ADHD in Women and Girls – Perspectives from an educator and coach.

ADHD in Women and Girls – what I have learned as an educator and coach.

In recent years, I have had the privilege of working in-depth with a range of families as a parenting coach with a particular philosophy around connection and quality attachment being crucial to supporting young people through their growing pains. Especially where neurodiversity is concerned – and the challenges facing parents and children are particularly strong. Here, I also draw on my experiences as a lead in girls’ education.

I feel drawn to follow up on my last article with a focus on ADHD now through a gender lens – looking at ADHD in women and girls. I’m also thinking of my coaching work with adult women with a late diagnosis of ADHD; the specific challenges they are facing in their working lives, and in their relationships – especially with themselves.

Rejection sensitivity, as a trademark part of the ADHD profile can have a particular signature in the lives of women ‘ADHDers’ – instead of self-compassion there can be a tendency to use compensatory strategies like overwork, perfectionism, a deep-seated struggle to mask when emotionally overwhelmed, people pleasing. All of which can lead to burnout, low self-esteem, a difficulty to see or accept their achievements, and even accepting abusive relationships or minimising their experiences of  bullying in the workplace.  

The conclusion I am drawing, is that it is hard to be neurodiverse. Our lifestyle pretty globally is prone to be pro-ADHD-esque problems, and counter executive functioning growth…It’s easy to fragment your attentional focus habitually and chronically. No one needs to manage time with a sense of urgent discipline when you can put off or rearrange in an instant via the phone. It’s easier to be outraged, resistant and entitled about the things that give us discomfort. It’s easy to fill the holes in our hearts with addictive patterns of behaviour – from a younger and younger age.

This article is about how I also believe that there are particular challenges that come with being a girl or a woman who has difficulties with executive functioning – especially where ADHD is concerned. I’m not here to argue whether or not one gender is having a harder time than another. I do feel very passionately though, that we can support each other so much better in family life, at school, and in the workplace with greater insight, and openness to developing our understanding.

If you’ve read my work for long, you’ll know that I always am mindful of confidentiality where my clients are concerned – so I will never use real anecdotes from that work – unless I have explicit consent.

What I do feel is of service, is to draw out the learning from those sessions, the perspective I am able to garner from young people about their struggles in school, and the pull through of how those experiences can affect them later in life. What helps, what hurts.  

I certainly feel a calling to bring the psycho-education and theory to life and give parents active, practical ways they can show up to minimize the harmful effects of feeling different, habitually on the back-foot, and even deficient. The onset of these negative core beliefs for neurodiverse children comes in from a very early age.  

In my work I also seek remove the relational clutter that is there for all of us as well-meaning parents. We worry – are we getting things right? Are we being too cossetting, too harsh…Should we nag harder, find the golden consequence that will finally teach them the lesson we’re so frustrated that they can’t yet get! We worry – did we put them in the right school? The shouting, followed by the second-guessing…

How we can energize our kids into growth, to motivate them to do their best – without shaming them, or getting locked into chronic criticism? Or messing them up? It’s hard at the best of times with the sand-tray of neurotypical child development patterns – let alone parenting plus where neurodiversity is at stake.

Teachers are often the first to suggest neurodiversity, and ADHD in particular, when a child seems have lagging skills in class with attentional focus, or following instructions, or in their social and emotional learning. Parents also tend to look for these conclusions when they face the repeated frustrations of growing pains at home, or when conflict loops and struggles with independent work or routines become the keynote of the relationship.

As previously, I’m not saying that we should be rushing to pathologize sticking points. Some kids genuinely do take longer to come to maturity, and that’s not necessarily a neurodiversity issue. Remember the randomness of our system eg in the UK, kids are formally assessed at 16 in 8 or 9 + subjects.

