My DS11 was diagnosed with ADHD by way a super-expensive neuropsych battery after K. I, like you, did not feel comfortable medicating him without a thorough investigation and expert medical opinion. I can't tell you if it was medically necessary but it was necessary for me. You will also have a certain amount of people judge your decision to medicate, if you do, and having a thorough work up from a board certified pediatric neuropsychologist tends to shut them up.
I can tell you based on our experience that the increased impulse control that the medication provides will be helpful for your DS socially, especially if he will be with older kids How a child interacts in a one-on-one homeschooling situation or with adults is quite a bit different than with peers in a school setting. Generally ADHD kids are "asynchronous" socially and will struggle with peer relations under the best of circumstances. My DS has been in counseling for being bullied and received social coaching with a different counselor because of social struggles at school. Adults love him because he is so very witty and clever with them, as well as being a sensitive and kind little guy. It's just the other kids!
In sum, don't ignore the social considerations of treating ADHD. Your gifted DS will likely find his peer relations the hardest part of school.
