The political realignment of ADHD scepticism

From Naughty Boys to neurodiversity

From left to right

About 10-15 years ago, back when Donald Trump was the guy off the American version of the Apprentice and Nick Clegg’s Dorian Grey-style portrait was only just starting to go south, I was an ADHD researcher. We were interested in neural biomarkers for the condition, that would differentiate between kids with and without ADHD.

When I told people what I researched, nine times out of ten they would ask whether I thought ADHD was a real thing or not. Left of centre people, my people, were generally a bit sceptical of the condition. The left saw ADHD as a ruse by pharmaceutical companies to sell psychostimulants to children. Diagnoses were generally viewed with suspicion, but none more so than ADHD.

I engaged with some of the critical texts on the topic. My old supervisor loaned me a book arguing against the diagnosis. I bought (but didn’t finish reading, some things never change) Sammi Tamimi’s Naughty Boys, an influential polemic. I felt a bit conflicted on the topic. I remember being at an ADHD conference in Istanbul, where there were drug reps handing out Turkish delight, which I declined, having read the Lion, the Witch, and the Wardrobe as a child. It was too on the nose, as we say nowadays.

Part of this conflict was intellectual, but I think a big part of it was that believing in the validity of the diagnosis felt a bit… Tory. Scepticism in ADHD was left-coded, and support for the diagnosis was therefore right-coded.

Fast forward to the present day. Donald Trump is president (again); Nick Clegg’s portrait is nightmarish; I still look great. The vibe on ADHD, however, has very much shifted. Scepticism about ADHD feels clearly right-coded. Celebrating ADHD as a form of neurodiversity feels clearly left-coded. What happened?

Epistemological drift

Firstly, conservatives have done a 180 on institutional expertise. As Michael Gove famously said, “the people of this country have had enough of experts”. Following the political polarisation of the Covid-19 pandemic (a topic I imagine we will come back to another time) this is particularly the case for medical expertise. Once upon a time, perhaps conservatives might have taken psychiatrists and researchers at their word that ADHD was a bona fide condition, but not anymore. The right is unwilling to take on trust that biomedical science is playing fair, and suspects that they are advancing secret political goals. This is likely also tied into the spread of accommodations for hidden disabilities, like ADHD, in the workplace, educational settings, and beyond, of which conservatives are sceptical. The right has developed a deep epistemology of suspicion.

On the left, I wouldn’t say that faith in institutions has grown – look at the decolonisation attempts of the early 2020s. However, like the right, the epistemology of the left has changed. On the left, we have seen a growth in standpoint epistemology, a belief that lived experience of the affected group is vital for making sense of a phenomenon. While previously left-wingers were instinctively suspicious of the motivations of pharmaceutical companies, now they would follow the lead of people with the diagnosis themselves. If they find it helpful, who are we to disagree?

ADHD grows up

This dovetails with the next part of the story. Twenty years ago, ADHD was essentially a condition of childhood. It was a diagnosis applied to naughty boys, as Tamimi’s book put it. These children weren’t participants in the ADHD debate, or in politics more broadly. These children, however, have now grown up. They have been joined by a growing proportion of people who have been diagnosed in adulthood. ADHD is no longer only a condition of childhood.

This means that people with ADHD can, and do, speak for themselves on the subject. Instagram and TikTok are full of people doing just that. While opinion on the diagnosis varies, a substantial proportion find it a helpful label for making sense of their experiences. Given the modern left’s commitment to respecting lived experience, particularly of marginalised groups like those with disabilities, scepticism of ADHD is seen at best as rude and at worst as bigoted.

ADHD has also become more than a diagnosis. It’s now a social identity, adopted not just by people with an official diagnosis but also those who feel that the label fits their experiences. ADHD has become part of the wider neurodiversity movement which advances a social model of disability and neuropositivity.

Moreover, people with ADHD are not just participants in the debate about ADHD, they are also participants in politics more broadly. Here, the left may feel as though it is the natural home for ADHD voters. ADHD often co-occurs with other health issues and other aspects of social disadvantage, issues which the left traditionally champions. As well as feeling intrinsic motivation to represent people with ADHD, left-wing parties may also be engaging in a degree of coalition management in seeking to represent this growing cohort of voters.

Conversely, the right sees this growing cohort with ADHD as part of a larger pattern of declining personal responsibility, identity politics, and political correctness. They think we are giving undeserved special treatment to a group who need to pull themselves together. They suspect that said special treatment might be rather expensive for taxpayers and businesses too. Rather than seeking to appeal to people with a diagnosis of ADHD, they play off the growing prominence of the diagnosis to try and land a broader critique of duplicitous experts mollycoddling ‘snowflakes’ on taxpayers’ money.

So here we are. On reflection, it’s really no surprise that scepticism about ADHD has become politically realigned. Everyone in question – people with ADHD, the left, and the right – have evolved markedly over the last couple of decades. It would have been amazing if the politics of ADHD scepticism hadn’t changed. But it would be a mistake to see this is an endpoint. The mapping between healthcare and culture is rarely durable. In another 15 years the debate may have changed beyond all recognition all over again.