The disruptive boy stereotype

When I tell you to picture a person with ADHD, what comes to mind? You probably thought of a boy at primary school age, unable to sit still in his chair. This stereotype is very common but harmful when girls and women with ADHD are entirely disregarded because of it. In fact, the proportions are shocking: boys in the UK are three times more likely to receive a clinical diagnosis compared to girls[1]. But where does this imbalance come from?

ADHD (attention-deficit hyperactivity disorder) is a condition that expresses itself in a person through inattention and hyperactivity. Some symptoms include the inability to focus on everyday tasks and remember things, act impulsively, or appear fidgety[2]. The condition lies on a spectrum, where some people only struggle with inattentiveness or hyperactivity, others with a mixture of both[3].

Since hyperactivity is usually visible to people on the outside, patients who lie on this side of the spectrum tend to be diagnosed more and hence receive appropriate treatment. Research has shown that especially young boys with ADHD exhibit hyperactivity. Girls on the other hand tend to suffer from inattention and less overt hyperactivity at a similar age and hence get diagnosed less. Early detection of the condition is crucial to help those affected manage their symptoms[4].

If support is offered from early on, it is possible that the likelihood of other illnesses developing as a consequence of untreated ADHD can be reduced. Unfortunately, it is common that patients only go to the doctor once these other conditions have developed and even then, there are differences between males and females. Boys tend to acquire externalised disorders that manifest themselves in antisocial behaviour such as fights. Girls however are more prone to developing internalised disorders like anxiety or depression. This means that other adverse illnesses, which may appear due to untreated ADHD, are less likely to be recognised by outsiders in girls and women, exacerbating the problem[5].

Gender bias also plays a big part in the underdiagnosis of ADHD in girls. Social norms cause girls to mask their symptoms to appear more compliant with society’s expectations. The result can be that girls use maladaptive coping mechanisms like disordered eating or self-harm to deal with their problems[6].

For this reason, experts emphasise the importance of dismantling the stigma surrounding ADHD, so that more people become aware that the condition isn’t one-size-fits-all. Especially healthcare professionals, educators and parents need to understand what symptoms to look out for in girls and young women (e. g. easily distracted and overwhelmed, disorganised, frequent daydreaming, etc.) to help them manage their impairments. An early diagnosis also means that girls will have access to the same medication their male counterparts do, which has been proven to enhance performance at school for example[7]. Getting rid of the disruptive boy stereotype associated with ADHD will improve not only the health of many girls and women, but most importantly their quality of life by making a diagnosis more accessible.

Edited by Liam Butler
Copyedited by Claire Thomson

[1] https://psychiatry-uk.com/adhd-in-girls-and-women/

[2] https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/

[3] https://www.bbc.com/future/article/20190530-why-is-adhd-missed-in-girls

[4] https://www.medicalnewstoday.com/articles/315009#symptoms

[5] https://www.healthline.com/health/adhd/adhd-in-girls?c=494103926349#Signs-and-symptoms-of-ADHD-in-girls

[6] https://www.healthline.com/health/adhd/adhd-in-girls#Can-ADHD-lead-to-other-conditions?

[7] https://www.medicalnewstoday.com/articles/315009#conditions-with-similar-symptoms