ADHD and Autism in Women The Hidden Epidemic: Why Millions of Women Are Finally Getting ADHD and Autism Diagnoses in Adulthood
In a quiet revolution sweeping through healthcare and social media alike, millions of women are discovering they’re neurodivergent—often decades after first struggling with symptoms that were dismissed, misunderstood, or misdiagnosed. From TikTok videos that spark recognition to late-night Google searches that finally provide answers, women in their 30s, 40s, and beyond are receiving autism and ADHD diagnoses that explain lifelong challenges they never understood.
The statistics are staggering: nearly 80% of autistic females are undiagnosed as of age 18, while nearly 80% of women with autism are misdiagnosed – often with conditions such as borderline personality disorder, eating disorders, bipolar disorder and anxiety. Meanwhile, it’s estimated that 16.13 million adults have ADHD in the US, with many women receiving their first diagnosis in their late 30s to early 40s.
This isn’t just a medical phenomenon—it’s a social awakening that’s reshaping our understanding of neurodiversity, gender bias in healthcare, and the profound impact of late diagnosis on women’s lives, careers, and mental health.
The Great Misunderstanding: Why Women Were Overlooked
For decades, autism and ADHD research focused almost exclusively on boys and men, creating diagnostic criteria that failed to recognize how these conditions manifest in females. The first is that autism and ADHD symptoms are different in women than they are in men, yet the medical establishment was slow to acknowledge this fundamental difference.
The Male-Centric Foundation of Diagnosis
Most autism research relied on male participants and examples, so what is known about autism is largely based on autism in males. As a result, boys are referred for autism diagnosis 10 times more than girls. Similarly, ADHD is traditionally thought of as a little boy’s disorder, and doctors are less likely to pick up on inattentive-type symptoms that don’t overtly disrupt a classroom or home.
This male-centric approach created a cascade of missed diagnoses. The autism assessment tools detect and measure known ASD traits — established on a male baseline. Identifying autism in females is harder if their traits don’t match what’s traditionally considered ASD.
The Art of Masking: How Women Hide Their Struggles
One of the most significant factors contributing to late diagnosis is the phenomenon of “masking”—the learned behavior of hiding neurodivergent traits to fit in socially. From a young age, societal expectations encourage girls to be socially adept, leading many neurodivergent girls to develop sophisticated camouflaging techniques.
Young females typically are more motivated than males to fit in and be social. Females with autism learn or mimic socially acceptable behavior by watching television shows, movies and the people around them. They may copy the facial expressions of others to hide social communication challenges.
This masking comes at a tremendous cost. The internal stress and cognitive load of maintaining these masks can manifest as anxiety, depression, eating disorders, and chronic fatigue. All of these may lead to misdiagnosis with conditions like anxiety disorders, depression, low self-esteem, or even borderline personality disorder.
The Different Faces of Neurodivergence in Women
Understanding why women were overlooked requires recognizing how autism and ADHD present differently across genders.
Autism in Women: The Internalized Experience
In women, autism often presents with a more internalized profile compared to men. While diagnostic criteria often highlight externalizing behaviors, autistic women may exhibit:
- Special interests that appear socially acceptable: intense, specific interests that align with societal norms, such as a deep focus on literature, animals, or social justice issues
- Social anxiety beneath social competence: experiencing anxiety in social situations, even if they possess strong surface-level social skills learned through observation
- Internalized sensory sensitivities: Sensory sensitivities, a core feature of autism, can also be internalized, leading to significant inner distress from seemingly mild stimuli that others barely notice
In comparison to males, young females may have different autism traits. And those signs aren’t always far enough outside socially acceptable norms to be noticeable. Research shows that autistic females may have better social and communication abilities in childhood. But once they reach adolescence and adulthood, they exhibit more severe social and communication difficulties than males.
ADHD in Women: The Inattentive Reality
ADHD in women also frequently takes on a more internalized presentation, often characterized by inattentive symptoms rather than the more outwardly visible hyperactivity. Women with ADHD often struggle with:
- Organization and time management challenges: difficulties with organization, time management, and maintaining focus, leading to a sense of underachievement or feeling overwhelmed by daily tasks
- Internal hyperactivity: While boys might display obvious hyperactivity, girls often experience this as racing thoughts or internal restlessness
- Academic underperformance despite intelligence: Many receive feedback like “she’s bright, she just needs to apply herself”
For girls with ADHD, they often aren’t as hyperactive and may not have the disruptive behaviour some boys may have, making their struggles less visible to teachers and parents.
The Revolutionary Concept of AuDHD
One of the most significant developments in understanding neurodivergence is the recognition that autism and ADHD frequently co-occur, particularly in women. This combination, often called “AuDHD,” represents a complex interplay of traits that can seem contradictory.