It’s a snapshot assessment of how they are at one point early in their lives – it is not and should not be seen as something truly defining. It’s not like the ‘sorting hat’ in Harry Potter – defining your personality, morality, and future trajectory…Whatever happens in our kids’ lives at 7+, 11+, 16+, 18+ it’s workable and not a guarantee of good or bad fortune. And when it comes down to it, what would you prefer, a child who peaks at 16 or 18, or someone whose engagement with their differences leads to self-awareness and wise decisions that will shape their later thriving.

As a parent coach, one of the most affirming questions I ask parents, is how they see their kid when they envision them in their 30s…However much they are tearing their hair out in the current moment, most know in their heart of hearts, that what’s going on right now is temporary, context-specific, and that is the gateway to a more resilient outlook.

It’s really important to underline that only a psychiatrist, or a clinician registered with Health and Care Professions Council (HCPC) or the General Medical Council (GMC) is able to make that diagnosis. However, we can look out for patterns when struggles become pervasive, or when the young people in our lives are really starting to suffer with their self-concept. This article extends from my last piece – written about how parents and educators can think about and work with executive function challenges. This more general piece covers what is helpful to know about having an affirming and progressive approach to lagging development in social, emotional or cognitive aspects of a young person’s journey – especially where ADHD is concerned. Here’s the link:

But is it ADHD?

A recent NICABM course I attended on ‘Rethinking ADHD in Women and Girls’ led by the inspirational Tasha Oswald PhD, shared a slide that summarised the 2025 piece of research by Babinski and Lipsack into women diagnosed with ADHD. In adulthood, the researchers asked them what ADHD meant to them and they created a word cloud of the words used. It’s striking to see how overwhelmingly negative these were. Different, anxiety, procrastination, attention, distracted, scattered, were the descriptors that came up most frequently. In fact it’s hard to see any positive words at all.

Speaking both as an ex-English teacher, and now as a coach and professional listener, the words a person uses to describe themselves, their ability or incapability, have an impact on their self-understanding and identity.

Coming to identify, understand and name areas of struggle AND areas of strength through the lens of realistic and appropriate developmental expectations is really key to being able to accept executive function challenges and adapt in healthy ways. A child is unable to do this for themselves. They are, however, adept at feeling their differences and creating narratives of their own based on how they are received by others about whether or not they are a ‘good child’.

It is really incumbent on the adults in their life to give them grace as a learner, to teach them, and give them time and scope to develop – and some young people need more of that grace, more creativity and adaptations to the standard instructional path – whatever that may mean- than others.

Certainly as a teacher, I learned more and improved more as a teacher from trying to meet the needs of the kids who were different, who learned in ways that were different to how I taught than from any educational theory or professor. And the whole class benefitted from trying to approach complex content from different approaches.

The essential life-skill EVERY child should acquire and have acess to is the ability to see their strengths and play to their strengths. Healthy happy adults shape healthy happy lives around these aspects. This is especially important for neurodiverse individuals to prevent the added challenges of rejection sensitivity encumbering them further.

A neuro-affirming approach becomes more possible when the adults around the young person are better informed about the nature of executive function challenges and strategies and approaches that have better chances of success.

The low-down on girls with executive functioning challenges:

