ADHD & Women: Unraveling the Gender Bias of ADHD Diagnoses

Though commonly believed to be a disorder in young men and boys, Attention Deficit Hyperactivity Disorder (ADHD) affects both men and women of all ages. The popular connotation of ADHD as a “boy’s disorder” is high on the list of factors that cause many women to live with symptoms of undiagnosed ADHD. The under-diagnosis of ADHD in women can be correlated with broad gender stereotypes, societal expectations, research bias, and variety of symptom presentation. The impact of living without treatment extends far into the future, statistically affecting the relationships, careers, and livelihoods of women with undiagnosed ADHD.

ADHD Misconceptions & Stigma

For years, ADHD has carried many misconceptions in the public eye. Primary among these was the myth that ADHD was simply a catch-all diagnosis for misbehaved boys, with many believing the symptoms - namely inattention and hyperactivity – to simply be the result of poor parenting or a lack of discipline. With more research, modern acceptance of the condition has grown, and treatment options continue to become more accessible. Medication, counseling, and lifestyle modifications offer symptom relief to those diagnosed, but other misconceptions remain. Though ADHD has come to be widely accepted and better understood, the condition still finds itself associated with a male population, allowing for potential misdiagnosis of ADHD symptoms among women and girls.

Historical Research Bias

The association of men and ADHD extends beyond the social context and is deeply engrained in the historical research of the condition. This widely accepted, male-centered research led to the creation of ADHD diagnostic tools that are still used today. These diagnostic assessments tend to favor the male-presenting symptoms as indicators of ADHD, leaving many women who undergo an assessment to remain undiagnosed. While strides have been made in modern ADHD research, the prevalence of male-centered research is still common. New, more thorough assessments are growing in popularity, and these tests aim to better recognize ADHD symptoms in both men and women and acknowledge that the presentation of symptoms varies between the sexes.

Symptom Presentation & Societal Expectations

ADHD is commonly categorized in sub-groups: hyperactive-impulsive, inattentive, and combined presentation. Men experiencing ADHD are more likely to exhibit hyperactive-impulsive symptoms, while women are generally more prone to presenting symptoms of inattention, but opposing symptoms may still exist. Women are prone to internalizing traits, such as impulsivity and fidgeting, due to gendered societal expectations. Women and girls are discouraged from exhibiting traits considered acceptable for their male counterparts, leading women to mask these symptoms to better align with feminine expectations. This internalization of symptoms contributes to misdiagnoses for many women with undiagnosed ADHD.

Comorbid Conditions & Misdiagnoses

Masking and internalizing symptoms often result in comorbid conditions, or conditions that are present in tandem with another condition. Women with ADHD frequently experience depression, trauma, and anxiety, due in part to their ADHD symptoms. ADHD has been associated with men for so long, women often struggle to receive an ADHD diagnosis and are instead diagnosed with another condition according to their presenting symptoms. A diagnosis for depression or anxiety, though often correct, can overshadow the need for further assessment of internalized symptoms that would indicate ADHD in female patients. Many women and girls with undiagnosed ADHD are likely to engage in self-harming, experience unplanned pregnancy, and endure intimate-partner violence. Girls with ADHD statistically perform poorly in academics or vocational achievements and are more likely to experience bullying or peer rejection. Without proper research and diagnostic assessments, women facing the social complications of a misdiagnosis are left vulnerable to the effects of their ADHD.

The path to changing the issue of gendered ADHD diagnoses begins with awareness. Recognizing the varied symptoms of ADHD, including the variety of symptom presentations across genders, is a large part of resolving undiagnosed ADHD among women. The implications of misdiagnoses for women with ADHD are far-reaching, leading to more instances of domestic violence, lower career achievement, and increased risk of self-harm and suicide. Women and girls deserve access to accurate testing, diagnoses, and treatment for ADHD, so that they may live successful lives and meet their full potential. While early intervention is ideal, it is never too late to seek help if you or a loved one is struggling with symptoms of ADHD.