springs from a study that appeared recently in the Australian and New Zealand Journal of Psychiatry
(Sydney Morning Herald
, 2/16/11). It discusses the phenomenon that's so often been remarked on in the U.S., Canada and elsewhere - boyhood as an illness. The study finds the astonishing fact that, over the last seven years in Australia, Ritalin prescriptions have quadrupled. That's right, a hefty four times the amount of Ritalin is being ingested in Australia as was the case a mere seven years ago. And, to those who follow such things, it'll come as no surprise that almost all of those pills are being downed by boys, and boys around the age of puberty at that. Boys get a Ritalin prescription at five times the rate girls do. That shocking fact causes the author of the piece, Elizabeth Farrrely, to ask
The Ritalin wars are usually treated as just another tussle between the pharmaceutical companies and the rest, but is there something else going on here as well? Is it part of a more generalised, covert war on boyhood?
Aye, there's the rub. Just for the sake of setting up a straw man to knock over, the article wonders whether the expansion of Ritalin prescribing could reflect "new behaviour, or just a new attitude to that behaviour?" What are the chances that boyhood behavior has undergone such a dramatic change in seven years? Next to none, I'd say, and the new study agrees.
A report last year by Dr James Scott and others in the Australian and New Zealand Journal of Psychiatry suggests the latter.
But maybe boys get more Ritalin because they have ADHD more often than girls. Indeed, that's correct, but
in Australia as elsewhere, the male-to-female ADHD ratio is 2.45:1, Ritalin rates are 5:1. Diagnosis is more than twice as likely in boys, and medication more than twice as likely again.
But even that doesn't cover the possibility that, increasingly, boyhood is considered a disease or a condition requiring medication to "correct." If that attitude prevails in society, it's likely to prevail among mental health professionals, who are then likely to over-diagnose boys.
So the argument is not just about medication or even deviation. It"s also about gender. And as the hetero heart-throb morphs from John Wayne into Justin Bieber, it is worth wondering whether our behavioural expectations show a similar shift.
The issue of medication for ADHD becomes even more vexed when one considers the fact that the condition stems from immature frontal lobes of the brain. Those control impulsive behavior and Ritalin helps them do that, but, in most cases, given time, those lobes will mature normally and the condition will resolve itself. As to the gendered aspect of diagnosis and medication of ADHD, Farrely points to other remarkable facts. One is this:
Thirty years ago Australian primary schools employed five male teachers for every four females. By 2006 there was one male teacher for every four females. This overwhelming feminisation of primary education, and of culture generally, has made boy-type behaviour stuff to frown upon. Are we in danger of seeing boyhood itself as a disorder?
That's nothing like what's happened in the U.S. Here, male school masters dominated primary and secondary education in the 19th century, but by the early 20th, women made up as much as 88% of teachers at those levels and men have been a fairly marginal presence in the classroom ever since. One thing the article doesn't mention is the impact of forty years of misandry in academia and popular culture. Few people who've lived through those years could fail to notice the condemnations of men and masculinity that have become routine in some quarters. Given that, it's easy to understand that the message has been received by educators and mental health professionals among others. Indeed, the "boys are from Mars, girls are from Venus" attitude finds its way into Farrely's own article. She cites with sympathy a boy she calls "Jack," who gets into a tussle with another boy at school. Farrely rightly notes that his transgression is viewed darkly as some harbinger of dangerous male behavior to come and that his parents are made to feel that they've nursed "a psychopath in their bosom." But according to Farrely, the remedy is "talk" and talk is "girl stuff," as opposed to fighting which, as exemplified by Jack and Tom Sawyer, is boy stuff. Hmm. The idea that women and girls talk, but men and boys don't is not only flat wrong, it's a direct product of the last forty years during which the strangest descriptions of men and women, masculinity and femininity have become coin of the realm. There are broad tendencies that can be used to generalize about the sexes, but that's all they are. Trying to draw individual conclusions from them is pointless. Still, Farrely is right about this:
But why the gender imbalance, and why now? We know that boys tend to be late maturers anyway, but Scott concedes there are also social and perceptual factors at play. Teachers with "less structured' teaching style and "more distracting' classroom environments, he says, yield many more of his clients than their more disciplined (my word) colleagues. Whereas ADHD girls "sit quietly in a corner', the boys are more disruptive and more noticed, more referred, more medicated. And although much the same is true of 'normal' boys and girls, the upshot is that 'girl' is a norm to which boys are expected to strive. Scott sees it as "an unintended consequence of how society operates'. But consequences this important should be either clearly intentional, if girlifying boys is really what we want, or remedied. Personally, I reckon the crazily creative are types we"ll need more of, rather than fewer of, in the future, even if they are male.