ADHD (Attention Deficit Hyperactivity Disorder) is a neurodevelopmental disorder, which means that the part of your brain controlling emotions and self-control are affected. It can lead to attention and concentration problems, hyperactivity and impulsivity. Depending on the type of ADHD someone with the disorder might suffer from all, some, or one of these symptoms.

When we talk about ADHD, the image of a young hyperactive elementary school boy who cannot sit still often comes to mind. While such behaviour can certainly be caused by ADHD, the symptoms are way more varied. The one-dimensional view of ADHD and its symptoms has led to a misunderstanding of the disorder and can lead to the misdiagnoses of those who do not conform to traditional symptoms.

This is where the gendered aspect of ADHD comes to the fore. Estimations show that ADHD occurs at a similar rate in people of all genders, however, men are three times more likely to get diagnosed than women. Furthermore, on average women get diagnosed five years later than men, and in 30-50% of women, ADHD is never properly diagnosed. Being undiagnosed or diagnosed late can have detrimental consequences with respect to school, work and social relations, and it can lead to other problems such as depression, anxiety, or low self-confidence.

ADHD is diagnosed partly based on behaviour, and most research has been done on the behaviour of boys and men. This while ADHD does not look the same for everyone; ADHD symptoms differ across genders. Women with ADHD are often less hyperactive and impulsive but display more of the disorganised, forgetful and inattentive symptoms. The socialisation of young girls plays a role in this. From a young age girls are taught that they should be nice. So, while hyperactive and interruptive behaviour is found to be quite normal for boys, this isn’t the case for girls.

This leads girls to internalise symptoms, and to try very hard to compensate for the symptoms. As a consequence, girls tend to develop more internalised symptons, such as inattention, problems with concentration and daydreaming. Behaviour that is seen as less disrupting for the outside world and is thus often missed by teachers or parents who could call for diagnosis. Note that research on ADHD in gender non-conforming and agender people is virtually nonexistent.

Another gendered aspect that relates to ADHD is hormone levels. Fluctuations of estrogen levels can influence the severity of ADHD symptoms. For those with ADHD and a menstrual cycle this could mean that their ADHD becomes worse once they hit puberty. For some it can also mean that the dosage of medication needed to treat ADHD differs across the menstrual cyclus.

So, as is the case with a lot of medical knowledge, in what we know about diagnosing and treating ADHD is gendered. Research amongst people across the gender spectrum is one key step to solve this. Next to that, we must stop socialising young girls to be nice and quiet.