ADHD and the Child’s Gender
Why do fewer girls have ADHD?
ADHD is a highly individualized disorder. The diagnosable traits differ between individuals, and what those traits present themselves as, differ as well. Just as the behavior of children with ADHD is distinct from that of adults with ADHD, gender plays a role in ADHD symptoms and behaviors. Before we dive into those differences, please review our previous article on the characteristics of the current diagnosis of ADHD.
Boys are three times more likely to be diagnosed with ADHD than girls. This is probably because the symptoms of ADHD tend to differ between boys and girls.
Girls are more likely to present traits associated with inattentive ADHD. It’s a subtler form of the disorder that is easily explained away or goes completely unnoticed. These traits are more internal, and therefore harder to observe. This may present as being “spacey” or withdrawn, being very talkative, having trouble staying organized, and/or being overly emotional.
It’s much easier for a teacher to see a child getting out of their seat and running around the room than a child quietly daydreaming or losing focus on a worksheet.
Because of this difference, girls are far less likely to be diagnosed with ADHD and are often diagnosed at an older age than boys. This means many girls and women struggle with ADHD without knowing they have it. Quite often, women are diagnosed with ADHD only after one of their children is diagnosed first.
It’s important to note that boys with inattentive ADHD often go undiagnosed, too.
ADHD traits in girls are often internalized, they are more likely to internalize their frustrations, too, leading to low self-esteem, underachievement, anxiety, and depression. Teenaged girls with ADHD are also more likely to start smoking or have unwanted pregnancies than girls without ADHD.
However, there has been evidence that girls are just as likely to exhibit hyperactive traits as boys. Girls are socialized differently than boys, which may be why their hyperactivity seems milder.
Let’s look at impulse control and aggression. People with ADHD have impulse control issues, which means they can become angry very quickly, but aggression looks different in boys and girls. Boys are more likely to be physically aggressive or violent. Girls more often show their aggression in their words or by shunning someone who has made them angry.
Much of this difference is due to how children are raised and which behaviors adults will tolerate in children. “Be ladylike” and “boys will be boys,” two common phrases, demonstrate the sorts of attitudes traditionally held toward the two genders.
We know that those with ADHD as children can carry their diagnosis into adulthood. More boys are diagnosed with ADHD than girls. As they age into adulthood, that uneven ratio (as high as 16:1, boys:girls) starts to even out more, with 1.6 men having ADHD to every 1 woman with ADHD.
Similarly, another study found that in adults there ceased to be a gender difference in inattentive versus hyperactive traits. Men and women had a similar number and distribution of traits between the two subtypes of ADHD. This could mean that ADHD symptoms become less gendered with age or that we have more gendered expectations of behavior in children than in adults.
So what can we take away from this? It is possible ADHD affects more boys than girls. It’s also possible they are equally affected, but girls are more likely to be undiagnosed. It appears boys show different symptoms than girls, but that might be due to socialization more than anything else.
There is a lot about ADHD we don’t know, but we need to keep in mind that the stereotypical picture of a child with ADHD – a young boy running around uncontrollably – isn’t always what ADHD really looks like.