• Girls with executive functioning challenges do not need to be told to try harder, or repeat the same strategies again and again harder.  They don’t need putting in detention for chronic lateness or disorganisation – unless it is to give them time with someone who can coach or mentor them to explore and unpack their difficulties so that they can been seen through a clearer lens, and learn more effective ways of operating. They need executive functioning coaching – training that will help them find the right strategies that will work for them.
• Research shows that there is a great deal of stigma for children with ADHD tendencies.  Studies by Lebowitz in 2016, and Psychogiou et al in 2007 unpacked the stigma showing up as people being less willing to interact, collaborate, work with, be friends with ADHD peers. But because often as a girl grows up, there are gendered differences about expectations of them. For example, a messy personal appearance in a girl is likely to attract more attention than in a boy. They experience higher levels of criticism, rejection, bullying, hostility, than their neurotypical peers.  And especially around puberty and early adolescence, belonging and peer approval are even more important to girls. (Larson R & Richards M.H. 1991 – Daily companionship in late childhood and early adolescence; Little, S.A. & Garber, J. (2004) Interpersonal and achievement orientations and specific stressors predict depressive and aggressive symptoms).
• The stigma doesn’t stop with ADHD children; decreased warmth, enhanced hostility and criticism are also experienced by their parents. (Lebowitz in 2016, and Psychogiou et al in 2007)
• ADHD in women and girls is also subject to discrimination and lack of support – diagnostic criteria are commonly seen though a gendered lens. There are 3 types of ADHD presentation – Impulsive and hyperactive, inattentive, and a blend of the 2. Women and girls tend to present with inattentive type and therefore don’t get picked up with the same speed and proactive approach that the typically male presentation does – so diagnosis is often more subject in delay, and there is less training and research and also less support available, and available less proactively.
• Because ADHD in women and girls is different, they are more subject to disbelief and mistrust – because their presentation isn’t the classic type it’s part of a social bandwaggoning  ‘Everyone’s got a little bit of ADHD’…Part of the much-discussed creep of neurodiversity diagnoses. When it is highly likely to be being under-diagnosed.

Inattentive ADHD

Inattentive ADHD which is predominantly – though not exclusively – in girls and women often shows up as a mental restlessness instead of hyperactivity.

For teachers or parents – how this might show up is very much more subtle. I might look back to A Level groups and not necessarily see someone who is obviously inattentive. But I might find that I would need to draw them in to the conversation in order to tap into their thinking and include them in discussion. At that point, I might notice that what they might say might not be entirely in step with the conversation so far. They might be less likely to be able to reference what’s gone previously in the lead up to that moment.

In their contributions to class or in their written work, they might make an interesting or left-field link perhaps with another subject altogether. They might well be drawn to some area of enquiry that has an intersectional element – which could be great – but it might also not slot so neatly into the marking criterial.

Pull this through into the world of work, this person may be able to harness these elements creatively – spotting a gap in the market, or bringing something more innovative to market as an entrepreneur. Someone with this ADHD profile may be drawn to work in projects that allow for hyperfocus – or to be in an environment where there’s more access to ‘flow’ states – like classroom teaching – where they can be utterly absorbed in ‘in the moment action’ – a varied and stimulating environment with lots if interest, novelty, collaboration.

• Mental restlessness means experiencing racing thoughts that compete for attention, it may mean they are constantly busy, or overstep and take over, talking excessively. In class it may be that their busy brains are definitely taking in some of what’s being said – maybe a good portion of it – but also making other connections and creative or obscure links…Channelled and -crucially to avoid burn-out – managed well, it can lead to great innovation and creativity.
• Time blindness is another feature of ADHD generally can have added dimensions in women who tend to be socialised to care for others. This might also have people pleasing or perfectionist tendencies. There’s difficulty estimating time, over-running – but also over-committing, or over-compensating with time or efforts or energies.
• Disorganisation – losing things, forgetting homework, equipment, creating clutter, living with clutter. In girls – this may make you more of an outlier with your compliant neurotypical counterparts.
• One significant trait of ADHD in women and girls is that of emotion sensitivity. Volatility with feelings, intense negative feelings, rejection sensitivity, and a tendency to overpredict disapproval, and misreading cues for belonging.
• Taking these gendered ADHD profile differences into account, we can see also that attentional focus challenges are different. Alongside the propensity for mental restlessness comes being forgetful, easily sidetracked, losing things, mind-wandering, avoiding boring tasks. Being able to regulate our attentional focus isn’t just about attending to one thing at a time.
• Girls are a lot more invested in their social belonging with peers and friendships from an early age – so it’s easy to see how the combination of their neurological differences – and their unique mixture of executive functioning challenges – can lead to rejection sensitivity and an exacerbation of the propensity to struggle with emotion regulation.

Regulating focus – a complex executive functioning skill unpacked.

