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Gender Differences in How Hyperactive-Impulsive ADHD is Expressed 

Posted
Updated
ByMy Patient Advice
Author: Lucia Alvarez, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

ADHD doesn’t always look the same in everyone. The hyperactive-impulsive type can appear very differently depending on gender, shaping how behaviours are understood, managed, and diagnosed. While often linked with noisy, energetic boys, hyperactive-impulsive ADHD is also common in girls and women, just not always in the ways people expect. 

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Understanding Hyperactive-Impulsive ADHD 

Hyperactive-impulsive ADHD is characterised by behaviours such as physical restlessness, difficulty waiting turns, impulsive talking, and fidgeting. It’s one of the three main types of ADHD and is usually the easiest to see 

Read full guide on what hyperactive-impulsive ADHD is . 

How Hyperactive-Impulsive ADHD Differs by Gender 

Clinicians and researchers have long noted that gender can influence how hyperactive-impulsive ADHD is expressed, and how quickly it’s recognised. 

In Boys and Men 

  • More likely to display externalised symptoms: running, shouting, interrupting. 
  • Often seen as disruptive or defiant, especially in school settings. 
  • Diagnosed earlier due to overt behavioural challenges. 

These classic patterns mean that hyperactive-impulsive ADHD is often spotted quickly in boys. 

In Girls and Women 

  • Symptoms may look like excessive talking, emotional swings, or disorganisation. 
  • Often mistaken for anxiety or mood-related issues. 
  • Appear socially engaged but still struggle with boundaries and impulse control. 
  • Less likely to receive an early diagnosis; many are only identified in adulthood. 

Rather than being “missed,” their symptoms are often misinterpreted. To learn more about the signs and symptoms, visit ADHD in women . 

Why These Gender Differences in Hyperactive-Impulsive ADHD Matter 

Misunderstanding how ADHD presents in different genders can lead to years of missed support and unnecessary struggle. Girls and women may blame themselves for challenges rooted in an overlooked condition. 

Understanding that hyperactive-impulsive ADHD doesn’t follow one template is essential for early intervention and effective support. 

Not sure if what you’re experiencing could be ADHD? Take free ADHD self-assessment to begin exploring your symptoms and the next steps. 

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Lucia Alvarez, MSc
Author

Lucia Alvarez is a clinical psychologist with a Master’s in Clinical Psychology and extensive experience providing evidence-based therapy and psychological assessment to children, adolescents, and adults. Skilled in CBT, DBT, and other therapeutic interventions, she has worked in hospital, community, and residential care settings. Her expertise includes grief counseling, anxiety management, and resilience-building, with a strong focus on creating safe, supportive environments to improve mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy. 

Dr. Rebecca Fernandez, MBBS
Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy. 

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