31 August 2025

"Synthetic Children" - a guest post by Adrian Gaty

Please welcome Adrian Gaty, of our own JiP community, as the author of today’s guest post! Adrian is a pediatrician who writes the Unofficial Pediatrics blog here on Substack.

While it is still unknown whether this week’s mass shooter was taking any kind of medications—for depression or ‘gender-supportive’ treatment or anything else—raising that question has become almost inevitable after such events. It’s difficult to ignore the presence, since 2004, of a ‘Black Box Warning’ on antidepressants: increased risk of suicide in young adults. Although some in the industry dispute whether that warning is legitimate, most of us can’t help wondering if psychiatric drugs might be affecting kids in harmful ways.

But it’s also difficult to know whether links to dangerous behavior are correlation or causation. The sad reality is that so many teens are taking some type of psychiatric prescription that it may be more difficult to find a teen who isn’t drugged than one who is. Particularly in the case of young men, this may take the form of ADHD medications, which some have been taking almost from the time they started going to school.

Today’s guest essay takes a closer look at the explosion, over the last few decades, of teachers and parents demanding an ADHD diagnosis—and the medication that comes with it—to make children behave more like those adults think children ‘should.’ The risks and the consequences are substantial.

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Synthetic Children

By Adrian Gaty

Photo by Sash Bo on Unsplash

I have degrees in the humanities from Harvard, in medicine from Northwestern, and years of experience as a successful pediatrician…and I am losing my mind.

Hardly a day goes by without a school sending a child my way. The schools expect, and my profession demands, that I diagnose these patients with a psychiatric disorder and prescribe them mind-altering drugs. Yet the children I see every day are not mentally ill, not in the least—but if I keep having to diagnose them as such, I soon may be. Help me, please. Let me share their stories with you.

Where Have All the Flowers Gone?

M.’s parents are at their wits’ end. While a kind, sweet boy, he is unable to finish his worksheets without constant redirection by his teacher. Homework is an hours-long struggle. With academic failure looming, his school advised medical intervention. M. is, after all, five years old.

One of the fastest-growing Attention Deficit and Hyperactivity Disorder (ADHD) demographics still wears pull-ups: a third of children are diagnosed before age six. The five-year-olds drugged for meltdowns over math homework? They can thank the American Academy of Pediatrics, whose all-influential practice guideline sets the standard for the nation’s doctors. The AAP expanded their recommendations to include preschoolers a decade ago; their latest decree doubles down, deeming psychostimulant use by four-year-olds “relatively low risk.”

While the experts hammer out the precise drug cocktail to optimize preschoolers’ worksheet efficiency, none seem to have asked why kindergartners are being assigned homework in the first place. It was not always so.

You don’t need to be fluent in German to guess what a place named kindergarten used to be like. Public early-childhood education spread across America via popular acclaim in the late 19th century, to provide a couple of hours a day of nature exposure, socialization, and the chance to work off the wiggles.

Today, it is a day-long academic grind. As one group of education historians describes the replacement of art and song with standardized tests and “rote, didactic tasks,” kindergarten is the new first grade. Modern educators have paved over the flower boxes to make room for textbooks: less than half of America’s increasingly ironically named kindergartens have any nature area at all. Ninety-five percent of them, however, have math spaces. What is the German for ‘academic drill factory’?

Within living memory, five-year-olds were expected to dance, sing, and play, with no homework in sight. It is not conceivable that kindergartners of old would be drugged for fidgeting. In a world where young children are not expected to work—a sane world—playing is not pathological.

Renaissance Men

R. is in first grade. He excels in math and science. He does not like reading and writing, does not exert himself in those subjects, and his grades are poor. His school suggested seeing a doctor for an ADHD evaluation.

There is a term for those rare people who can, like Da Vinci, excel in a wide variety of unrelated fields on a daily basis: genius. There is another term for those considerably less rare people whom we expect to excel in a wide variety of unrelated fields on a daily basis: eighth-grader.

