How Might ADHD Look Different in Women? Let’s Look at What Research Says
Historically, ADHD researchers have primarily focused on young boys, ultimately establishing an image of ADHD as a male-dominant diagnosis today. Not only has this impacted our perception of the condition, but more men are diagnosed with ADHD compared to women, despite more recent research showing that ADHD has a near-equal effect across genders
Written by
Raychel Hatch
Published on
Tuesday, April 29, 2025
How Might ADHD Look Different in Women? Let’s Look at What Research Says
Historically, ADHD researchers have primarily focused on young boys, ultimately establishing an image of ADHD as a male-dominant diagnosis today. Not only has this impacted our perception of the condition, but more men are diagnosed with ADHD compared to women, despite more recent research showing that ADHD has a near-equal effect across genders (Faheem et al., 2022). This is because the male-focused research has lacked in identifying the phenotypic characteristics in women.
You may be reading this and wondering if you have ADHD, but aren’t sure. It’s important to remember that you know yourself best and your diagnosis is your own journey! If you are seeking guidance, it may be helpful to know that some research has shown that women might have slightly different presentations of ADHD characteristics. This article aims to review ADHD research in adults, in hopes of giving you a larger scope of how ADHD can manifest and provide a better understanding of your own experience.
As a reminder, everyone is unique in their catalogue of ADHD characteristics and experiences. These are possible differences. You may identify with some or none of these experiences –or somewhere in between. Wherever you land, I hope reading a little about it can bring some reassurance that others share common experiences with you. Let’s take a look at some of the possible gender differences of ADHD in women vs. men.
- Cognitive/behavioral areas affected: Women with ADHD were found to be more affected in areas of social functioning, stress tackling, and mood. Men were found to be more affected in their working memory and educational functioning. The reason behind these tendencies are largely unknown, but it may be helpful to view them as a general trend in categorizing your own experience. These trends may also explain correlations of women with ADHD scoring higher than male counterparts on standardized, written IQ tests (Faheem et al., 2022).
- Women are more likely to be diagnosed with ADHD inattentive type. As you may know, ADHD diagnoses are categorized into three types –hyperactive and impulsive, inattentive, and combined ADHD. In general, adults are most commonly diagnosed with ADHD inattentive type, with inattentiveness remaining relatively consistent throughout adulthood. On the other hand, children are more likely to be diagnosed with hyperactive and impulsive type, with symptoms decreasing as they reach adulthood (Schiros, et al., 2023). Because inattentiveness is the dominant ADHD style in women, women who exhibit inattentiveness can be overlooked, as inattentiveness is less likely to be observed and recommended for evaluation compared to hyperactive or impulsive behaviors. Research has also found that women often mask symptoms with compensatory behaviors such as compliance, coping strategies, and resilience. On top of that, inattentiveness may also be misdiagnosed with anxiety or depression due to overlapping characteristics, such as appearing withdrawn to the outside eye (Redus, 2024). While ADHD can still exist concurrently with other diagnoses, from this we can get an idea around how people might fail to notice, or misinterpret, ADHD in women. Has there been a time when a part of you has been overlooked or mislabeled? It may be helpful to remember and take note of how that misalignment impacted you in that moment.
- Research on women with ADHD has shown that inattentiveness may surface through social relationships compared to men. Research has demonstrated that women with ADHD diagnoses may find it more challenging to maintain relationships with friends, family, or significant others. Some of these challenges may include, but are not limited to, difficulty with assertiveness, leadership, or tendency for social withdrawal. Some mothers with ADHD reported facing challenges in procrastination, organization, and difficulty with the demands of motherhood. Fostering positive social relationships is a powerful indicator of quality of life, so if you feel that you are struggling with social functioning, it may be an area to pinpoint for managing your ADHD (Schiros, et al., 2023; Redus, 2024).
Diagnosis and Treatment
Again, you know yourself best! If themes surrounding gender expression or identity are important to you, and if you find it relevant to your mental health, I invite you to open these conversations with your provider (or whoever you go to find support!). In mental health care, the number one predicting factor of effective counseling is a strong relationship with your therapist (Lambert, 2013). A good therapeutic alliance is a collaboration between both the therapist and client, which means teamwork in creating a treatment plan that is helpful to your unique desires. Good therapists welcome feedback on what you find helpful or unhelpful during the therapy process. More than solving any particular symptoms, counseling is meant to empower people with mental health conditions as a whole!
How do these gender differences affect counseling?
Both non-pharmacological and pharmacological methods are effective at managing ADHD. Generally, women receive less pharmacological medications to treat ADHD compared to men. This may be due to underdiagnosis or low levels of hyperactive or impulsive behavior (Kok et al., 2020). Because my educational background focuses on counseling, this article will center around how research informs therapy practices.
In a study of 10 therapists in Texas who have worked with clients with ADHD for over five years, most of those therapists noticed a qualitative difference in ADHD presentation across genders, however these gender differences were not the main focus in therapeutic treatment. In the research findings, therapists reported women having more desire to explore topics of presenting issues and the emotional impact associated, while men gravitate towards cognitive and external topics seeking a stepwise approach. Despite this difference in process, once the therapists are able to identify ADHD, they proceed with the same steps in treatment –investigation of the contextual factors and individual presentation, then tailoring their counseling towards building coping skills in areas the client is concerned with. Therapists are more likely to account for the individual’s personality, rather than gender-related expression of ADHD, even if there may be presentational differences (Redus, 2024).
Discussion and Conclusion
While some research has found identifiable gender differences, there are also research studies that did not find any significant differences in ADHD expression. Research methodology and cultural influence may have also impacted study conclusions (Williamson). In my opinion, some bias in researchers towards particular gender roles in studies that observe the impact of ADHD on a mothers’ responsibility as a parent, but not the impact on a fathers’ responsibility.
Additionally, there is little research on the ADHD presentation in nonbinary and gender nonconforming identities. It seems like current research is deeply centered around a biological male/female gender, when gender expression has wider variability in the people of this world. A clinician’s understanding of gender as a social construct containing norms and attitudes is important to truthfully empathize with a client’s experience in the world, but it is also important to refrain from overgeneralizations surpassing people’s individual differences. Though, people may have differing opinions on whether or gender-specific treatment plans should be investigated or if they would create an unfair divide in how people of different genders are treated in mental health systems.
All in all, I hope this introduction to research on ADHD and gender has been interesting and helpful to learn about! I encourage you to think of ways the information may be applicable across your own life or how you view mental health care as a whole!
-Raychel Hatch
Counseling Psychology Graduate Student at Santa Clara University
References
Faheem, M., Akram, W., Akram, H., Khan, M. A., Siddiqui, F. A., & Majeed, I. (2022). Gender-based differences in prevalence and effects of ADHD in adults: A systematic review. Asian Journal of Psychiatry, 75, 1–7. https://doi-org.libproxy.scu.edu/10.1016/j.ajp.2022.103205.
Kok, 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.
Lambert, M. J. (2013). The efficacy and effectiveness of psychotherapy. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th ed., pp. 169–218). Hoboken, NJ: Wiley.
Redus, Casey, "A Therapist Perspective: Gender Differences in Treatment Recommendations for Adults with ADHD, Inattentive Presentation" (2024). Walden Dissertations and Doctoral Studies. 16211.
https://scholarworks.waldenu.edu/dissertations/16211
Schiros, A., London, A. S., & Antshel, K. M. (2023). Gender differences in adults with ADHD. In Clinical handbook of ADHD assessment and treatment across the lifespan. (pp. 17–35). https://doi-org.libproxy.scu.edu/10.1007/978-3-031-41709-2_2
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