The Paradox of Dual Diagnosis
It’s not surprising that people used to think Autism and ADHD couldn’t occur together, because a lot of the traits appear to contradict each other. ADHD likes NEW, Autism likes the SAME. ADHD is IMPULSIVE and spontaneous, Autism likes PLANNING.
Imagine how disorienting it is to have your brain constantly pulled in two opposite directions. This can feel like a tug of war in an AuDHD-er’s mind, and it can feel impossible trying to balance two completely opposing needs.
The Masking Effect of Dual Conditions
Residuality generates conflicting feelings about autism, ADHD, and the self, resulting in fragmented identities shaped more by societal narratives than by interpersonal perceptions. As one participant described: “Daily life is like a constant battle between my single-track mind and the myriad of jumbled thoughts in my brain. I can be so frustrated with myself, for example, when I lose my earbuds for the Nth time (ADHD) but I need them to regulate (autism). . . A lot of the time I feel like a contradiction within myself”.
The two can mask each other, either compensating for each other’s difficulties or making those challenges even harder. For example, the organisation and focus from the autistic brain may compensate for the disorganisation and chaos of the ADHD brain. Or, the mess and chaos from the ADHD may leave the person in a constant state of overwhelm.
Remarkably, autism and ADHD could not be diagnosed together until 2013. The fourth edition of Diagnostic and Statistical Manual listed autism as an exclusion criterion for ADHD, meaning countless individuals were denied accurate diagnosis for years.
The Rise of Adult Diagnosis: Breaking Through Barriers
Over the last decade or so, there’s been an uptick in the number of adults being diagnosed with autism and ADHD. Any number of factors might explain this rise, including greater public awareness of both conditions, broader diagnostic criteria and changing perceptions in who autism and ADHD affects.
The Role of Social Media and Self-Advocacy
Social media may also be playing a role, with women able to use platforms such as Twitter and TikTok to spark discussions and share their experiences and stories. These platforms have become unexpected catalysts for self-recognition, with women sharing their experiences and realizing they’re not alone in their struggles.
One constant in the experiences that many women have shared on social media is how long they waited for a diagnosis. Many have even spoken about how they were even brushed off by healthcare professionals when seeking a diagnosis, told pointblank that they’re “not autistic” or that their problem is “anxiety and not ADHD”.
The Challenge of Getting Diagnosed as an Adult
The older an autistic woman gets without a formal diagnosis, the more likely clinicians are to be skeptical when she seeks an autism evaluation. These women often hear, as I once did, that they seem “too normal” or have had too much success to be autistic.
These sentiments are borne out of misinformation, which can affect the most qualified psychologists and scientists when it comes to women on the spectrum. The irony is profound: women who successfully masked their symptoms to survive in a neurotypical world are then told they can’t be neurodivergent because they’ve been “too successful.”
The Profound Impact of Late Diagnosis
The consequences of delayed diagnosis extend far beyond missing support services—they fundamentally shape a woman’s sense of self and her life trajectory.
The Emotional Toll of Living Undiagnosed
Without a diagnosis, women with ADHD often report spending their lives feeling “different,” “stupid,” or “lazy” and blaming themselves for their underachievement. For many, not knowing why they felt different from others left them feeling confused and even depressed.
Many women experience diagnosis as a lightbulb moment, giving an external explanation for their struggles and allowing them to accept themselves more fully. Consequently, receiving a diagnosis of ADHD can be instrumental for a woman’s self-esteem and identity.
Career and Professional Impacts
~14.1 million American adults with ADHD (87%) will experience career struggles in 2025. The workplace implications are particularly significant for women who spent decades developing elaborate coping strategies.
Like many undiagnosed women, Erin grew up feeling different. She did not seem to fit in, and couldn’t understand societal rules that everyone else just naturally knew. It puzzled Erin’s teachers when she struggled with her schoolwork, and she regularly received the same criticism: “Erin is bright, she just needs to apply herself”.
This pattern of being seen as having potential but not “applying oneself” follows many neurodivergent women throughout their careers, leading to chronic underperformance anxiety and imposter syndrome.
Academic and Educational Consequences
When not properly diagnosed and treated in childhood, girls with autism or ADHD may experience poor academic performance, behavioural problems and trouble making friends. As they get older, this could make it more difficult for them to cope with professional demands in the workplace.
The ripple effects are profound: It may also lead to anxiety and stress because they feel misunderstood or confused about why they find certain experiences so difficult, alongside other mental health problems such as depression and eating disorders.
