I was inserviced about ADHD. I recognized the behavior in my family and students. It was always male students. I was told that was because it was nearly always the boys who had ADHD and were often on meds. I’d seen it in my life among those I love. My husband might wake at 2am, drink a cup of coffee or two, and be able to get back to sleep. Think about that. He drank coffee to manage his overactive head—the stimulant allowed him to focus. That’s what Ritalin does—it seems a sort of backwards response to find that a stimulant allows the mind to slow down. [The way that the appearance of being laid back by smoking dope is countered by the reality that blood pressure rises with use. Yes, really.]

These days, I understand what we were all missing. Girls have ADHD as often as boys, only the symptoms, the way the issue presents, is different. The Facebook algorithm sends me reels as if I were ADHD. It’s also true of what I am reading about autism—all the early research done by men was about boys. Whoops! Girls can be on the spectrum too. What’s troubling is that I recognize the symptoms in myself, and have recognized this for a couple of decades. I once suggested to two psychiatrist-friends that I might be on the spectrum. They laughed. I shut up about that. Still…

At that time, in the early oughts, our sons were in college, I was teaching the largest student-load at my high school, I was teaching English with a particular focus on writing, I was in peri- and menopause, I was a full-time MFA student in writing, I’d deliberately cut my night’s sleep from 8 hours to 7 in order to get everything done, and my mother was dying. My brother thought I was being dramatic when I asked him for more help with Mom. He told me I was the most dysfunctional person he knew, and he would treat any further communication from me as spam. He was retired and saw her once a month or so; I saw her daily. I didn’t tell Mom, but when she found out her children weren’t talking, she blamed me. She demanded I “fix it!” Heaven knows, I tried, Gary tried, many times. I was told by student’s parent, who thought he was joking, that my brother said I was not his sister. Tell me this isn’t a lot going at once.

Most of what I needed to know about myself as a person and especially as a woman were never taught. Sure, pulled from class in grade school to watch a slide show about ovaries and period pads. Not a word about so much else I would have appreciated knowing. Mostly this is because the men directing health and medical research weren’t looking at women at all.

The powers that be finally noticed women and men present different symptoms in response to the same illness, that they respond differently to medication and require different medications. I first heard about this with heart attacks, which are still more likely to kill a woman than a man who is having one. I know of a woman whose heart attack was diagnosed only because she was in an exam room, and her doctor noted she was having one at the time! When I asked, the Red Cross Medic teaching the required Red Cross certification classes allowed that yes, women present differently during a heart attack, but he didn’t remember what those differences were.

It’s also true of mental illness. We begin grooming girls to be polite and accommodating, to smile and accept direction, and to blame themselves rather than anyone else, pretty much from birth. Don’t be loud, don’t make a fuss, that is unacceptable behavior, young lady! Contrast that with “boys will be boys,” which is an attitude of acceptance and has even been said literally dozens of times in my hearing. Anyone who knows me should know better. While I was subbing, I often covered for the head of the math department at the local high school. He told me that girls [women] simply weren’t good at mathematics. I told him I’d scored in the 99th percentile, and he raised his eyebrow. I don’t think he believed me, but there I was, the next week, working through teaching equations I’d never even learned in school myself. After he retired, instead of no more than one girl in the most advanced math classes, they made up half. [I was very good at math once upon a time, but at nearly 74, I need to see the problem on the page instead of only in my head.]

We know now that perimenopause and menopause cause changes that make ADHD symptoms different or worse. No doctor ever told me that menopause was the likely reason my 90/60 blood pressure abruptly became elevated. A scientist thought to study menstrual flow—what I was taught in childhood was composed only of blood and tissue from the lining of the uterus. She found (well, of course it was a woman scientist) that menstrual “blood” contains viable stem cells. Stem cells, the cells that can develop into anything—any human organ or tissue. Stem cells became an issue when anti-abortionists discovered they were collected from the umbilical cords of aborted fetuses. There was a great deal of screaming and a lot of promising research treating cancer and other diseases was abandoned. They could have been collecting stem cells all along from any woman between adolescent menarche and late middle age menopause, harmlessly and every darned month. Worth noting, they still aren’t using stem cells. One article suggested this was because of what men felt was the “ick” factor. Get over it, I’d say—we already do genuinely horrible things to treat some illnesses.

I was watching a drama on Netflix set in the nineteenth century and a character mentioned estrogen. I thought, “Did they know about estrogen in 1896?” So I looked it up. No. Estrogen was identified in the 1920s. Testosterone, by contrast, was the focus of experiments in the early 1800s. That shouldn’t have surprised me.

The Christian metaphor/mythology is that woman came second, that Eve was made from Adam. It is an absurd premiss. Woman is human, and male humans exist to fertilize what she grows. Lately I’ve seen some funny reels about this sort of thing.

It’s not new, this notion of women possessing the critical role in life. I suspect I’m not the only person alive to witness a boy crying because he could never give birth. It happened to me twice while I was still in high school. There’s even an official term for it. It’s called “womb envy.” I didn’t learn about that in school either, though the concept makes a lot more sense than penis envy, which I did learn. I mean, so what, he can pee standing up? So could white pioneer women making that long journey west in the 1800s. No underwear or a designed opening, stand with her legs apart and pee while concealed by her skirts. I don’t imagine I’m the first to think of how “women managed,” but I’ve never once seen anyone address the obvious.

It’s not rocket science, as they say, or brain surgery. It’s letting go of a bias that the originator of the controversial term “womb envy,” Karen Horney, explained as the unconscious envy toward women’s reproductive capacities, including pregnancy, childbirth, and lactation.

Emotion. My mother told me that people often looked for logical reasons to validate emotional choices. [She was talking about my dad, which was not entirely fair, since he was likely on the spectrum himself.] Teaching the persuasive essay, I’d explain that the opening, the hook, provides the emotional motivation for readers to agree with the thesis, but that purpose of most of the essay is to provide logical support for what the reader already wants to believe. Logic alone rarely convinces anyone who has an emotional attachment to a countering opinion. I saw this in students who absolutely could not change their mind about an issue even when science and logic proved otherwise. Their emotional attachment made them cling to the thesis they could not prove.

In one case, a student wrote a strong paper about the impact of exposure to violent video games tending to promote more violent behavior. She didn’t believe her own thesis was true, but she found it easier to write that thesis. She insisted to me that her brother played a lot of violent video games but was not at all violent. Her attachment and loyalty to her brother overload her own research. Another student was sure that testing those on public assistance for drug use and then using positive tests to throw them off government support would save money. His research found that this had been done, that abuse was rare, and that the savings were a tiny fraction of the cost. He didn’t change his opinion either. He proved his opinion was incorrect and still didn’t change his mind.

Students who were able to change their minds, usually managed this because an opposing view made more emotional sense.

Yet, these days, it seems like the woman who is most often labeled “emotional,” while the man screaming at the television about a missed call somehow escapes that label. All the time and in the moment, we make emotional choices while failing to consider the broad implications of our own bias or even that such bias exists at all.

Throughout my life I have understood that scientists are not without bias. What they assume, what they study, and the conclusions they reach supposedly based entirely on hard facts are too often influenced by their bias about culture, sex, poverty, war. As an undergrad, I saw bias in my class instructors, as a teacher I saw it in my peers, and as a patient I’ve found that it hampered my care.

So. I don’t routinely trust meds or doctors anymore. I could list all the other reasons and experiences, and you might still think I’m nuts or biased. Maybe I am.