek treatment and mental health concerns for people with ADHD in a clear and straightforward way.

Click here to see practitioners who specialise in

Gender identity

What is gender identity?

Gender identity is a term used to describe the sense of who one is, one’s masculinity and femininity, and how we see and describe ourselves.

Some people feel their gender identity is different from the sex they were designated at first.

Others do not define themselves as having a "binary" gender identity.

It is important to clarify that gender dysphoria is not a mental illness, although some people do suffer mental ill-health because of gender dysphoria.

What gender identity is not

Gender identity is not the same as sexual identity, and just because a person questions or changes their gender identity doesn’t mean they must question or change their sexuality. So for example, being non-binary does not ‘make’ a person gay, straight or asexual.

That said, having the freedom to explore or express your gender identity in therapy might raise new questions about other aspects of life – family, culture, society, work, love, and sexuality. The way we’re seen, and see ourselves, has a huge impact on self-esteem and wellbeing.

What is gender dysphoria?  

Children are often interested in clothes or toys that society tells us are more often associated with the opposite gender. They also frequently struggle with the development of their physical sex characteristics. This is common and usually just part of getting older.

However, a small percentage feel significant distress about their sex or gender, which may worsen with time and may be a sign of gender dysphoria.

How many people have gender dysphoria?

There are no good statistics showing how many people have gender dysphoria. However, in 2018/19 some 8000 adults were referred to adult gender dysphoria clinics for consultation.

What are the causes of gender dysphoria?

The cause of gender dysphoria is still poorly understood.

What help is available for gender dysphoria?

The first step is to talk about it. We have a number of experts within our team who are available to discuss any issues around gender identity a person may have. Our professionals can also help signpost to other specialist services, both NHS and private.

What treatment options are there for gender dysphoria?

If a child has a gender dysphoria diagnosis and wants more help to cope with their gender presentation or their experience of dysphoria, they might eventually be referred to the Gender Identity Service, part of the Tavistock and Portman NHS Foundation Trust in London.

The child/teenager is then reviewed by a team consisting of:

  • A clinical psychologist
  • A child psychotherapist
  • A child and adolescent psychiatrist
  • A family therapist
  • A social worker

They will then conduct a full assessment over a number of sessions.

Depending on the results of the assessment, possible outcomes include:

  • Therapy
  • Parental support or counselling
  • Group therapy
  • Referral to a specialist hormone (endocrine) clinic for hormone blockers for children who meet strict criteria (at puberty)

Talk therapy is the mainstay of treatment in children and adolescents

Adults who may have gender dysphoria are normally referred to a gender dysphoria clinic (GDC)

Much like children and adolescents, they will undergo a series of assessments by a team of health professionals.

Suggestions about treatment may include:

  • Counselling
  • Cross-sex hormone therapy
  • Speech and language therapy (voice therapy) to help you sound more typical of your gender identity
  • Surgery

History of trans rights in the UK


The Gender Recognition Act comes into effect, which gives legal recognition to transgender people in the UK.


The Equality Act makes gender reassignment a protected characteristic, which protects transsexual people’s right to fair treatment at work and when accessing public services.

Books, podcasts and events about gender identity

NB: My Non-binary Life (2019)

Caitlin Benedict & Amrou Al-Kadhi present a BBC series about NB identity.
Listen online

The Trans Teen Survival Guide (2018)

Fox and Owl Fisher’s practical guide to trans and non-binary identity includes information on dysphoria and depression.
Buy online

Other helpful resources for people questioning their gender identity

Gender dysphoria (NHS)

The NHS’s own guide to diagnosis and treatment of gender dysphoria.

Gender Identity Clinic (NHS Tavistock and Portman)

The website for the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust.


For people in distress or despair, especially for people experiencing suicidal thoughts, Samaritans is open 24 hours a day by phone (116 123) and email (