Why ADHD Looks Different in Different Genders

Medical researchers, healthcare professionals, and society as a whole have all come a long way in correcting the misconceptions surrounding attention-deficit/hyperactivity disorder (ADHD). Despite our progress, there is still a significant gender bias when it comes to ADHD diagnosis and treatment. 

Although ADHD can affect anyone regardless of gender, boys are almost twice as likely to receive a diagnosis than girls. This means that compared to girls, boys with ADHD are also twice as likely to receive the treatment, support, and validation that comes with an accurate diagnosis. 

To clear up the persistent, widespread misunderstandings about women with ADHD, let’s take a look at what ADHD is, how it affects genders differently, and why it’s more common in males.

What Is ADHD?

ADHD is a developmental disorder that’s characterized by three core symptoms: inattention (attention deficit), hyperactivity, and impulsivity. The hallmark signs of ADHD stem from these core symptoms, and include:

• Difficulty with staying focused
• Executive dysfunction
• Disorganization
• Forgetfulness
• Restlessness
• Impulsive behaviors and emotions

ADHD is often considered to be a spectrum disorder, meaning the range and severity of these symptoms can vary greatly from person to person. However, even those with mild ADHD symptoms can find it extremely difficult to maintain control over their work, school, relationships, and daily tasks. 

Read our complete guide for an in-depth look at ADHD, its symptoms, and how it’s treated. 

ADHD Gender Differences—How ADHD Presents Differently in Boys and Girls

The signs and symptoms of ADHD can look a lot different in women than they do in men. This is because of gender roles, societal norms, and physiological differences that influence how ADHD symptoms are expressed. 

Although ADHD can manifest differently in women, they still experience the same three core symptoms: inattention, hyperactivity, and impulsivity.

Inattention Symptoms

Inattention, or attention deficit, symptoms can make it difficult for someone with ADHD to ignore distractions, maintain focus, and stay organized. These symptoms can be linked to differences in brain structure, such as the prefrontal cortex, and neurotransmitter imbalances .

Inattention Symptoms in Men

Men are more likely to show obvious signs of inattention, especially in environments where a high level of focus is required, like school or work. 

In men with ADHD, inattention symptoms may appear as: 

• Frequent forgetfulness
• Disorganization
• Being easily distracted
• Tendency to make mistakes
• Difficulty following through with tasks 

While the more visible signs of inattention can lead to challenges in academic and professional settings, they also make it easier for ADHD to be recognized and diagnosed earlier. 

Inattention Symptoms in Women

Women are more likely to mask their inattention symptoms and compensate for them by working harder than others to stay on top of tasks.

In women with ADHD, inattention symptoms may appear as:

• Daydreaming
• Being easily sidetracked by other tasks
• Strong reliance on organizational tools
• Internalized frustration
• Tendency towards perfectionism

On the outside, some women with ADHD can appear to be organized, composed, and in control. However, it takes a lot of effort to mask their inattention symptoms, and this can lead to feelings of exhaustion, burnout, and guilt.

ADHD is commonly misdiagnosed as anxiety in women. Read our related article to discover the similarities and differences between anxiety and ADHD.

Hyperactivity Symptoms

Hyperactivity in ADHD can lead to restlessness and an inability to sit still. Regardless of gender, it can manifest as:

• Fidgetting
• Excessive energy
• Excessive talking
• Frequently interrupting others
• Difficulty waiting their turn
• Difficulty regulating their energy levels

Although both men and women are likely to experience the same hyperactivity symptoms, there are some distinct differences in how they’re expressed.

Hyperactivity Symptoms in Men

Men are more likely to express their hyperactivity physically. As children, boys with ADHD tend to display more overt signs of excessive energy by running around, climbing, and frequently leaving their seats. As adults, they’re more likely to talk excessively, interrupt others, and appear fidgety. 

Hyperactivity Symptoms in Women

Compared to men, women with ADHD tend to internalize their hyperactivity. Instead of appearing outwardly restless, they’re more likely to experience internal restlessness as racing thoughts and difficulty relaxing. 

Although women may also display external signs of hyperactivity, they usually express them in less disruptive or apparent ways. This makes it harder to identify ADHD in women, especially at a young age.

Impulsivity Symptoms

Impulsivity symptoms can make it difficult for someone with ADHD to control their immediate behaviors and emotions. This can lead to struggles with fulfilling responsibilities, regulating emotions, and maintaining relationships.

On the outside, impulsivity symptoms may appear as spontaneous actions, emotional outbursts, and a lack of consideration for others. Internally, impulsivity can cause someone with ADHD to feel inadequate, frustrated, or embarrassed that they can’t easily control their impulses. 

Impulsivity in Men

Just like with the other core symptoms of ADHD, men are more likely to express their impulsivity physically. This can appear as:

• Engaging in risky behaviors
• Aggressive outbursts
• Higher levels of anger
• Making hasty decisions without considering the consequences

Men with ADHD are less likely to hide their impulsive behaviors. Although this can be more disruptive to others, it does make it easier to recognize the signs of ADHD and get the treatment and support they need to live a balanced lifestyle. 

Impulsivity in Women

Compared to men, women with ADHD are more likely to internalize their impulsivity and make impulsive decisions that are harder to detect. This can appear as:

• Impulsive shopping 
• Overeating
• Emotional outbursts, like crying
• Higher levels of guilt or shame

Due to societal expectations for women to be calm and composed, women with ADHD tend to express their impulsivity in ways that are “socially acceptable”. This makes it harder for others to recognize their internal struggles with behavioral and emotional regulation.

Why Is ADHD More Common in Males?

Males tend to exhibit ADHD symptoms in ways that are more easily identifiable, making it much more common for them to receive an accurate diagnosis. Females tend to mask their ADHD symptoms and express them more subtly. This makes it more common for women to be misdiagnosed or have their ADHD symptoms overlooked completely.

Although more men are diagnosed with ADHD than women, it doesn’t necessarily mean that they’re more likely to get it or experience it more severely.

Correcting the ADHD Gender Bias

Recently, more women have been receiving an accurate ADHD diagnosis as a result of better diagnostic criteria and heightened public awareness. 

Thanks to popular social media platforms like TikTok, more people are learning about ADHD and how it manifests in women. Although social media has been known to perpetuate misinformation, it’s undeniably a powerful tool for spreading awareness and normalizing mental health issues.

Through continuous awareness and understanding, more women with ADHD will gain access to the treatment, support, and validation they deserve.

Read our related article to discover why you shouldn’t self-diagnose mental illnesses with TikTok.

Take the First Steps Toward Managing Your ADHD

At Inner Balance, we can help you manage your ADHD symptoms and teach you how to thrive in your personal and professional life. Our counseling services are designed to provide a supportive environment for you to develop the skills needed to live life on your own terms.

‍Request a consultation today to connect with a mental health expert and take the first steps towards managing your ADHD.