Are females underdiagnosed due to different genetic expression of ADHD? 

Yes, research increasingly shows that ADHD underdiagnosis in females stems partly from differences in genetic expression and behavioural presentation. While males often display more visible hyperactive symptoms, females tend to internalise theirs, appearing inattentive or anxious rather than disruptive. This difference, combined with diagnostic models historically based on male traits, contributes to diagnostic bias that delays or overlooks ADHD in girls and women. 

How genetic expression and gender influence ADHD visibility 

A closer look at why ADHD in females is often missed. 

Gene expression varies by sex 

Emerging studies reveal that gene expression sex differences may impact how ADHD-related genes activate in females. This can alter symptom severity or shift presentation toward subtle traits like low self-esteem, disorganisation, or emotional dysregulation. 

Female presentation is less disruptive 

Girls with ADHD frequently present as daydreamy or withdrawn traits that fly under the radar compared to externalising behaviours. This female presentation mismatch with standard diagnostic criteria contributes to underrecognition in clinical settings. 

Cultural expectations reinforce diagnostic gaps 

Societal norms often expect girls to be compliant and attentive, causing parents, teachers, and clinicians to overlook or misinterpret ADHD signs in young females, even when the condition is genetically present. 

Addressing ADHD underdiagnosis in females requires refining diagnostic frameworks and increasing awareness of how genetic and social dynamics intersect. Visit providers like ADHD Certify for comprehensive evaluations that consider gender-specific ADHD pathways. 

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Genetic Factors in ADHD.