The Scale of the Crisis: Understanding the Numbers
The scope of undiagnosed neurodivergence in women represents a genuine public health crisis. Current estimates suggest that the conditions coexist at rates between 20% and 37% for autism and ADHD co-occurrence.
Gender Disparities in Diagnosis
For every woman diagnosed with autism spectrum condition (ASC), roughly 3 to 6 men are diagnosed. Meanwhile, it is also estimated that the most common age for women to be diagnosed with ADHD is late 30s to early 40s, compared to aged 7 for boys.
These disparities represent not just individual tragedies but systemic failures in healthcare recognition and support.
The Growing Recognition
Adults under 50 are far more likely to have an ADHD diagnosis (84.5%) than those over 50 (51.2%), suggesting that increased awareness is gradually closing the gap, though many older women remain undiagnosed.
In 2025, it’s estimated that 404 million adults have ADHD globally, representing a significant increase in recognition and diagnosis.
Breaking the Cycle: The Path Forward
Improving Diagnostic Practices
The medical community is slowly recognizing the need for gender-informed diagnostic criteria. I spent 2024 educating providers on the unique ways that ADHD and autism can manifest in women, including during menopause, and how women’s symptoms and most effective treatments can differ from those seen in men.
Addressing Workplace Needs
By 2025, I expect more adults to seek holistic treatments alongside medication. This multi-pronged approach, combining medication with strategies like coaching, can help people build the skills they need to succeed beyond just symptom management.
The Importance of Self-Advocacy
In one study of women who weren’t diagnosed with ADHD or autism until adulthood, many participants reported feeling like they were “wrong” and didn’t fit in anywhere. Others even went as far as trying to change their clothes or personality to better fit in. But after diagnosis, participants felt they better understood why they might feel the way they do and felt a greater sense of personal value after receiving their diagnosis.
The Revolutionary Impact of Recognition
The late diagnosis movement represents more than individual healing—it’s fundamentally changing how we understand neurodiversity, gender, and human variation.
Redefining Success and Normalcy
Women who receive late diagnoses often experience a profound shift in self-perception. Instead of viewing themselves as fundamentally flawed, they begin to understand their brains as different, not defective. This reframe can be life-changing.
The Ripple Effect on Families
Many women who receive adult diagnoses recognize similar traits in their children or other family members, leading to earlier identification and support for the next generation.
Advancing Research and Understanding
As the first study to explore the lived experiences of adults diagnosed with both autism and ADHD, it makes an original contribution by developing an AuDHD phenomenology and analytical framework. Women’s voices are finally being centered in research, leading to more accurate and inclusive understanding of neurodivergence.
Looking Ahead: The Future of Neurodivergent Women’s Health
The recognition of widespread underdiagnosis in women represents both a crisis and an opportunity. As awareness grows and diagnostic practices improve, millions more women will finally receive the answers and support they’ve long deserved.
Treatment and Support Evolution
~5.68 million US adults will combine behavioral treatment with medication in 2025, representing a more holistic approach to neurodivergent support that extends beyond medication alone.
Workplace Transformation
As more women receive diagnoses, workplaces will need to adapt, creating more inclusive environments that recognize and accommodate neurodivergent thinking styles and needs.
Cultural Shift
The neurodiversity movement, powered largely by women’s voices and experiences, is challenging fundamental assumptions about normalcy, productivity, and human value.
Conclusion: ADHD and Autism in Women From Invisibility to Empowerment
The story of late-diagnosed neurodivergent women is ultimately one of resilience and recognition. For too long, these women have carried the burden of feeling different, broken, or inadequate. Now, armed with understanding and community, they’re rewriting the narrative.
ADHD is a manageable condition; early detection and treatment can dramatically change the outcomes for children with ADHD as they continue into adulthood. While many women missed the opportunity for early intervention, adult diagnosis still offers profound benefits: validation, appropriate treatment, workplace accommodations, and most importantly, self-acceptance.
The revolution is far from over. As diagnostic practices continue to evolve and awareness grows, we can expect to see continued increases in adult diagnoses. This isn’t just a medical trend—it’s a societal awakening to the reality that neurodivergence is far more common than previously understood, and that women’s experiences have been systematically overlooked for far too long.
For the millions of women still wondering if their lifelong struggles have a name, the message is clear: your experiences are valid, your struggles are real, and answers are finally within reach. The hidden epidemic is hidden no more, and with recognition comes the possibility of understanding, support, and ultimately, healing.
Medical Disclaimer
This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. ADHD and autism are complex conditions that require proper evaluation by qualified healthcare professionals. Individual experiences vary, and self-diagnosis is not recommended. Always consult a licensed provider before making decisions about your health, treatment, or medications. If you are in crisis, seek immediate help from emergency services or a mental health hotline.