Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women
Open accessAbstract
Background: There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. Methods: The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. Results: A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. Conclusions: This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.
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Hormonal fluctuations seem to impact ADHD symptomatology.
“Hormonal fluctuations seem to impact ADHD symptomatology. Available evidence has confirmed this [23,88].”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [23]
The Interventions and Treatments section says women with ADHD may report symptom changes during hormonal transitions, supporting the hedged claim. But it describes the evidence as early or anecdotal, and the Discussion calls for more research; it does not support the citing sentence’s assertion that the effect has been confirmed. Page numbers are unavailable in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThere is a dire need for female-specific treatment options for ADHD expressed by many, including patients.
“We developed this female-specific treatment option in response to the dire need expressed by many [1,17,19,23,24,25,26,28,41,55,85], including patients.”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [23]
The Discussion (page not provided) says treatment approaches need adjustments to better support girls and women with ADHD. The Interventions and Treatments section recommends sex-sensitive management and monitoring, but does not report a dire need for new female-specific treatment options expressed by patients or by many others; it says pharmacological treatments themselves should not differ by sex. (LLM, conf=0.84)
Experimental — accuracy not yet measuredWomen are more often misdiagnosed and diagnosed later than men with ADHD.
“However, women are more often misdiagnosed [23] and diagnosed later [85] than men with ADHD.”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [23]
The Discussion says females with ADHD are more likely to be unrecognised or misidentified, and the Presentation of ADHD in females section says an initial diagnosis of another disorder may delay ADHD diagnosis. The Background says it is unknown how often ADHD is misdiagnosed in females; the cited passages do not establish that women are diagnosed later than men. (LLM, conf=0.82)
Experimental — accuracy not yet measuredA lifespan approach is important for women with ADHD.
“Like others in the field [23], we recognise the importance of a lifespan approach for women with ADHD.”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [23]
Addressing ADHD symptoms can itself mitigate secondary depression.
“addressing ADHD symptoms can itself mitigate secondary depression [141]”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [141]
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Polanczyk, G., Faraone, S., Bau, C. H. D., Victor, M., Becker, K., Pelz, R., Buitelaar, J., Franke, B., Kooij, S., van der Meulen, E. M., et al. (2008) · American Journal of Medical Genetics Part B: Neuropsychiatric Genetics · doi:10.1002/ajmg.b.30855 · Cited by 35 · see citing works
Alcohol and Substance Use History Among ADHD Adults
Huntley, Z., & Young, S. (2012) · Journal of Attention Disorders · doi:10.1177/1087054712446171 · Cited by 35 · see citing works
Self-citationSex-specific trajectories of ADHD symptoms from adolescence to young adulthood
Millenet, S., Laucht, M., Hohm, E., Jennen-Steinmetz, C., Hohmann, S., Schmidt, M. H., Esser, G., Banaschewski, T., Brandeis, D., & Zohsel, K. (2018) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-018-1129-9 · Cited by 35 · see citing works
Edvinsson, D., Lindström, E., Bingefors, K., Lewander, T., & Ekselius, L. (2013) · PubMed · doi:10.1111/j.1601-5215.2012.00682.x · Cited by 33 · see citing works
Mayes, S. D., Calhoun, S. L., Waxmonsky, J. G., Kokotovich, C., Baweja, R. K., Lockridge, R., & Bixler, E. O. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716664409 · Cited by 32 · see citing works
A Randomized Effectiveness Trial of a Behavioral Teacher Program Targeting ADHD Symptoms
Veenman, B., Luman, M., Hoeksma, J. B., Pieterse, K., & Oosterlaan, J. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716658124 · Cited by 31 · see citing works
Children’s ADHD Interventions and Parenting Stress: A Meta-Analysis
Theule, J., Cheung, K., & Aberdeen, K. (2018) · Journal of Child and Family Studies · doi:10.1007/s10826-018-1137-x · Cited by 31 · see citing works
Sternat, T., Fotinos, K., Fine, A., Epstein, I., & Katzman, M. A. (2018) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s170645 · Cited by 31 · see citing works
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Neurodiversity at work: a biopsychosocial model and the impact on working adults
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“Women with ADHD are also at a higher risk of engaging in risky sexual behavior, unplanned pregnancy, and are more likely to be coerced into having sex than women without ADHD (Young et al., 2020).”
