According to the Centers for Disease Control and Prevention (CDC), boys are far more likely to be diagnosed with ADHD than girls. Boys are also more likely to receive a diagnosis at a younger age.

Many women and girls with attention deficit disorder are not diagnosed for years. Why is that happening?

There is a neurological condition called attention deficit hyperactivity disorder. There are three different types of attention deficit disorder.

  • Primarily hyperactive and impulsive: characterized by excessive fidgeting, high levels of energy, and difficulty with impulse control
  • Primarily inattentive: characterized by difficulty with attention, organization, and focus (formerly called attention deficit disorder, or ADD)
  • Combined: characterized by both hyperactivity and difficulty with attention

In popular media, attention deficit disorder is often seen as a male disorder. The condition affects both boys and girls. It looks different in girls.

When you hear the term, you probably think of the impulsive and hyper-caffeinated type. That is the description of the kid who is bouncing off the walls, talking nonstop, and unable to sit still or play quietly. The stereotypical presentation of a child with attention deficit disorder is depicted in this image.

But more often, the girls with ADHD present with the primarily inattentive subtype. That describes the kid sitting quietly in class, lost in their own thoughts.

A child with mostly inattentive ADHD is not disrupting the class or sitting in their seat. They are facing the board, looking deep in thought. They might be writing in their notebook. You may think they are paying attention, but they are staring off into space, daydreaming or doodling.

The little boy is shouting out answers without remembering to raise his hand or get up every 5 minutes to throw something away.

Who is more likely to be noticed by a teacher?

“Girls with the primarily inattentive subtype of ADHD don’t always have that. They often present with both impulsive and hyper-caffeinated attention deficit disorder. The disorder tends to look different even then.”

Regardless of the subtype, girls often display internalized rather than externalized symptoms.

Externalized hypertensive behaviors are overt, but not internalize hypertensive behaviors. It can look like that.

  • excessive talking
  • In class, doodling is done instead of taking notes.
  • thoughts
  • Feelings of anxiety.
  • emotional reactivity
  • Making friends is difficult.

“These symptoms are hard to recognize for many parents and teachers. These kids don’t receive the evaluations they need for diagnosis”

Girls can be overlooked by adults due to gender expectations. Girls are expected to be calm and soft-spoken. Being shy is more accepted in girls.

So, let’s say there’s a female student who never raises her hand in class. One day, the teacher does call on her. Suddenly, a look of panic flashes on her face — she doesn’t know the subject they’re talking about, let alone the question, because she hasn’t been paying attention at all.

The teacher sees her expression and thinks she is just shy.

Girls are seen as being more emotional than boys. A girl with attention deficit disorder who cries easily, talks too much in class, or is overly sensitive may not cause concern. She is more likely to be labeled a chattery than a struggling student.

How symptoms are interpreted is not the only impact of gender expectations. They can be involved in how symptoms are managed.

Girls with attention deficit disorder tend to hide their symptoms.

“They might try to rein in their behavior because they have been conditioned to think that girls aren’t supposed to do that. They could draw in their notebook to keep their hands busy instead of being restless in class.”

Because girls are often people-pleasers, they may hide their struggles more. To cope with inattentiveness and difficulty focusing in school, they might spend more time studying or doing homework to maintain good grades.

A girl with attention deficit disorder may be seen as a nerd. She is simply trying to get over her attention deficit disorder.

This can lead to increased stress and anxiety. Girls with attention deficit disorder may blame themselves for their perceived failures and develop low self-esteem.

Girls with attention deficit disorder go undetected because of differences in symptoms, social expectations and strategies.

Many women receive an ADHD diagnosis much later in life, especially compared to men, who are likely to be diagnosed in childhood.

“Even though women show signs of attention deficit disorder in their younger years in school, it is often overlooked by parents and teachers. Girls with attention deficit disorder might be labeled as being’spacey’ or ‘ditzy’, rather than being taken seriously.”

In other cases, though, symptoms are noticed, but they’re attributed to something else. Many women with ADHD are diagnosed with other disorders, such as anxiety or depression. It’s worth noting that both anxiety and depression are comorbid (coinciding) conditions of ADHD.

It is possible that years of undetected ADHD could contribute to these mood disorders in women. It is possible that women with attention deficit disorder are more likely to be diagnosed with anxiety, depression, eating disorders, self- harm, and substance misuse than their male counterparts.

“What can be done to make sure that future generations of girls have their needs recognized? How can the women who weren’t diagnosed in their younger years find the support they need?”

Researchers have acknowledged that a key part of addressing the underdiagnosis of girls with ADHD is educating teachers, parents, and healthcare professionals regarding what ADHD can look like in girls.

It is crucial that the research into the subject of attention deficit disorder adjusts. Researchers must consider how gender stereotypes may affect results when recruiting female participants.

It’s not just pediatricians but family doctors and physicians who should be open to recognizing and identifying ADHD symptoms. The CDC noted that between 2003 and 2015, the number of women ages 15 to 44 with private insurance who filled an ADHD prescription rose by 344%.

As more women are diagnosed, it is important that healthcare professionals who can offer resources and information to help them learn to manage their condition safely and effectively.