How Parents and Teachers Can Close the ADHD Diagnostic Gender Gap

A girl could have the most attentive parents and teachers she could ask for and still suffer from ADHD unnoticed by them. Some studies estimate that as many as 50% to 75% of girls with ADHD are undiagnosed due to a misogynistic and ableist culture that results in those responsible for getting a child evaluated uneducated about what to look for.

Some might assume the underdiagnosis of girls with ADHD is based on a different presentation of symptoms — that girls must present ADHD differently than boys. But ADHD in girls is just that: ADHD in girls. There aren’t any confusing feminine symptoms that keep girls from being referred to get diagnosed, but rather the misconception that girls cannot have ADHD at all.

What we know about ADHD is based on research that has favored male cases, which has resulted in gendered stereotypes of symptom presentations. In our culture, the face of ADHD remains white, male, and young; it looks like disruptive behavior and getting low grades in school. It is more socially acceptable for white boys to “act out” — girls and children of color are penalized for the same behavior, so it follows that they do not exhibit these symptoms as prominently.

The male-centric caricature of ADHD is probably why my teachers in school constantly commented on my slow working pace and rambling comments and how motivated I was to get my work done well. These are textbook symptoms, but my teachers never identified them as such, so, like many other girls with ADHD, I pushed through to turn out assignments.

To be fair, so many things can cause a child to struggle — trouble at home, trouble with friends, or any number of other psychological conditions. When ADHD is culturally thought to be a “boy disorder,” it’s not unreasonable that teachers and parents may not immediately identify it in girls.

But at the end of the day, parents and teachers are the ones who can stop the cycle of underdiagnosis: Girls can’t get a diagnosis if no one takes them to get evaluated, and when fewer girls get diagnoses, the idea that ADHD is a male disorder is perpetuated.

So what can be done?

Parents and teachers must educate themselves about ADHD, unravel their preconceptions about the disorder, and pay attention to the girls in their lives. For example, “masking,” or compensating for symptoms, as I did, is a symptom of girls with ADHD. Teachers need to pay attention to the habits of high-achieving girls in their classrooms, and parents should ask themselves if their daughters are actually doing well or if they are getting good grades but still struggling. Parents should examine the suffering “behind the scenes” at home: Girls with ADHD experience many personal problems, like self-harm and strained relationships with others, as they grow up undiagnosed. Taking girls to get evaluated gives them the vocabulary to begin to manage and medicate their ADHD.

The diagnostic gender gap for ADHD holds wider implications for the rest of the medical world. ADHD isn’t the only condition that researchers have relied solely on male cases to learn more about. For example, heart attack symptoms are routinely missed in women because male bodies are studied as the default. Throughout most, if not all, medical fields, female bodies are viewed as irrelevant, and their differences from male bodies are ignored. As a result, medical conditions in female bodies often go undiagnosed, and women suffer needlessly.

There are very real consequences for girls with ADHD who remain undiagnosed; they are at higher risk of dropping out of college, developing eating disorders, experiencing intimate partner violence, and attempting suicide. Imagine how different a girl with ADHD’s life would be if her parents and teachers worked to unlearn the false connection between ADHD and maleness. Educating parents and teachers about ADHD in girls is the first step in ending an entirely avoidable cycle of suffering.