How ADHD Shows Up DIfferently in Women New 2025 Study Reveals Key Gender Gap

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Understanding ADHD Through a Gender Lens

ADHD isn’t just a childhood disorder—or a “boy’s diagnosis.” A new study analyzing over 2,200 adult patients reveals that ADHD symptoms and impairments manifest differently in men and women, especially in adulthood. While the core features of ADHD remain consistent, how those symptoms are expressed, remembered, and managed varies significantly across gender lines.

This insight could reshape how clinicians screen, diagnose, and support adults with ADHD—especially women, who are often misdiagnosed or overlooked due to outdated diagnostic frameworks.

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What the Study Looked At in Regards to ADHD

Published in Frontiers in Global Women's Health, the study titled “Bias by Gender: Exploring Gender-Based Differences in the Endorsement of ADHD Symptoms and Impairment Among Adult Patients” analyzed 2,257 Dutch adults who were diagnosed with ADHD using the DIVA-5, a global diagnostic interview based on DSM-5 criteria.

Researchers focused on:

How patients endorsed ADHD symptoms in childhood vs. adulthood
Which predefined behavior examples they selected
How ADHD impaired different life areas
Gender differences across all categories

Key Takeaways: Gender Differences in ADHD

1. Women Report More Symptoms in Adulthood

Women endorsed more adult ADHD symptoms than men, especially:

Losing things easily
Feeling restless
Talking excessively

This challenges the outdated view that ADHD is less severe or less common in women. In fact, female patients showed higher symptom presence in adulthood, especially for hyperactivity and impulsivity.

“Feels restless” was endorsed by 88% of women vs. 78.5% of men.
— Platania et al., 2025

2. Men Recall More Childhood Symptoms

In contrast, men reported more childhood symptoms like:

Leaving their seat during class
Avoiding tasks requiring sustained attention
Not completing homework

Girls, who tend to internalize symptoms more, often go undiagnosed until much later—ages 16–28—compared to boys, who are typically diagnosed between 11–22.

3. Impairment Types Also Vary by Gender

ADHD isn’t just about symptoms—it’s about how it affects real life. Here’s how impairment reports differed:

Impairment Area	More Reported By
Self-confidence issues	Women
Social contact problems	Women
Work/education issues	Both
Relationship strain	Men
Legal/impulsive issues	Men

Self-confidence was the most reported impairment overall:
89% of women vs. 81% of men.

4. Women Use Coping Strategies That Mask ADHD

Women often endorsed behaviors that reflect overcompensation or perfectionism, including:

Rigid use of lists (30% of women vs. 19.5% of men)
Creating schedules they don’t follow
Perfectionism (44% of women vs. 29% of men)

These efforts to stay “on top of things” may actually mask ADHD symptoms, leading professionals to miss the diagnosis.

Why This Matters

Outdated Tools Lead to Misdiagnosis and Missed diagnosis in Women

Diagnostic tools like DIVA-5 rely heavily on observable, disruptive behaviors—like interrupting or getting out of a seat—behaviors more typical in boys.

Girls and women are socialized to hide their struggles, so ADHD symptoms often present as anxiety, emotional overwhelm, or burnout, making it harder for clinicians to recognize the underlying neurodivergence.

Diagnostic Bias Is Built In

The DIVA-5 still includes many male-centered childhood examples—like “doesn’t hand in homework” or “talks out of turn.” These don’t reflect how ADHD often shows up in girls, who may be emotionally dysregulated or excessively self-monitoring instead.

How ADHD Symptoms Show Up by Gender

ADHD Feature	Women	Men
Most Endorsed Adult Symptom	Feels restless	Difficulty sustaining attention
Childhood Symptom Recalled	Talks excessively (chatterbox)	Leaves seat, avoids tasks
Coping Style	Rigid lists, overplanning	Missed tasks, lack of structure
Impairment Focus	Self-confidence, social issues	Relationship strain, impulsivity
Diagnostic Challenge	Masking, internal symptoms	Early, externalized behaviors

What Needs to Change

The study’s authors recommend that ADHD diagnostic tools be improved to:

Include more female-relevant behaviors
Remove rarely endorsed examples (like gambling or legal trouble)
Expand beyond the male/female gender binary
Validate tools on both ADHD and non-ADHD populations

This would ensure more accurate diagnoses, especially for women and gender-diverse individuals who are currently underserved.

Final Thoughts

While ADHD may look similar on paper across genders, how it's experienced, reported, and masked varies greatly. This study highlights the need for more inclusive tools and deeper understanding—so that fewer women are left undiagnosed, untreated, or misunderstood.

Even if the statistical gender differences were small, the impact on real lives is big.

Additional Resources

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