BackgroundInfluentialAlcohol use disorders and ADHD.
Luderer, M., Ramos Quiroga, J. A., Faraone, S. V., Zhang-James, Y., & Reif, A. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.07.010 · Cited by 102 · see citing works
Skoglund, C., Sundström Poromaa, I., Leksell, D., Ekholm Selling, K., Cars, T., Giacobini, M., Young, S., & Kopp Kallner, H. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13920 · Cited by 77 · see citing works
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Female-specific pharmacotherapy in ADHD: Premenstrual adjustment of psychostimulant dosage
de Jong, M., Wynchank, D. S. M. R., van Andel, E., Beekman, A. T. F., & Kooij, J. J. S. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1306194 · Cited by 39 · see citing works
Platania, N. M., Starreveld, D. E. J., Wynchank, D., Beekman, A. T. F., & Kooij, S. (2025) · Frontiers in Global Women's Health · doi:10.3389/fgwh.2025.1549028 · Cited by 27 · see citing works
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“Emotional dysregulation and internalizing burden often require integrated management of ADHD and mood/anxiety symptoms [125], and addressing ADHD symptoms can itself mitigate secondary depression [141].”
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Moldekleiv, C. D., Lundervold, A. J., Solberg, B. S., Engeland, A., Fadnes, L. T., Chalabianloo, F., & Klungsøyr, K. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07305-1 · Cited by 8 · see citing works
Cognitive Profiling of Children and Adolescents with ADHD Using the WISC-IV
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Hare, C., Leslie, A. C., Bodell, L. P., Kaufman, E. A., Morton, J. B., Nicolson, R., Kelley, E., Jones, J., Ayub, M., Crosbie, J., et al. (2024) · British Journal of Clinical Psychology · doi:10.1111/bjc.12485 · Cited by 5 · see citing works
Sweiss, E. C., Vargas, V., Sandman, C., Poggi Davis, E., Hankin, B. L., & Glynn, L. M. (2026) · Journal of Developmental Origins of Health and Disease · doi:10.1017/s2040174426100622
- Authors
- Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., Gudjonsson, G., Hill, P., Hollingdale, J., Kilic, O., Lloyd, T., Mason, P., Paliokosta, E., Perecherla, S., Sedgwick, J., Skirrow, C., Tierney, K., van Rensburg, K., & Woodhouse, E.
- Affiliations
- Reykjavík University (IS)
- King's College London (GB)
- Manor Hospital (GB)
- South London and Maudsley NHS Foundation Trust (GB)
- The Tavistock and Portman NHS Foundation Trust (GB)
- St Thomas' Hospital (GB)
- University of Bristol (GB)
- Corresponding author
- Young, Susan
- ORCID
- Venue
- BMC Psychiatry
- Published
- 2020-08-12
- Volume
- 20
- Issue
- 1
- Pages
- 404-404
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC7422602
- OpenAlex
- W3048800205
- Cited by
- 610
- References
- 216
- Citations by year
- 2026: 207 · 2025: 130 · 2024: 96 · 2023: 96 · 2022: 48 · 2021: 29 · 2020: 2 · 2019: 1 · 2018: 1
- FWCI
- 31.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Collections portal (Koç University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Opin vísindi (Opin vísindi) (submittedVersion, cc-by)
- Bristol Research (University of Bristol) (submittedVersion, cc-by)
- Funders
- UK ADHD Partnership (N/A)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- sex differences in ADHD, referral bias, presenting symptoms, comorbidities, compensatory strategies, gender bias, lifespan care, ADHD medication, psychological intervention, care transitions
- MeSH terms
- Attention, Attention Deficit Disorder with Hyperactivity, Female, United Kingdom, Humans, Longevity, Male, Consensus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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