Beyond Boys: Why Earlier Diagnosis in Girls & Women with ADHD is Important

Discover why ADHD in women and girls is often missed, how it uniquely impacts executive functioning, and what we can do to support earlier diagnosis and compassionate care.

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When I was a kid, I was outgoing, chatty, and energetic. I seemed to be doing fine socially and academically, although my parents decided I was a little overly sensitive and my room seemed to flip-flop confusingly between perfectly organized and total chaos, complete with drawers half pulled out and the floor unreachable. These were early warning signs of ADHD. More evidence continued to pile up. In second grade, I distinctly remember getting ready for parent-teacher night and noticing that none of the class projects or art on the walls were mine. I hadn’t finished a single assignment. Even as a young kid, I remember thinking that was a little unusual.

Fast forward to high school, and I was on the honors track. I got all of my work done and kept my grades up, but I had to stay up until the early morning hours to finish it all. I assumed everyone else was up late like me, spending hours on what should've been simple assignments. It wasn’t until someone told me I was exaggerating that I realized: no, this really was taking me longer. Much, much longer. In spite of the mounting evidence, when I was struggling with overwhelm at work I was diagnosed with anxiety, not ADHD. It wasn’t until my own child was diagnosed in my thirties that I finally got the full picture.

This story is far from unique. Many of my female clients come to me with a late diagnosis and regret that they didn’t know sooner. For decades, ADHD research and diagnosis were centered around boys, particularly those who were disruptive or hyperactive. Girls, especially those who were social, bright, or high-achieving, often flew under the radar. Their struggles with executive functioning like planning, focus, time management, and emotional regulation, were chalked up to anxiety, perfectionism, or just being "too sensitive."

Why Women Are Undiagnosed

Many women aren’t diagnosed until adulthood—roughly 61% according to the CDC—often after a child receives their own diagnosis and the pieces start to fall into place. Before getting help, many of these women report spending years feeling “different,” “stupid,” or “lazy,” and blaming themselves for falling short in areas where others seemed to thrive. So, why is it taking so long to get recognized?

One reason is that the diagnostic criteria for ADHD were originally based on how the condition shows up in boys. And while clinical training is improving, it still often misses how ADHD looks in women. Boys are more likely to show outward signs like hyperactivity or impulsive behavior, while girls tend to internalize their symptoms. They may struggle with focus, organization, or emotional regulation, but learn to hide it through perfectionism, people-pleasing, or over-preparing. Girls who do show external symptoms are more likely to be judged harshly, since behaviors like impulsivity or disorganization are viewed as breaking social norms for how girls “should” behave (Holthe, 2013).

This gender bias shows up in more than just medical settings - it’s present at home and in the classroom too. In one study, teachers and parents were given identical case descriptions of a student with ADHD symptoms, but with different names to indicate gender. Both groups were less likely to recommend services for the girl (Attoe, 2023). This reflects a widespread misconception that ADHD is mainly a “boy thing,” even though research shows it affects boys and girls at similar rates.

The Risks of Going Undiagnosed

The consequences of undiagnosed ADHD in girls and women aren’t just frustrating, but can can be quite serious. Untreated ADHD in women is linked to higher rates of anxiety, depression, eating disorders, substance use, and self-harm (Connolly, 2019). Many women spend years feeling like they're failing at things that come easily to others, internalizing shame and burnout from constantly masking their struggles.

Socially, girls with ADHD are more likely than boys to be rejected by peers, as female friendships often demand greater emotional awareness, communication, and social nuance (Connolly, 2019). This can lead to early experiences of isolation and self-doubt, compounding emotional distress over time. Without proper diagnosis and support, this chronic stress can take a deep emotional and physical toll. 

Women with ADHD, according to a 2023 meta-analysis, are also more likely to be victims of domestic and sexual violence. There is also concern around poor self-image, poor outcomes in the workforce, and the significant mental load of struggling to care for home and children. The stakes can be high.

Executive Functioning Challenges Across the Lifespan

Executive functioning difficulties often become more obvious as demands increase. What might be manageable in early grades becomes overwhelming in middle school, college, or adulthood. For women, the load only increases with time with as they add careers, parenting, and home management - all while struggling to manage time, remember details, start tasks, and follow through.

Hormonal shifts play a significant role as well. Estrogen impacts dopamine, a key neurotransmitter in ADHD. As hormone levels fluctuate through puberty, pregnancy, and perimenopause, ADHD symptoms can intensify, often leaving women confused or overwhelmed without knowing why. Doctors often chalk these changes up to the natural progression of aging, so few women are offered the relief of hormone replacement without some level of self-advocacy.

What You Can Do to Promote Earlier Diagnosis

Fortunately, awareness is growing and there is an increased effort to diagnosis girls and women sooner. You don’t have to be a professional to help close the gender gap in ADHD care. Talk openly about ADHD, especially how it shows up in girls and women. Encourage the people around you to question stereotypes and advocate for themselves or their children. Sometimes, simply hearing that their experience is valid can be the spark someone needs to seek a diagnosis.

If you're a woman with ADHD, remember that executive function challenges aren't a moral failing. They are a symptom. Take the time to educate and empower yourself if you are one of many women joining the ranks of the newly diagnosed. Seek out support through coaching, therapy, medication, and support groups. A BrainBrakes recommended reading is A Radical Guide for Women With ADHD to get you started on the journey. You can also find more information on screening for girls at FindtheADHDGirls.org.

Arrondo, G., Osorio, A., Magallón, S., Burgo, C. L., & Cortese, S. (2023). Attention-deficit/hyperactivity disorder as a risk factor for being involved in intimate partner violence and sexual violence: a systematic review and meta-analysis. Psychological Medicine, 53(16), 7883–7892. https://doi.org/10.1017/s0033291723001976

Attoe, D. E., & Climie, E. A. (2023a). Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. Journal of Attention Disorders, 27(7), 645–657. https://doi.org/10.1177/10870547231161533

Attoe, D. E., & Climie, E. A. (2023b). Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. Journal of Attention Disorders, 27(7), 645–657. https://doi.org/10.1177/10870547231161533

Connolly, M. (2025, March 18). ADHD in Girls: The symptoms that are ignored in females. ADDitude. https://www.additudemag.com/adhd-in-girls-women/?src=embed_link

Wachsman, M. W. (2024, October 15). CDC: Half of People with ADHD Diagnosed in Adulthood. ADDitude. https://www.additudemag.com/adult-adhd-diagnosis-cdc-report/?srsltid=AfmBOoqP7NRXvGlW3MiWM2nHh8aowxNMXcnZL4BO2ya84P-E4ZOcNz6S