Are Boys More Likely to Be Misdiagnosed with ADHD Than Girls? 

Yes, the boys’ ADHD misdiagnosis rate tends to be higher than that of girls, largely due to observable gender differences in how ADHD presents and how those behaviours are perceived by adults. Boys are more frequently referred for ADHD assessments, often because their symptoms, like hyperactivity and impulsivity, are more outwardly disruptive. However, not all these referrals reflect genuine cases of ADHD, raising concerns about diagnostic bias. 

Teachers and parents may be more likely to interpret active or defiant behaviour in boys as pathological, even when it falls within the range of normal development. This can lead to boys being over-represented in ADHD statistics, while girls who may show more subtle signs, like inattentiveness or daydreaming, are underdiagnosed or overlooked entirely. 

Why Boys Are More Frequently Misdiagnosed 

External vs Internal Symptoms  

Boys are more likely to exhibit externalising behaviours (e.g. fidgeting, shouting out, physical restlessness), which draw attention in classroom settings. Girls, on the other hand, often display internal symptoms like quiet inattention or social withdrawal, which are less likely to prompt referrals. 

Behavioural Expectations  

There’s a cultural tendency to view active boys as “troublemakers” and quiet girls as “well-behaved.” This can lead to diagnostic bias, where boys are referred to often, and girls not enough. 

Broad Diagnostic Criteria  

When ADHD is diagnosed without considering gendered behavioural norms, boys may meet the threshold for diagnosis more easily, even if their challenges are situational or developmentally typical. A more balanced approach, one that accounts for gender differences and context, is essential for accurate diagnosis.

For a deeper dive into ADHD diagnosis and treatment, read our complete guide to Mislabelling Behavioral Issues as ADHD.