No.
ADHD affects males and females at similar rates—population studies show ratios closer to 2:1, not the 4:1 to 9:1 ratios seen in clinical samples.1
The disparity isn’t because fewer girls have ADHD; it’s because girls are consistently underdiagnosed.
Please note: Research on ADHD has historically used binary sex categories. The patterns described here reflect how people are perceived and treated based on gender presentation, which affects diagnosis regardless of gender identity.
When gender differences were assessed in non-referred children, boys and girls did not differ in ADHD subtypes, psychiatric comorbidity, or treatment history, leading researchers to conclude that “gender differences observed in clinical settings may be caused by referral biases“.2
When researchers actually screen all children for ADHD symptoms instead of waiting for referrals, the kids who meet the criteria but haven’t been diagnosed are significantly more likely to be girls: with an odds ratio of 1.83.10
And even when children assigned female at birth show comparable symptom severity, they require a greater burden of emotional and behavioural challenges to meet diagnostic criteria compared to boys.6
Why do people think only boys can have ADHD?
Historically, ADHD diagnostic criteria were developed based on samples that were only 21% female, making the symptom descriptions more appropriate for behaviours typically seen in boys.3
Healthcare providers are less likely to suspect ADHD in girls. Their presentation is often dismissed as ‘subthreshold’, because they show more inattentiveness than hyperactivity, and girls with ADHD often develop better coping strategies to mask their symptoms than boys do.9
Gender bias in schools
Girls are more likely to present with inattentive symptoms rather than the hyperactive-impulsive behaviours that disrupt classrooms and prompt referrals.
While teachers do recognise problems in both boys and girls (and often rate girls’ impairments as more severe when they exhibit difficulties), they are significantly less likely to take the next step of recommending clinical referral or treatment for girls.4
In one study5, only 15% of teachers thought medication might be helpful for a girl meeting ADHD diagnostic criteria, and teachers were less likely to correctly identify girls with inattentive presentations as having ADHD, despite recognising their attentional and emotional difficulties. 4
This pattern suggests teachers can identify girls with ADHD but fail to refer them to services, possibly due to gender-based expectations where boys’ disruptive behaviour is seen as more concerning, or because girls’ “tractability” (easier to manage) in school settings makes their struggles seem less urgent. 48
Delayed identification leads to delayed support
The result of all of this is delayed identification or misdiagnosis, which leads to more mental health problems.
Women, girls and female-presenting folk are diagnosed an average of 4+ years later than boys (the mean age of ADHD diagnosis ranged from 16.3 to 28.6 years for females, compared to 11.2 to 22.7 years for males)12. And for women, often it only happens after developing prominent anxiety, depression, or other co-occurring conditions that finally prompt evaluation. 7
“Can you grow out of ADHD?“
Interestingly, the historical belief that people “grow out of” ADHD may have been reinforced by studying primarily men3 whose symptoms appeared to diminish in adulthood.
This often could happen because their partners’ invisible labour was compensating for executive function difficulties that never actually went away.
Many people perceived as female aren’t diagnosed until adulthood, when increased demands and decreased external support make their executive function challenges impossible to mask.
Change is already happening
ADHD is not overdiagnosed, but finally correctly diagnosed. Between 2003 and 2015, the number of US women ages 15-44 filling ADHD medication prescriptions increased by 344%, suggesting that women who were previously overlooked are finally starting to get the support they needed all along.11
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“Does ADHD mean you’re always hyperactive?”