“You can’t have ADHD or autism because…”. Why women are still being missed, and why this needs to change
Again and again, I hear the same stories from women who’ve finally started to wonder whether they might have ADHD, be autistic, or perhaps both.
They’ve struggled for years, often decades, to hold things together. And when they finally reach out for help, they’re told things like:
“You can’t be autistic, you make eye contact.”
“You’ve got a degree, ADHD wouldn’t let you do that.”
“You’re a mum, so clearly you’re functioning well enough.”
“You’re not hyper, so it’s not ADHD.”
“You’re very friendly and articulate — that’s not autism.”
“If this were really an issue, it would’ve shown up in childhood.”
These are not just unhelpful. They’re wrong.
They reflect outdated beliefs about what ADHD and autism look like, as these beliefs are rooted in how these conditions tend to present in boys and men, not in women and girls.
The problem with masking and misunderstanding
As girls, many of us were quiet, shy, perfectionistic, or people-pleasing. We were labelled sensitive, anxious, overly emotional. Or, if you were like me and chatted (alot) or couldn't concentrate in class, it was overlooked……. as nobody saw the internal chaos. Many girls got through school by overachieving, shutting down, or blending in, often struggling to make and maintain friendships and frequently feeling like an outsider around others.
We became adults who looked like we were coping, we held down jobs, raised children, looked after parents, ran households. Until, one day, we couldn’t anymore.
And then, when we finally asked for help, many were told they were too articulate, too smart, too capable to possibly be struggling in the way we described.
But ADHD and autism in women often look nothing like the stereotypes. We internalise rather than externalise. We mask and compensate. We hold ourselves to impossibly high standards. And when it all gets too much, we crash, often during life transitions like motherhood or perimenopause.
Current research says:
“Autistic females may camouflage their social differences, leading to delayed or missed diagnosis.”
(Hull et al., 2020)
“ADHD in women is under-recognised due to internalised symptoms, strong compensatory strategies, and a lack of awareness among professionals.”
(Young et al., 2020)
“Diagnostic frameworks developed with male-biased data contribute to underdiagnosis in females.”
(Lai & Szatmari, 2020)
This is why so many women are only realising later in life that they’ve been living with ADHD and/or autism all along.
If this is you…
If you’ve ever been dismissed, misunderstood or invalidated by those around you, please know that you are not alone.
There is a growing body of evidence, community, and support and you deserve to be listened to, to be taken seriously, and to receive care that reflects your reality.
References:
Hull, L., Mandy, W., Lai, M. C., et al. (2020). Development and validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders, 50(3), 819–833.
Young, S., Adamo, N., Ásgeirsdóttir, B. B., et al. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach. BMC Psychiatry, 20(1), 404.
Lai, M. C., & Szatmari, P. (2020). Sex and gender impacts on the behavioural presentation and recognition of autism. Current Opinion in Psychiatry, 33(2), 117–123.