The gap

>> In The Sexual Paradox, psychologist
Susan Pinker examines fundamental
gender differences and show how
they shape the workplace

by Juliet Waters

Like her brother (cognitive scientist Steven Pinker,) psychologist Susan Pinker believes men and women have significantly different brains. She also believes this is a better explanation for the large gender gaps in science, politics and business than discrimination.

Society accepts large gender gaps in learning disabilities, autism and many disorders that hurt boys more than girls. Why not accept that there will be certain things at which men will always be more successful? This is one question raised in The Sexual Paradox: Extreme Men, Gifted Women and the Real Gender Gap.

In “Turbocharged: Men With ADHD Who Succeed” Pinker devotes most of the chapter to the spectacular careers of men who were diagnosed and treated early in life for Attention Deficit Hyperactivity Disorder, like the founder of Kinko’s and the CEO of West Jet. When asked what had helped them succeed, the reply most often given was “someone had believed in them.”

Pinker also includes five paragraphs on ADHD in women and recent research into the possibility that girls are under-diagnosed and under-treated because their symptoms aren’t as disruptive in the classroom. She dismisses it, citing a Harvard study by Dr. Joseph Biederman supporting her conclusion that girls, though fewer in number are, “just as likely to be treated” for ADHD as boys. But when I noticed a discrepancy between a gender ratio she quoted, and its footnote, I figured I should read Biederman’s work before I interviewed her:

Mirror: It’s encouraging that boys who get treatment are doing well, but what about girls who aren’t diagnosed?

Susan Pinker: I don’t really think it’s true that a lot of them aren’t getting diagnosed.

M: But in the Biederman study you cited, it’s clear that he thinks they’re under-diagnosed. [Pointing to the significant difference between the referral ratio of adult men to women—1.5 to 1—and the ratio of boys to girls—10 to 1—Biederman calls the under-identification of girls with ADHD an “issue that has large public health implications.”]

SP: Actually, he reversed. If you look in the reference section, there are six studies that are quoted by Biederman, and there was one that came out where he bemoaned the fact that fewer girls were identified with ADHD; then there was also a second study that came out, probably a later one, Absence of Gender Effects on Attention Deficit Hyperactivity Disorder in Non-Referred Subjects. That’s the one you should read.

M: That is the one I read. The 2005 study.

SP: In that, he said the girls in the non-referred populations tended to have a milder form that was less disruptive. And the ones who were identified with having ADHD were no less likely to get treated.

M: But what about the ones who aren’t identified?

SP: As I said, that has to do with the fact that more of the girls have ADHD without hyperactivity.

M: I get that. But what’s happening to them if they’re not being identified?

SP: That’s a good question. I’m not saying it doesn’t exist, but I don’t think it’s as big a problem as all that.

M: Ten to one in kids vs. 1.5 to 1 in adults? That’s a red flag to me.

SP: That 1.5 to 1 is not the statistic I would put the most confidence in…I don’t think any clinician worth his salt would use it.

M: But it’s the ratio you reference. You write it’s 3 to 1, but your footnote says it’s 60 per cent to 40 per cent, which is 1.5 to 1. Your math is off.

SP: I’ll have to take a look at the book again. Obviously, if that’s true, it will have to be revised in the paperback. How about I look into it and get back to you before publication?

She did, in an e-mail, with new ratios from other studies (including a Biederman study from 2002). But I got a more definitive answer from Dr. Joseph Biederman: “I still believe that girls with ADHD are under-diagnosed and under-treated.”

The Sexual Paradox by
Susan Pinker, Random House
Canada, hc, 346 pp, $34.95