MISSED, MASKED, MISUNDERSTOOD
ADHD in Women and Folks Assigned Female at Birth
Often missed, masked, or misdiagnosed, ADHD in women and folks assigned female at birth (AFAB) deserves a closer look, especially through hormonal transitions like postpartum and perimenopause.
UNDERSTANDING ADHD
ADHD in women and AFAB folks
ADHD in women and AFAB folks, thankfully, is something that is beginning to be talked about with new awareness, although unfortunately, many health care providers remain unaware and underinformed about the distinct differences in identifying ADHD and AFAB folks as well as the impact of hormonal fluctuations during menstruation, pregnancy, postpartum, and menopause that can impact greater symptom severity and overall mental health in AFAB folks with ADHD.
Studies as recently as 2025 suggest that women and AFAB folks are not only identified or diagnosed later but their symptoms are often more severe. Particularly, women and AFAB folks tend to struggle less with hyperactivity that is physically apparent as is often the case in young boys - but live with significant internal hyperactivity (e.g. racing thoughts, restlessness). Additionally, women and AFAB folks tend to experience significantly higher rates of anxiety and depression.
Adult women with ADHD also experience a significantly higher prevalence of severe perimenopausal symptoms than peers without ADHD. Additionally, major hormonal transitions such as perimenopause and menopause occur a full ten years earlier (35-39) compared to those without ADHD (45-49).
Sometimes adult women and AFAB folks present to counseling reporting that their brain’s functioning and overall capacity suddenly feels very different postpartum or in their mid 30’s when major hormonal shifts begin to emerge. This can be incredibly jarring and unsettling. Amethyst Holistic Counseling was established with women and AFAB ADHD’ers in mind. Please reach out for a complimentary consultation, and let’s explore how we can collaborate to help you feel more informed and equipped with knowledge that supports your understanding of yourself and where you are in life.
Sources:
Amoretti, S., & Collaborative Group. (2025). Sex differences in adults with attention-deficit/hyperactivity disorder: A population-based study. European Psychiatry, 70(1), Article e24. doi.org
Halldorsdottir, T., Sigurdardottir, S., & Valdimarsdottir, U. A. (2025). Perimenopausal symptoms in women with and without ADHD: A population-based cohort study. European Psychiatry, 68(1), 13–21. doi.org
Young, S., Buitelaar, J. K., & Eunethydis Special Interest Group on Female ADHD. (2025). Research advances and future directions in female ADHD. Frontiers in Global Women's Health, 6, Article 161362. doi.org
FAQ
Frequently Asked Questions
-
At Amethyst Holistic Counseling, I (Lea), I am passionate about talking with AFAB folks who have curiosity about ADHD as a diagnostic profile that seems fitting. Unfortunately, many common ADHD screening tools do a great job at capturing traditionally more “male” symptoms of ADHD (physical hyperactivity, difficulty with impulse control) but are less adept at capturing features of ADHD that often impact women and AFAB folks. Girls and women are often socialized to “mask” (a term used in neurodivergent spaces to describe the experience of covering, hiding, or even blunting certain features of neurodivergence) often inadvertently. Girls and women are often taught to be polite, amicable, accommodating, and just plain old pleasant. For this reason, many girls, women, and AFAB folks do live with ADHD that greatly impacts their internal world, functioning, and mental landscape but have often been overlooked by teachers and healthcare providers.
-
Yes, being able to advocate for yourself is so important. At Amethyst Holistic Counseling, I (Lea), really enjoy empowering folks with education and language that accurately reflects the areas you’d like greater support in. With your written consent, I am also happy to collaborate with your providers in an effort to provide the most holistic, comprehensive care possible.
ENDORSEMENTS
Endorsements
"Lea is so warm and caring, she's incredibly easy to talk to. Her relational approach and unique lived experience as a queer, neurodivergent therapist makes her especially qualified to help folks who want to be seen, heard, and understood."
Corina Bair, LCSW
"Having known Lea for over 10 years, I can firmly and confidently speak to her incredible depth of compassion, empathy and kindness. She truly embodies what it means to be a healer."
Micaela Krusemark, MS, LPC, YTT-500
Amethyst Holistic Counseling of California