ADHD in Girls and Women: Key Facts

The good news: there are effective interventions for helping girls and women manage their ADHD symptoms.

1. Girls and women can have ADHD. Yet, ADHD often looks different in girls and women compared to boys and men.

ADHD is not a “boy disorder” — girls and women can have ADHD too.
Compared to boys and men, girls and women with ADHD are more likely to show inattentive symptoms — such as difficulty focusing in conversations, disorganization of their belongings, or trouble remembering steps in routines—rather than hyperactivity and impulsivity, which are more common symptoms in boys.^{1, 2, 3}
Girls and women can also experience hyperactive and impulsive behaviors due to ADHD, but these behaviors may be less obvious and disruptive.³ For example, girls and women may be more hyperverbal and talkative rather than physically hyperactive. ⁴

2. While rates of ADHD in adulthood are equal among men and women, their journeys through diagnosis and treatment can look extremely different.

Studies suggest that girls and women are likely to be diagnosed with ADHD significantly later than boys and men.⁴
Boys are around 3 times more likely to be diagnosed with ADHD in childhood compared to girls.²
Women are more likely than men to be diagnosed with ADHD for the first time in adulthood.⁵ This may be due to women being able to report on their own internal experiences and seek evaluation rather than relying on parents and teachers to notice difficulties and make referrals.
After diagnosis, girls with ADHD are prescribed ADHD medication less often than boys with ADHD.^{4, 6, 7}

3. ADHD symptoms in girls and women are often missed completely or misinterpreted as other conditions.

Clinicians,⁹ teachers,^10,11 and parents¹¹ may be less likely to endorse ADHD symptoms in girls compared to boys on rating scales.
Girls and women with ADHD often have other conditions, such as anxiety and mood disorders,⁴ that can make it difficult to identify ADHD.
Girls and women frequently develop coping skills and become “master maskers” of their struggles,^3,12 making it harder for others to notice the signs of ADHD.

4. Girls and women with ADHD are at risk for unique challenges.

Untreated ADHD is associated with a range of difficulties regardless of sex and gender.¹³
Yet, girls and women with ADHD may be at higher risk for additional negative outcomes such as eating disorders,¹⁴ anxiety,⁴ depression,^4,15 suicidal thoughts,¹⁵ suicide attempts¹⁶ and dying younger¹⁷ compared to compared to boys and men with ADHD.
Problems with friendships,¹⁸serious behavior problems,¹⁹ experiencing abuse by a partner,²⁰ and having a teenage²¹ or unplanned pregnancy²² are more common in girls and women with ADHD compared to those without ADHD.

5. The good news: there are effective interventions for helping girls and women manage their ADHD symptoms.

Evidence-based treatments for ADHD include medication, such as psychostimulant medicines, and behavior therapy, such as parent management training (PMT) for young children with ADHD and Cognitive Behavioral Therapy (CBT) for adults with ADHD.^13,23
Combining medication and behavioral therapy to address ADHD symptoms is recommended for all people ages 6 and older with ADHD²³— there are not currently different recommendations based on sex or gender.³
There is some emerging research investigating how hormone changes (e.g., menstrual cycle, menopause) might impact the effectiveness of ADHD intervention in girls and women.²⁴ More research is needed to better understand how hormones might play a role in ADHD symptoms and treatment.

Citations

¹Babinski D. E. (2024). Sex Differences in ADHD: Review and Priorities for Future Research. Current psychiatry reports, 26(4), 151–156. https://doi.org/10.1007/s11920-024-01492-6

²Hinshaw, S. P., Nguyen, P. T., O’Grady, S. M. & Rosenthal, E. A. (2021). Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.13480

³Young S, Adamo N, Ásgeirsdóttir BB, et al. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. Bmc Psychiatry. 2020;20(1):404. doi:10.1186/s12888-020-02707-9

⁴Skoglund, C., Sundström Poromaa, I., Leksell, D., Ekholm Selling, K., Cars, T., Giacobini, M., Young, S., & Kopp Kallner, H. (2024). Time after time: failure to identify and support females with ADHD - a Swedish population register study. Journal of child psychology and psychiatry, and allied disciplines, 65(6), 832–844. https://doi.org/10.1111/jcpp.13920

⁵Staley BS, Robinson LR, Claussen AH, et al. Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults — National Center for Health Statistics Rapid Surveys System, United States, October–November 2023. MMWR Morb Mortal Wkly Rep 2024;73:890–895. DOI: http://dx.doi.org/10.15585/mmwr.mm7340a1.

