More than half of adults with ADHD prefer to keep their diagnosis to themselves, according to a recent Understood.org survey of 2,100 adults conducted online by The Harris Poll. However, an even more concerning pattern emerges when we break down the results by gender: 66% of young women (ages 18–34) prefer to stay silent compared to 42% of young men with ADHD.
Why Women with ADHD Don’t Disclose Their Diagnosis
In part, the survey results suggest that women with ADHD are perceived differently than are men with ADHD — a finding that more than half of survey respondents (three-quarters of whom were women) agree to be true.
We know that self-stigma is a key barrier to seeking professional support. (Footnote 1) While the survey’s findings relate to ADHD specifically, they speak to a larger societal phenomenon: Individuals internalize public stigma, e.g., stereotypes, prejudice, and discriminatory attitudes endorsed by the public. We see examples of internalized public sigma across women’s mental and general health, including their ADHD diagnosis.
Although men and women are just as likely to have learning and thinking differences, girls with ADHD are diagnosed as often as boys. (Footnote 2) Many women receive their ADHD diagnoses in their 30s, 40s, and beyond. When a woman is diagnosed with ADHD later in life, she’s likely spent decades struggling without understanding why. A late-in-life diagnosis may be the route of frustration, self-doubt, and anxiety.
Researchers have primarily based assessment tools on studies of boys and they do not norm for female populations. Gender bias built into testing instruments is one of the biggest reasons women and girls with ADHD may go undiagnosed, something 87% of survey respondents acknowledged, the survey revealed.
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Women diagnosed with ADHD later in life often express how they made efforts and investments to get answers, but providers routinely dismissed their concerns as “hormones,” “mom brain,” or “lack of self-care.” Many received diagnoses of depression or anxiety instead of ADHD.
They finally got an accurate diagnosis after enduring years of unsuccessful treatments — along with blame for non-compliance. The experience of having their providers meet their initial concerns with disbelief, in a sense, trained women not to disclose.
Many women develop the core belief that “there’s something wrong with me.” And this doesn’t change overnight. Often, women need time, support, and community to learn how to voice their newly learned diagnosis in a way that feels right to them.
Choosing not to disclose an ADHD diagnosis is a logical response to stigma, bias, and backlash. Half of the adults surveyed believe that the negative stigma surrounding neurodiversity is stronger now than ever before. Among respondents with learning and thinking differences, 59% worry that disclosing their diagnosis would negatively impact their careers. Nearly 1 in 4 respondents who requested workplace accommodations said they lost their jobs or got demoted after asking. In that kind of workplace culture, it’s no surprise that people stay silent.
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How to Create an Inclusive Culture
The culture that too often makes silence the best option for women must shift. The solution to silence is not as simple as telling women to “speak up” at work. We need to create a culture that places women’s voices and needs at the core. We need to raise awareness and challenge the stigma around neurodivergence (particularly ADHD and dyslexia) for women. We need better resources, awareness, and action, to start the shift toward progress.
Here are a few steps individuals, providers, and employers can take to create a more inclusive culture:
Learn: Patients, employers, and providers need to let go of old assumptions and dial up their curiosity because the information about ADHD has historically been based on homogeneous, primarily male experiences. Even among the most knowledgeable, there’s still much to learn and unlearn.
Embrace the gray: Disclosure isn’t “on” or “off.” You don’t need to share your diagnosis with everyone. You get to choose who, when, and how much you share.
Listen: Often people don’t speak up because when they do, they aren’t heard or understood. For providers, this means actively listening to clients and patients. Employers need to actively listen to employees and take their concerns and requests seriously. Individuals need to listen to their inner voice without judgment.
Inclusive Culture: Next Steps
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1 Lannin, D.G., Bible, J. (2022). Self-Stigma of Seeking Help: A Meta-Analysis. The Cambridge Handbook of Stigma and Mental Health. Cambridge Handbooks in Psychology. Cambridge University Press; 111-142.
2 Young, S., Adamo, N., Ásgeirsdóttir, B.B. et al. (2020). 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. BMC Psychiatry. 20, 404. https://doi.org/0.1186/s12888-020-02707-9
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