PURPOSE: The purpose of this study was to examine associations between identifying as transgender and attention deficit hyperactivity disorder (ADHD) symptoms in US early adolescents. METHODS: We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (Year 3, 2019-2021) to estimate associations between gender identity and ADHD symptoms using the Child Behavior Checklist Diagnostic and Statistical Manual of Mental Disorders-oriented attention problem scale scores, adjusting for age, sex, ethnicity, parent education, household income, and study site. Additional models adjusted for stress problems and depression symptoms. Multiple linear regression analyses estimated the association between gender identity and ADHD symptoms. RESULTS: In a sample of 10,277 adolescents, mostly 12-13-year-olds, 1.0% self-identified as transgender and 1.1% self-identified as gender-questioning. Self-reported transgender status (B = 3.41
95% confidence interval = 0.79-6.04
p = .011) and gender-questioning status (B = 2.72
95% confidence interval = 0.79-4.65
p = .006) were both associated with higher ADHD symptom scores when compared to cisgender peers after adjusting for sociodemographic variables. In models adjusting for stress problems and depression as well as sociodemographic variables, the associations between transgender and gender-questioning status and ADHD symptoms were attenuated and no longer statistically significant. DISCUSSION: Our results indicate that gender minority status may be linked to higher ADHD symptom scores, potentially due to higher minority stress.