Are Girls More Likely to Be Underdiagnosed with ADHD and Anxiety? 

Underdiagnosis girls with ADHD and anxiety is a persistent problem, with many girls slipping through the cracks of the diagnostic process. While ADHD in boys is often identified early due to visible hyperactivity and impulsivity, girls tend to display more subtle, internalised symptoms such as inattention, daydreaming, or quiet anxiety. This difference in presentation, combined with recognition gaps and diagnostic bias, means that many girls remain undiagnosed or misdiagnosed well into adolescence or adulthood. 

The underdiagnosis is not just a matter of delayed treatment, it can lead to years of unmanaged symptoms, impacting education, mental health, and self-esteem. 

Why Girls Are Often Underdiagnosed 

Several factors contribute to the underdiagnosis girls with ADHD and anxiety experience: 

Subtle Symptom Presentation  

Girls with ADHD are more likely to display inattentive behaviours rather than disruptive ones. This means their struggles in concentration and organisation can be mistaken for shyness, lack of effort, or emotional sensitivity, rather than recognised as ADHD. 

Anxiety Masking ADHD  

Many girls develop coping mechanisms for their ADHD symptoms, but these can create or worsen anxiety. Teachers and parents may notice the anxiety but overlook the underlying ADHD, leading to incomplete or inaccurate diagnoses. 

Diagnostic Bias  

Historically, ADHD criteria were based on studies of boys, leading to a diagnostic framework that prioritises hyperactive and external behaviours. This bias leaves many girls outside the diagnostic radar. 

Social Expectations  

Society often expects girls to be organised, compliant, and socially adept. When they struggle in these areas, the behaviour is more likely to be attributed to personality flaws rather than neurological conditions. 

Conclusion 

Underdiagnosis girls with ADHD and anxiety is driven by recognition gaps and diagnostic bias that fail to account for gender differences in symptom presentation. Increasing awareness among educators, parents, and clinicians is essential for ensuring girls receive timely and accurate diagnoses. 

For more information on recognising ADHD and anxiety in girls, visit ADHD Certify. For further insights into recognition gaps and diagnostic bias, read our complete guide to Anxiety disorders.