It’s hard to grasp this from a neurotypical standpoint. Hence the long line of adults that neurodivergent children tend to meet who see them as a ‘won’t’ not ‘can’t’ problem, that they ‘just’ need to listen harder, try harder…etc.

There are various descriptions that psychologists have given, to try to help it live in a lay person’s understanding. In a Mindsight course on ADHD I attended, the course Leader Stephanie Sarkis PhD quoted Clinical Psychologist Joseph M Carver PhD who puts it like this:

“Imaging trying to thread a needle, in low light, while sitting in a row boat in the ocean. The waves tossing and rolling all the time. The amount of concentration needed to thread the needle makes us anxious, tense, and irritable – as if someone were trying to ask us questions while we were trying to thread that needle.”

This really makes the added load of the experience of being in class as a young person vivid – especially the impact on the capacity to be able to connect with others.

I have also heard Dr Dan Siegel describe it well -as being akin to being able to ride a bike down the road successfully. You need to be able to balance and stay upright, and steer, manage the controls of the bike, as well as be mindful of movement around you and environmental data – like oncoming traffic, pedestrians potentially walking out onto the road, pot-holes…Managing your focus means being able to hold these different stimuli in balance – rather than being completely side-tracked by the puppy in the garden over there…or over-focused on the cracks in the road-surface.

The neurotypical brain has greater facility to be able to adapt in real time – bringing some things to the fore in your attention for just as long as they need to be taken into consideration, and allowing others to be in more ambient awareness. The ADHD brain, especially the Inattentive type, has a lot more stimulus and chatter – a wider and less filtered sensory field of awareness. It’s different.

And indeed that difference has its difficulties when trying to fit with an educational world structured for the neurotypical brain – but it also has strengths too. Once engaged, and interested, the ADHD brain is capable of extended periods of hyperfocus – so it is not entirely true to say that the attention span is shorter. This isn’t always the case by any means.

Comparative data – boys and girls with ADHD…

• Currently in the US, there are 2 diagnoses of boys or men to every 1 diagnosis for women or girls (down from 3 male diagnoses to every 1 female diagnosis.). Again US data places the gender gap in children at 7.4% more boys than girls being diagnosed, whereas in adult-hood, the gender gap narrows to 2.2%. NHS primary care records show about 2.5% to 3.6% of boys diagnosed versus 0.7% to 0.85% of girls – so the picture is very similar in the UK. More boys than girls are identified, assessed, and diagnosed in childhood. And according to ADHD UK, girls in the UK are likely to be diagnosed much later.
• 2024 US Center for Disease Control & prevention data based on Children aged 3-17 years shows that 48.1% of boys with ADHD have a behavioural or conduct problem, as opposed to 36.3% of girls. Whereas 52.8% girls with ADHD have anxiety as a co-occurring condition in comparison to 31.7% of boys with ADHD. ADHD girls with depression as a co-occuring condition are at 28.6% as opposed to fewer ADHD boys who also have depression – 13.8%.

What this means and why this matters.

• ADHD symptoms are more internalised in girls, less disruptive: their struggles are held for longer and their suffering is more internalised too – with co-occuring mental health issues that compound the situation – like anxiety and depression which create avoidance or withdrawal tendencies that reduce the scope for skill-building and experiential learning.
• Inattentive ADHD traits often get mislabelled as character judgments which has an impact on the a harsh and strident voice of the inner-critic that develops.
• The impact of this is seen in the self-concept of ADHD girls as they go, and women further down the line. There’s more masking, therefore the allostatic load of feeling different, and wrong  but without knowing why is a more pervasive experience. The study by Visser et al in 2024 revealed the psychological and relational costs: loneliness, imposter syndrome, feeling fake.
• Emotion regulation challenges (one type of executive function challenge) are more characteristic of ADHD-ers who are girls than boys.
• Allied to these context for girls and women coming to terms with ADHD, they are more likely to adopt maladaptive strategies than boys. They are less likely to be accepting towards the reality of their diagnosis, less open and welcome to working with their neurodiversity profile, and more likely to try to suppress or avoid emotions, and use over-compensation strategies – eg people pleasing or perfectionism- that lead to burnout.
• As ADHD girls enter adulthood, the societal expectations of gender roles place an additional load of challenge: the expectation for mothers to multitask, take responsibility for the family, to be more orderly, and organised, can lead to feelings of shame and failure to keep up with peers.