The children sent my way are hardly ever straight-F students. In one case, a girl was brought in for a single B on a report card otherwise overflowing with As. She told her parents she had a hard time paying attention in English, so they asked me to drug her. More commonly, the children I meet with have a mix of Bs and Cs, with perhaps a lone A in a favorite topic.

One middle schooler met all the criteria for ADHD based on questionnaires filled out by a host of teachers…except her art teacher, who enthused over her talent and reported not a hint of inattention when before an easel. A bookworm got easy As in English, but couldn’t focus in Math. A computer prodigy could program everything…except the ability to look engaged in English class. In other words, these students were like every successful adult I’ve known.

As anyone who’s been seated next to a stamp enthusiast can tell you, the line dividing interest and apathy cuts through the heart of every human being. If you happen to be skilled at making yourself care about topics that don’t interest you, you are the stuff honor rolls are made of. For those with a harder time faking enthusiasm for other people’s passions, an unflattering report card is bound to follow. It remains unclear why the latter disposition should be considered any more of a mental illness than the former.

I think of another patient of mine, a carpenter. At least, he hopes to become one. He thrives in his carpentry and auto repair electives and is on stimulant medication to get him through the rest of the school day. He prefers building something that may still be around after he’s long gone over filling out pages of homework destined for the landfill. Is that mental illness?

From a purely mercenary perspective, a skilled craftsman is in higher demand than a college graduate with a mountain of debt and no career prospects outside the ‘latte art’ field. If we must medicate one into becoming the other, are we sure we’re drugging in the right direction?

From a deeper perspective—as another carpenter once put it—where your treasure is, there your heart will be also. What business do doctors have treading on such sacred ground?

Easy Answers

C. started acting out in school when his parents divorced. After a couple years, things calmed down. Now he is struggling in class again. This coincides with a new woman moving into the house he shares (every other week) with his dad. Parents took him to a psychologist, who diagnosed C.’s problem as…ADHD. The parents expressed relief at having a diagnosis to explain his behavior.

I am informed by my colleagues that divorce, the death of a loved one, and other such instances of ‘adversity’ are “a strong risk factor” for developing ADHD. That’s one way to put it!

Don’t let the pharmaceutical salesmen gaslight you: it is normal for a child to struggle when his family is destroyed. I would worry far more about an eight-year-old who takes a family break-up in nonchalant stride.

If pediatricians are to have any role as regards the broken homes we encounter far too often, it should be as advocates for stable, married families, not as pill-peddling accomplices to the devastation that adults wreak on their children. What prescription will give a child her family back? We ought to fight for the children in our care, not excuse their soul-hurt with medical jargon (which is meant to absolve parental guilt), while making the innocent child doubt the validity of her own pain. Doctors simply pile adversity upon adversity—and prime suffering children for a lifetime of pharmacological dependence—when we teach kids that their normal emotions are a sickness in need of a cure.

Synthetic Minds

B., 11, moved to town a year ago. He has no friends. He does not play outside, does not read for pleasure. He loves video games, plays these for hours daily. He struggles with focus in class, so parents took him to a therapist. She did not suggest making friends or touching grass, but did advise getting tested for ADHD.

Back when Horace Mann was born, George Washington was President of the United States and there was no such thing as YouTube. Today, Washington wouldn’t make it out of the Iowa caucuses and there is hardly a student alive who has not been exposed to smartphones from birth.

Most kids I see don’t go out to a restaurant, store, or doctor’s office without a tablet to stare at. They live in a world where the most popular movies—among adults, not just children—feature superheroes flying around in tights, shooting lasers out of their eyes, and tossing off non-stop one-liners between CGI fight scenes. How can trigonometry compete?

Adults who have bought into this world, who have raised their kids in it, now bring me those children because the impressionable little ones are having a hard time sitting still…in a schoolroom setting that continues to resemble one from the nineteenth century. Is it any wonder that synthetic minds cannot bear too much reality without the help of synthetic drugs? Medicating kids to pay attention in a culture that poisons attention seems a low blow.

