ADHD in Girls Often Underdiagnosed

by Vins
Published: Updated:

The rate at which ADHD goes undetected in girls is increasingly higher than their male counterparts. As of September 2021, 12.9 percent of boys were diagnosed with ADHD while only 5.6 percent of girls were. As Cheyenne Leonard reported for Women’s eNews, “The reason for this diagnosis gap is not because ADHD is more prevalent in boys but, as research is beginning to show, it is more complicated in girls.” ADHD affects about 8.4 percent of children, but the staggering difference in detection between genders can be attributed to the way ADHD manifests differently in girls, making it harder to diagnose.

Leonard highlights the case of Kyrie Speer, who wasn’t diagnosed with ADHD until she was 20 years old, although her brother was diagnosed during childhood. Speer says, “For myself, I was able to do my schoolwork, I wasn’t as energized as my brother, and I was able to control myself more. In my parents’ eyes, that meant I didn’t have ADHD. For many years I didn’t think I did either.” Girls and young women often remain undiagnosed until their twenties, due partly to their ability to mask their ADHD symptoms during childhood.

Part of why ADHD so often goes undiagnosed among girls is due to the standards placed upon them by society. Dr. Patricia Quinn, director and co-founder of the National Resource Center for Girls and Women with ADHD, says that girls with ADHD do not present as hyperactive as boys do. Quinn says, “People imagine little boys bouncing off the walls and think: That’s what ADHD looks like and if this girl doesn’t look like that then she doesn’t have ADHD.” Oftentimes common characteristics of ADHD such as being “chatty” or talking too much are deemed by adults as typical behaviors for a young girl but unusual for a boy.

Woodhead recalls in elementary and middle school being reprimanded for behaviors she couldn’t control such as getting bad grades and talking too much. “Because I’m a female I think that in elementary and middle school people just thought I was ‘unruly’ and probably came from a home where education wasn’t valued,” Woodhead said. It wasn’t until parent-teacher conferences in 10th grade when Woodhead’s teacher told her mom that her daughter “should get her brain checked” did she finally receive a proper diagnosis.

Furthermore, women who display combined type ADHD (experiencing both a mood disorder such as anxiety or depression in tandem with ADHD) are often brushed off as moody and emotional, when in reality they have a difficult time processing their emotions due to their ADHD. Research has begun to show that mood disorders present more often in girls with ADHD than in boys, but this may have less to do with gender than  with the pressure to live up to society’s standards while dealing with ADHD symptoms.

In May 2020, the Washington Post published an article highlighting the experience of 57-year-old Leslie Crawford. While two private therapists had told Crawford that she had ADHD, her health plan’s psychiatrists refused her treatment because she performed well in school as a child. Unlike the independent news articles on the topic, the corporate coverage fails to explain how improved understandings of individuals’ unique neuro-strengths and weakness could narrow the gender gap in diagnoses. While the Washington Post does detail the struggle women face in their quest for an ADHD diagnosis compared to that of males, this has been the only corporate news coverage of such facts.

Source: Cheyenne Leonard, “ADHD: Too Often Misdiagnosed in Females,” Women’s eNews, August 29, 2021.

Student Researcher: Victoria Recco (SUNY Cortland)

Faculty Evaluator: Christina Knopf (SUNY Cortland)