When Girls Don't “Look” NEURODIVERGENT

ADHD and autism often go undetected in girls. DR SANVEEN KANG, lead clinical psychologist and founder of Psych Connect in Singapore, explains why so many women are only diagnosed in adulthood — and what needs to change to support neurodivergent girls earlier.

- BY JESS SMIT

What is neurodiversity - and why does it look different in girls?

Neurodiversity describes the natural range of differences in how brains function, including ADHD, autism, dyslexia and more. Rather than viewing these differences as deficits, neurodiversity reframes them as part of normal human variation.

But when it comes to girls, these differences often show up in quieter, more internalised ways than in boys. Girls with ADHD may appear dreamy, perfectionistic or anxious - not the stereotypical hyperactive or disruptive child. Autistic girls often mask their difficulties by mimicking others, following social scripts or avoiding situations that feel overwhelming.

Because most diagnostic tools were developed based on male behaviours, many girls are either misdiagnosed or missed entirely— until anxiety, depression or burnout emerges in adolescence or adulthood.

Hormones add another layer. Oestrogen affects brain development and dopamine - key to ADHD regulation. During puberty, menstruation and perimenopause, hormonal changes can amplify emotional reactivity and executive dysfunction in neurodivergent women.

Why are girls still being missed?

Even now, girls remain underdiagnosed due to gender-biased diagnostic models and outdated cultural assumptions. Standard ADHD and autism checklists focus on externalised behaviours like fidgeting or outbursts - traits more commonly observed in boys.

Girls, on the other hand, often internalise distress. They might try hard to fit in, mimic others or overcompensate in structured settings. This masking makes their symptoms harder to spot. Instead of being flagged for assessment, they're often described as “sensitive”, “shy” or simply “well-behaved”.