The Battle of the Sexes

Let’s take a look beyond anecdotes to understand the scope of this medically-imposed madness. The most damning statistic: boys are more than twice as likely as girls to be diagnosed with ADHD. Doctors have made boyhood into a disease.

Similarly, the youngest children in any given classroom are far more likely to be diagnosed with ADHD than their older classmates; relative immaturity is now a psychiatric condition. If your kid was born in August and pees standing up, go ahead and start stockpiling amphetamines now.

Rubber Stamps

ADHD is second only to asthma in the race for most common medical condition of childhood. Conservative estimates find it affects one in ten kids, two-thirds of whom will end up on medication. Look closer and you find districts where thirty to forty percent of schoolboys are medicated.

Why has the condition spread faster than a Fauci-funded gain-of-function mutation?

Well, the life-altering label of ADHD is handed out as cavalierly as possible. Nine out of ten children are diagnosed using rating scales that are filled out in minutes by parents and teachers, and typically reviewed by pediatricians like me between visits for earaches and colds. A child deemed to showcase six of the below characteristics “often” (in stark contrast to “occasionally”) enters the school-to-pharma pipeline:

1. Fidgets with hands or feet or squirms in seat.

2. Leaves seat in classroom or in other situations in which remaining seated is expected.

3. Runs about or climbs excessively in situations in which remaining seated is expected.

4. Has difficulty playing or engaging in leisure activities quietly.

5. Is “on the go” or often acts as if “driven by a motor.”

6. Talks excessively.

7. Blurts out answers before questions have been completed.

8. Has difficulty waiting in line.

9. Interrupts or intrudes on others (e.g., butts into conversations/games).

There are rumors of a child who can blurt answers out (#7) without interrupting (#9), and who can run about (#3) without leaving his seat (#2). To date, this Chosen One remains elusive; his mythical status shows that these nine ridiculous items can be simplified as follows:

1. Do they move too much?

2. Do they talk too much?

Skeptics compare the checklists to a quiz in Cosmopolitan—yet at least when a Cosmo quiz goes awry, one rarely ends up on brain-altering pharmaceuticals. No wonder, with my profession relying on such repetitive and subjective questionnaires, that stimulants have become a multi-billion-dollar industry.

Side Effects

I used to have difficulty convincing parents that the AAP would push drugs on children with less concern for tomorrow than a Marvell poem. Today, thanks to years of pediatrician-approved trans and Covid madness, let’s just say the audience is more receptive.

Consider: while a kindergartner started on stimulants can expect to remain on them through senior year, the average length of the trials involving the most prescribed such medication, Ritalin, was…less than thirty days. On that timeline, cigarettes seem a safe bet too—and boy do they help with focus!

Having prescribed these drugs to countless children over decades, the medical community is understandably reluctant to admit irresponsibility. Experts may concede the possibility of heart disease (in the words of one leading pro-stimulant researcher, a little cardiovascular mortality is a “tricky trade-off” for an improved middle-school GPA).

Yet stimulants aren’t heart drugs, they’re brain drugs. They work on dopaminergic pathways—dopamine being a neurotransmitter involved in focusing on worksheets, yes, but also in rather more important domains, like the pursuit of happiness and falling in love. Next time your doctor hands over that Adderall, ask whether drugging your daughter to love her homework may leave her incapable of loving anything—or anyone—that matters. The only truthful answer? Well, it didn’t come up in the month-long trial, and there’s no questionnaire for that—sorry. Keep an eye out for the possibility of nausea, though!

Heartache of all kinds aside, ADHD treatment highlights the biggest blind spot in modern medicine: the population-wide dangers of widespread psychiatric medication use. It is one thing to worry about side effects for the individual taking Prozac, but when everybody in town is on antidepressants, it’s time for deeper questions about society’s sadness-inducing ills.

One may pose similar questions of a school system that needs to medicate a fifth of its students. Pharmaceutically-compelled attention is now an integral part of education. Is there a warning label for that?

