The Gender Gap In ADHD Diagnosis

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ADHD is often diagnosed more frequently in boys than in girls, a pattern many are aware of, yet there seems to be little effort to understand why.

A study conducted in Sweden found that females with ADHD are diagnosed and treated approximately four years later than males.

“The little boys who were getting diagnosed would jump around, but I was just daydreaming—so they couldn’t tell we were both being distracted,” says Natalie Goyarzu, a fourth-year university student who was diagnosed later in life.

Thelacsana Rajaganapathy, a third-year student and professional dancer who teaches children, believes the issue also stems from how diagnoses are approached. “People hesitate to diagnose kids, but I try to make sure all the kids are doing okay, not just the ones disturbing the class.”

Melissa Gummeson, a registered psychotherapist who specializes in adult ADHD in women, attributes this disparity to socialization. “We often see boys diagnosed because their hyperactivity is more obvious. Girls, on the other hand, are socialized to behave differently, so their hyperactivity can manifest in less disruptive ways, like fidgeting.”

Expert consensus developed by a team of researchers led by Susan Young also notes women often present ADHD differently due to being socialized to be more controlled and 'well-behaved,' which causes many women to go undiagnosed for years. I had never thought I had ADHD because I only knew the hyperactive traits commonly associated with boys, assuming that wasn’t me.

Gummeson expanded on this, saying, “Boys are allowed to be loud, while girls are told to be quiet.”

Research conducted by Darby Attoe and Emma Climie highlights that women with ADHD often internalize their struggles, believing they are simply failing to meet societal expectations.

The research also identifies that clinical practices have historically been based on male presentations of ADHD, resulting in a bias that overlooks how the disorder manifests in females, contributing to the underdiagnosis in women.

Additionally, Attoe and Climie find that women with ADHD are also more likely to experience other mental health issues like anxiety and depression. These issues can overshadow ADHD symptoms, leading to misdiagnosis or delayed recognition of the disorder.

To close the gap, Gummeson emphasizes the need for better awareness and education, especially among parents and educators, in understanding both the hyperactive and inattentive types of ADHD and how ADHD manifests in women to help diagnose it earlier.