ADHD has long been missed in girls because research, diagnosis and treatment were built around boys—leaving generations of girls to mask their symptoms, be misdiagnosed and wait years to be seen.

A teenage girl watches a 30-second TikTok video by @Clairebear describing “a day in hell” in her life, “ADD edition”:

“I get up and go to work and realize I don’t have gas in my car. I get to the gas station and reach for my credit card and remember that I don’t in fact have my card because I keep thinking it will turn up at some point.”

She continues explaining her day and reveals that these are all symptoms and signs of attention deficit hyperactivity disorder (ADHD).

The teenage girl in question sees much of herself in that scenario, goes to the doctor and is evaluated and diagnosed.

Welcome to modern medicine.

Is this a new era marked by the democratization of information, or a morass of social media-fueled misinformation?

Critics are rightly raising the alarm to the potential for a wave of overdiagnosis and self-diagnosis trends. But when it comes to ADHD, the real story here isn’t that TikTok is prompting girls to invent symptoms; it’s that our healthcare system is finally catching up to a crisis that has long existed.

… Finally they have the language and support to identify the disorder that was always there.

For too many girls and women, our healthcare system has missed ADHD diagnoses for entirely gendered reasons—namely that they don’t present the same symptoms as boys. This lack of awareness of ADHD symptoms in girls stems from the lack of scientific research about girls specifically.

Of the 70 studies on ADHD in the Journal of Abnormal Child Psychology, 81 percent of the participants were male; only 19 percent were female.

Population studies estimate a roughly three-to-one ratio of boys to girls with ADHD.

But in clinical settings, where diagnoses actually happen, that ratio climbs as high as nine-to-one.

The disorder isn’t rarer in girls—it’s rarer for girls to be recognized.

The past year, however, has marked a turning point. Over the past 12 months, out of all recorded children with ADHD, the percentage of girls being treated is 47 percent while the percentage of boys being treated is 43 percent.

A study published in April about ADHD cases post-pandemic shared that the largest immediate incident increases of ADHD cases were found in high-school-aged girls, not boys.

This is a reversal of a century-long pattern. So if an abundance of females have ADHD and are being diagnosed, in some countries more than males, why have the data trends for centuries shown males have more cases of ADHD?

… The real story here isn’t that TikTok is prompting girls to invent symptoms; it’s that our healthcare system is finally catching up to a crisis that has long existed.

ADHD in girls and boys looks very different. The most commonly known ADHD symptoms—hyperactivity, fidgeting, inability to sit still—show up more frequently in boys, while girls’ symptoms tend to present as daydreaming, inattentiveness, emotional dysregulation and internalized anxiety. These differences in symptoms affect doctors’ and society’s ability to recognize the disorder in girls at all. Research on ADHD has been built almost entirely on a male model and those symptoms are highly visible. When doctors and parents consider testing girls, they measure them against the stereotypical “boy” presentation, often without realizing ADHD can look entirely different in girls.

The gender bias not only affects how girls are being tested, but also the kind of treatment they receive. In a nationwide survey comparing how frequently girls in the United States are treated with antidepressants before receiving ADHD treatment versus boys, 14 percent of girls fit the profile while only 5 percent of boys did. Because girls’ symptoms are more “mellow,” and more internalized, they often get mistaken for depression or anxiety first before being correctly identified as ADHD.

Even the hyperactive piece of ADHD, the behavior that doctors are most commonly trained to recognize, often gets missed in girls. Instead of being flagged for evaluation, they’re written off as rowdy or out of control.

While symptoms in girls are already hard to find and notice, societal pressure amplifies that difficulty. Our culture has socialized girls to hide their emotions, to stay attentive at all times, to never falter. ADHD symptoms and executive-function struggles often don’t fit that mold.

These impossible expectations push girls to hide their symptoms, so they mask those behaviors rather than stand out. Girls are more likely to internalize their ADHD symptoms than boys, according to research published in the National Library of Medicine. Partly, this is because society holds girls to such a high standard that when they don’t meet it, we assume something is wrong with them and not with how the system sees them. And when girls do share their symptoms or feelings, they are often dismissed as moody or overdramatic rather than being a candidate for ADHD evaluation. Masking and dismissing the symptoms doesn’t make the ADHD disappear, it just delays the diagnosis.

When a young girl is compelled to resort to TikTok instead of our healthcare system, we have failed her. Research and awareness surrounding disorders as common as ADHD must require studying both males and females equally. We need gender-responsive ADHD training programs to educate our parents and teachers on how to properly recognize symptoms as they present in girls, preventing suffering with a late diagnosis.

This isn’t simply a TikTok trend, and this isn’t an instance of overdiagnosis. This is overdue diagnosis, decades in the making and only now catching up to the girls it always should have seen. More girls are being diagnosed this year than ever before, and it is at least in part thanks to social media that finally they have the language and support to identify the disorder that was always there.

The blind eye on women’s healthcare spans well beyond ADHD. From heart disease to autoimmune disorders to chronic pain, women have long been understudied, misdiagnosed and invalidated. Women’s healthcare is constantly being overlooked and it is finally time for them to be seen.

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