⁶Kok, F. M., Groen, Y., Fuermaier, A. B. M., & Tucha, O. (2020). The female side of pharmacotherapy for ADHD-A systematic literature review. PloS one, 15(9), e0239257. https://doi.org/10.1371/journal.pone.0239257

⁷Mowlem, F. D., Rosenqvist, M. A., Martin, J., Lichtenstein, P., Asherson, P., & Larsson, H. (2019). Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. European child & adolescent psychiatry, 28(4), 481–489. https://doi.org/10.1007/s00787-018-1211-3

⁸Danielson, M. L., Bohm, M. K., Newsome, K., Claussen, A. H., Kaminski, J. W., Grosse, S. D., Siwakoti, L., Arifkhanova, A., Bitsko, R. H., & Robinson, L. R. (2023). Trends in Stimulant Prescription Fills Among Commercially Insured Children and Adults - United States, 2016-2021. MMWR. Morbidity and mortality weekly report, 72(13), 327–332. https://doi.org/10.15585/mmwr.mm7213a1

⁹Bruchmüller K, Margraf J, Schneider S. Is ADHD Diagnosed in Accord With Diagnostic Criteria? Overdiagnosis and Influence of Client Gender on Diagnosis. Journal of Consulting and Clinical Psychology. 2012;80(1):128-138.

¹⁰Carbonneau ML, Demers M, Bigras M, Guay M-C. Meta-Analysis of Sex Differences in ADHD Symptoms and Associated Cognitive Deficits. Journal of Attention Disorders. 2021;25(12):1640-1656.

¹¹Meyer BJ, Stevenson J, Sonuga-Barke EJS. Sex Differences in the Meaning of Parent and Teacher Ratings of ADHD Behaviors: An Observational Study. Journal of Attention Disorders. 2020;24(13):1847-1856.

¹²Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. The primary care companion for CNS disorders, 16(3), PCC.13r01596. https://doi.org/10.4088/PCC.13r01596

¹³Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., Atwoli, L., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neuroscience and biobehavioral reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022

¹⁴Mikami, A. Y., Hinshaw, S. P., Arnold, L. E., Hoza, B., Hechtman, L., Newcorn, J. H., & Abikoff, H. B. (2010). Bulimia nervosa symptoms in the multimodal treatment study of children with ADHD. International Journal of Eating Disorders, 43(3), 248–259.

¹⁵Babinski, D. E., Neely, K. A., Ba, D. M., & Liu, G. (2020). Depression and Suicidal Behavior in Young Adult Men and Women With ADHD: Evidence From Claims Data. The Journal of clinical psychiatry, 81(6), 19m13130. https://doi.org/10.4088/JCP.19m13130

¹⁶Fuller-Thomson, E., Rivière, R. N., Carrique, L., & Agbeyaka, S. (2022). The Dark Side of ADHD: Factors Associated With Suicide Attempts Among Those With ADHD in a National Representative Canadian Sample. Archives of suicide research : official journal of the International Academy for Suicide Research, 26(3), 1122–1140. https://doi.org/10.1080/13811118.2020.1856258

¹⁷Dalsgaard, S., Østergaard, S. D., Leckman, J. F., Mortensen, P. B., & Pedersen, M. G. (2015). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet (London, England), 385(9983), 2190–2196. https://doi.org/10.1016/S0140-6736(14)61684-6

¹⁸Kok FM, Groen Y, Fuermaier ABM, Tucha, O (2016) Problematic Peer Functioning in Girls with ADHD: A Systematic Literature Review. PLoS ONE 11(11): e0165119. doi:10.1371/journal.pone.0165119

¹⁹Tung I, Li JJ, Meza JI, Jezior KL, Kianmahd JSV, Hentschel PG, O’Neil PM, Lee SS. Patterns of Comorbidity Among Girls With ADHD: A Meta-analysis. Pediatrics. 2016;138(4):e20160430.

²⁰Guendelman MD, Ahmad S, Meza JI, Owens EB, Hinshaw SP. Childhood Attention-Deficit/Hyperactivity Disorder Predicts Intimate Partner Victimization in Young Women. Journal of Abnormal Child Psychology. 2016;44(1):155-166.

²¹Skoglund C, Kallner HK, Skalkidou A, Wikström A-K, Lundin C, Hesselman S, Wikman A, Poromaa IS. Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden. JAMA Network Open. 2019;2(10):e1912463.

²²Owens, E. B., & Hinshaw, S. P. (2020). Adolescent Mediators of Unplanned Pregnancy among Women with and without Childhood ADHD. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 49(2), 229–238. https://doi.org/10.1080/15374416.2018.1547970

²³Wolraich, M. L., Hagan, J. F., Jr, Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., Zurhellen, W., & SUBCOMMITTEE ON CHILDREN AND ADOLESCENTS WITH ATTENTION-DEFICIT/HYPERACTIVE DISORDER (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528

²⁴de Jong M, Wynchank DSMR, van Andel E, Beekman ATF and Kooij JJS (2023) Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage.Front. Psychiatry 14:1306194. doi: 10.3389/fpsyt.2023.1306194

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