“It seems like everyone has ADHD these days” is a phrase you’ve probably heard before. It seems like learning disabilities such as ADHD and Autism are more prevalent now than they ever have been, with an explosion of #womenwithADHDandAutism and #neurodivergent content on social media platforms like TikTok. Many people see this simply as a trend, yet now figures show that diagnosis rates are rising, particularly among women. The number of female patients being prescribed ADHD medication has more than doubled in recent years, from 25,000 in 2015/16 to 58,000 in 2021/22 (1). But why have diagnosis rates risen so dramatically in recent years? Is neurodiversity just a social media trend, or are a population of women and girls that have been overlooked for generations finally being heard?
Neurodiversity is a term first coined by sociologist Judy Singer in 1998 and refers to the differences in brain function in regards to learning, sociality, mood, and attention. The umbrella term covers ADHD and Autism, as well as other conditions like Dyslexia, Dyspraxia, and OCD. Singer believed this new term would challenge some of our most taken for granted assumptions, including that we all hear, see and process information in the same way (unless visibly disabled) (2). Thus, 'neurodiversity' is a fairly modern term, which until recently was mainly used to describe men with any of the above conditions. For many years, neurodivergent women and their symptoms have been vastly ignored by those who claim to be experts in their field. This is because diagnostic criteria tends to only take male symptoms into account. For example, boys with ADHD tend to be naughty and very disruptive, whereas ADHD girls are seen as daydreamers and doodlers (1). This illustrates how symptoms can present differently between the genders, and the effects of patriarchal values on diagnosis. Symptom display reflects our society’s gender norms, and therefore girls with ADHD and other neurodivergent learning disabilities are overlooked. However, since Singer’s paper was published in 1998 there has been a 787% increase in recorded Autism diagnoses. This increase in diagnoses was far greater in females and adults than it was in males (3). This is not a social media ‘phase’ - neurodivergent women have been ignored and belittled for years, and social media has given them a platform to talk about their experiences and mistreatment.
Outdated research, misdiagnosis, and patriarchal values
According to Lise Eliot, a professor of Neuroscience, the history of gender difference research is rife with misinterpretation and sexism (4). For example, the widely held 19th century belief that female brains had “a missing five ounces” has been used in the past to explain why men have ‘mathematical’ brains and women can multitask. However, in her book The Gendered Brain, Gina Rippon debunks this, and concludes that the reason for gendered differences in behaviour is because “a gendered world will produce a gendered brain”. This shows that sexist attitudes from patriarchal values have informed research in the past, and continue to do so now. If the majority of learning disability research has been carried out on men, then our understanding of symptom display is only through a male lens. For example, the Extreme Male Brain Theory proposed by Simon Baron Cohen, argues that people with ASD (autism spectrum disorder) view the world through a ‘male’ lens and take an interest in “stereotypically male subjects”, such as how machines work. It also proposes that they struggle at things that come naturally easy to women, such as grasping social cues (5). According to the theory, there are innate biological differences that account for discrepancies in diagnosis rates between genders. However, these theories fail to consider the broader context, including how biased research and/or diagnostic pathways may be to blame instead.
Historically, research into learning disabilities has been carried out on samples using mainly males. This research informs diagnostic criteria around learning disabilities to be heavily male-centred. For example, diagnostic criteria for ASD has been developed using only male behavioural and symptomatic presentation (6). This criteria acknowledges the male externalisation of distress (e.g. violence or disruption) but ignores female internalisation of distress (e.g. anxiety), thus male neurodivergence is more visible to others. It is easy to see how patriarchal gender norms and values contribute to this. Women are expected to be quiet and compliant, they are ‘naturally’ more timid than men so anxiety is inevitably a female trait to have. Consequently, these neurodivergent traits in women are overlooked.
