Is the DSM-5 Biased Toward Detecting ADHD in Boys More Than Girls? 

The DSM-5 ADHD gender bias has been a topic of much discussion in the field of psychiatry. The diagnostic criteria bias in the DSM-5 can make it harder for girls to be diagnosed with ADHD. This is because the criteria were largely developed based on how ADHD presents in boys, leading to a male-focused criteria that doesn’t fully account for the ways ADHD symptoms manifest in girls. As a result, many girls with ADHD go undiagnosed or are diagnosed later in life. 

Why Is ADHD Diagnosed More in Boys Than Girls? 

Several factors contribute to the DSM-5 ADHD gender bias: 

Male-focused diagnostic criteria 

The DSM-5 criteria for ADHD have traditionally been based on studies of boys, who tend to exhibit the more noticeable symptoms of hyperactivity and impulsivity. These more overt behaviours are easier to recognise and diagnose. In contrast, girls often present with inattentive symptoms, such as daydreaming, forgetfulness, and difficulty focusing, which are less disruptive and harder to identify, leading to missed or delayed diagnoses. 

Gendered symptom presentation

 Girls with ADHD are more likely to display symptoms like emotional dysregulation and internalised behaviours, which may be misattributed to other issues such as anxiety or depression. This creates a diagnostic criteria bias that causes ADHD in girls to be overlooked or confused with other conditions. 

Social expectations

There is a societal expectation for girls to be well-behaved, organised, and focused. These expectations lead to masking of ADHD symptoms in girls, making their struggles less visible. Because their symptoms are often less disruptive, they may not be recognised as ADHD and are instead attributed to personality flaws or other disorders. 

The Consequences of Diagnostic Bias 

The male-focused criteria in the DSM-5 can have significant consequences for girls with ADHD. A delayed diagnosis means that girls may struggle with ADHD symptoms for years without proper support. This can lead to emotional distress, low self-esteem, academic challenges, and co-occurring mental health conditions like anxiety or depression. 

Recognising the DSM-5 ADHD gender bias is key to improving diagnosis and treatment for girls with ADHD. By better understanding how ADHD presents in both boys and girls, clinicians can provide more accurate and timely diagnoses. 

Visit providers like ADHD Certify for personal consultations and guidance tailored to the unique symptoms of ADHD in girls. 

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Late diagnosis and gender differences.