Another major factor is the societal expectations placed on women. From a young age, girls are often socialized to be quiet, organized, and attentive—qualities that can make ADHD symptoms harder to detect. Girls who struggle to meet these expectations may internalize their difficulties, blaming themselves rather than recognizing that they’re dealing with a medical condition.

As these girls grow into women, the pressures only increase. Many women with ADHD describe feeling overwhelmed by the demands of adulthood—managing careers, households, relationships, and parenting. Dr. Sandra Kooij points out that these pressures can exacerbate ADHD symptoms, making it even harder for women to keep up with societal expectations (Kooij et al., 2019).

Diagnostic tools and criteria for ADHD were historically developed with boys and men in mind. As Dr. Martin Katzman has noted, this male-centric approach has led to significant underdiagnosis in women, whose symptoms often look very different (Katzman et al., 2017). For example, while boys with ADHD may act out in class, girls are more likely to daydream or struggle quietly, leading teachers and parents to overlook their struggles.

Even when women seek help as adults, they often encounter clinicians who are unfamiliar with how ADHD presents in women. This is why education and training are so important—not just for women themselves, but for the professionals who care for them.

We also cannot ignore the role of intersectionality. Women of color face additional barriers to diagnosis and treatment, including racial bias and cultural stigma. Dr. Napoleon Higgins has emphasized that African American women, in particular, are often misdiagnosed with other conditions or dismissed entirely, further delaying access to appropriate care (Higgins, 2021).

This is an area where we need to do better as a field. By acknowledging these systemic issues and advocating for culturally competent care, we can help ensure that no woman is left behind.