• With delayed diagnoses come negative self beliefs that make life harder than it needs to be – character judgments about deficits, needing to try harder, being ‘too much’ or ‘not enough’, ‘too sensitive’ or a failure – and less self-compassion.
• Girls are expected to be more compliant in their gender nurturance – and therefore there can be a greater sense of surprise or negativity towards the differences in the ADHD motivational system which tends to be interest-based than importance based. This means that ADHD girls will have a tendency to need a strong interest in order to complete a task: if the task isn’t important to them, but is important to others, they are less likely to engage – which can be seen as a very negative disengagement. Unlike a neurotypical girl, girls with ADHD are more likely to find it easier to initiate and stay with a task if it’s urgent. And – most frustratingly and bafflingly of all for the adults in their lives, they are not so likely to be motivated by rewards and consequences. This can be mislabelled as defiance…we all have brains that are meaning making machines, so adults can fall into the trap of mind-reading the lack of progress with engaging with the rewards-and-consequences equation and become more punitive or damning in criticising what seems to make no sense.
• Self-compassion interventions are especially important to women and girls who often internalise and suppress frustration and anger and become particularly harsh in their self-talk around setbacks.

ADHD has a gendered element to it – that parents and teachers of girls need to have a mind to so that we can ask the right questions, and create a more productive working alliance. Even in Enid Blyton, it was always the girls who were expected to wash up and deal with the ginger beer bottles. Today, the pressures on girls to conform to unrealistic beauty standards are more intense, more early on…Girls get criticised differently for being messy in their appearance or in their environment…They certainly police each other in their peer groups – for instance if there are lagging skills with personal hygiene around puberty. They can experience less overt but nonetheless sharply felt social consequences.

One can note in perhaps an speculative way that the data shows, for instance, that gender questioning is more prevalent in girls rather than boys – by some way. And that there are numerous studies that have revealed an intersection where there is 3 or 4 times greater likelihood of a young person with ADHD questioning their gender. The way that difference is felt in a young person’s self concept, is always fraught in the period of adolescence where finding your tribe and fitting in can be so important.

The way we approach problem-solving with the messiness of ADHD – on top of the normal growing pains children and teens experience, is important when it comes to girls. Boys are generally culturally allowed to be a bit messier and more chaotic. I’m not wanting to draw invidious comparisons – but whether we are looking at the patterning of how a neurotypical sibling or child experiences the world vs a neurodiverse sibling or young person, it is worth being mindful of the patterning of communications.

Are they deficit based, and corrective more consistently, more often? And how do we go about those corrective conversations in tone, energy, and content…? Whether or not there is a diagnosis of ADHD, it is important to build motivation from momentum, to be affirming in our approach. To create the pulls that will draw young people onward and upward, instead of feeling we have to constantly push, push, push them – that it’s all about us getting them over those milestones rather than them wanting to develop, extend and use the skills that work for them.

How does this resonate with you as a parent? Reading this, what are your key take-aways?

As a teacher, what might you have learned about how you engage with the pupils and their parents where there may be questions about neurodiversity? How you might see that, and how you might broach it with parents and pupils.

Contact me if you might be interested in training, coaching, around ADHD in family life, or in your working or parenting life. I offer bespoke in-depth coaching for parents. I also offer support for small parent groups who have children with ADHD – which has the benefit of helping parents find community, and gain perspective on family dynamics – as well as learn ways to stay connected and strengthen connection through times of struggle.

contact@emmagleadhill.com