We have been here before. A leading psychiatric diagnosis of the past was a fraud. It never occurred to the Victorian physician that the women he diagnosed with “Hysteria” might aspire to be more than domestic ornamentation; all he believed in was finding the best treatment to fit them into his unrealistic notion of womanhood (one agreed upon by all the experts). Thankfully, he had no access to advanced pharmacology or he may have succeeded.

Today’s doctor faces no such technological limitations; her success at pharmaceutically bending her patients’ minds to her will is undisputed. In other words, never has it been so important to step back and look at the big picture, because never before has our science been advanced enough to ensure that, if we are wrong, we have the drugs to continue being wrong indefinitely. If the mercury pills and other quack remedies in the Victorian physician’s repertoire actually worked, women would still be in chains today. If our children are currently in chains, our modern ‘mercury’ will ensure they remain forever captive.

The 1%

If this is anything like past exposés of the overuse of ADHD medicine, it will shock you, scandalize you…and do nothing to stop the overuse of ADHD medicine. The industry has been ignoring criticism for decades, and not just from parvenus like me. In 2013, Dr. Conners, the “Father of ADHD”—the man who pioneered its diagnosis and treatment—gave an impassioned speech to his young colleagues raising the alarm about the scandalous rise of stimulant use, calling it a “national disaster of dangerous proportions.” Yet, as former New York Times reporter Alan Schwarz illustrates in ADHD Nation, Big Pharma took a few days of bad publicity in stride and was soon pumping out product like never before.

The ADHD horse is out of the barn, and he makes more money than you. With that cash comes untold influence over the nation’s doctors, policy makers, and schools. We cannot rely on our compromised institutions to rein this high-living Clydesdale in.

Parents sometimes ask me if there are some ants-in-the-pants, scatter-brained young people who truly benefit from their daily Adderall. Dr. Conners believed there were; he did not want to get rid of ADHD drugs, simply limit them to the rare child—one in a hundred, maybe—whom he felt truly qualified. I’m more skeptical than Conners, but would nonetheless take his one percent in a heartbeat.

But how? Conners’ own history, and the plain evidence of our eyes, reveals the question is moot. Make the drugs available for the rare hard case and there’s no way to keep them from the masses, preschoolers included. Once a parent knows a pill can end the nightly homework battle, once a teacher knows a pill makes the hour before lunch go that much faster, once a doctor knows a pill will get parent and teacher alike off his back, once a pharmaceutical executive knows a pill can make that second home in Aspen a reality—how can we count on them to value a child’s humanity over the convenience and profit of an easy answer?

Dear Colleagues

There may never have been a better time than now to be a sick kid in America. There also may never have been a more dangerous time to be a healthy one. Doctors need, for once in our history, to respect the boundaries between medicine and sociology. Giving a child a functioning pancreas—that’s medicine. Getting a child to sit still through a lecture on the genderbread person—that’s social policy.

Medicine ought to be about healing the sick, not engineering the healthy. Medicine as social control has been tried before; it never ends well. Mercury for hysterical women, sterilization for black people, lobotomies for the promiscuous, the list goes on. My fellow doctors, we’ve been on this ride before. It is time to get off. We are physicians, not utopian social planning apprentices. Our calling is to heal Man, not play God.

The Naked Truth

We are an ADHD nation…yet we don’t have to be. Prior efforts to sound the alarm failed because parents trusted the medical community not to harm their children. That trust is gone. In the past few years, parents witnessed doctors’ insistence on masking toddlers and castrating teens. Meanwhile, medicine’s bosom buddy in the ADHD business—the school system—is widely distrusted thanks both to its overall incompetence and its embrace of faddish, hateful ideologies. The world of ADHD, where the authority of teacher and doctor reign supreme, is ripe for a reckoning. Spread the word: the ADHD emperor has no clothes.

What of me? A doctor who won’t push pills is about as useful as a university bureaucrat who won’t apologize for Hamas; the times have passed us by. To be a pediatrician in good standing today is to wage war against childhood. I cannot do so—at least not until the AAP rolls out a drug powerful enough to numb me to my conscience. Until then, I muddle on, and pray I can keep both my practice and my mind.