Experiences of women in early childhood, the education system, and the workplace
With diagnosis bias and patriarchal values set against them, it is inevitable for neurodivergent women to suffer and face barriers throughout the different stages of their life. This typically starts in the schoolroom. For example, many neurodivergent girls feel that they don’t fit in and they don’t understand social cues as easily as other children. Typical comments from teachers include phrases like “she needs to apply herself”, “she daydreams too much”, and “she needs to come out of herself” (7). Because girls are more likely to internalise their symptoms, they tend to get a mental health diagnosis like anxiety instead. These misdiagnoses often act as a self-fulfilling prophecy, as the confusion and pain that comes from being misunderstood can exacerbate mental health issues. Furthermore, socialisation from a young age causes girls to pick up on prioritising social cues and the importance of fitting in. Jenara Nereneberg, author of Divergent Mind, explains that this form of ‘masking’ is the reason that neurodivergent women blend in and go undiagnosed. This camouflaging is an emotional strain, causing these women to think that everyday headaches, sensory overload, sensitivity and introverted-ness is normal (8). Research shows that women with autism are more likely to ‘employ camouflaging’ than men with autism (9). As a result, many women enter life or the workforce with low self esteem. This could explain why there is a prevalent number of neurodivergent women in prisons. Though research into this is small (but growing), one study conducted at Newhall Secure Female Prison in Yorkshire found that 59.5% of a sample of 69 women met the diagnostic criteria for adult ADHD (10). Thus, part of the reason for their detainment could be due to undiagnosed learning disabilities and a lack of support in this area throughout their life.
Playing catch up
The rise of female neurodivergent content on social media is not just a passing trend, but instead represents the world catching up on the challenges and experiences that neurodivergent women are facing. Neurodiversity is starting to become a mainstream word in society, with employers, universities, and schools choosing to celebrate it. For example, the consultancy Genius Within, which works with neurodiverse individuals within companies and the UK prison system (11), wants employee onboarding to be neuro-inclusive. This can be achieved by managing wellbeing in a neurodivergent-friendly style, and managing performance in a more explainable way. Additionally, reports like the Sparta Global report highlight the benefits that neurodivergent staff bring to the workplace, due to their unique way of thinking and problem solving. Increasing awareness in the education sector has been raised through events such as Neurodiversity Celebration Week (March) and Disability Awareness Month (July), giving students with learning disabilities a platform they can identify with. Thus, there is more to the term ‘neurodivergent’ than just being a trending hashtag on social media. For people who fall under this label, it is an identity that encompasses all the struggles and ‘quirks’ they have faced throughout their life. For neurodivergent women, it does all this and more. It brings clarity and understanding to a lifetime of inner turmoil and difficulty that has always been overlooked and not listened to. Whilst research on female neurodiversity is only beginning, social media can provide support for these women until the research field catches up.
Written by Lucy Williams, Thrive Research Hub Member
Sources
[1] iNews, Rising ADHD diagnosis rates for women are not a trend, it’s healthcare playing catch-up (Accessible here)
[2] Spectrum Suite, An interview with the Australian Sociologist who coined the term ‘Neurodiversity’ (Accessible here)
[3] The Journal of Child Psychology and Psychiatry (Accessible here)
[4] Nature Journal, Neurosexism: The myth that men and women have different brains (Accessible here)
[5] Spectrum, The extreme male brain, explained (Accessible here)
[6] Research in Autism Spectrum Disorders: Sex, Gender and the diagnosis of Autism- a Biosocial view of the male preponderance (Accessible here)
[7] The Brain charity, Why neurodivergent women are diagnosed with ADHD and autism in later life, and what this means for their careers (Accessible here)
[8] Bitchmedia, Jenara Nerenberg Seeks to Empower Neurodivergent Women (Accessible here)
[9] National Library of Medicine, Quantifying and exploring camouflaging in men and women with autism (Accessible here)
[10] Farooq et al, Prevalence of Adult ADHD in an all Female Adult Prison Unit (Accessible here)
[11] Financial Times, The rise of adult diagnoses of neurodiversity (Accessible here)
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