Masking in Girls and Women with Co-occurring ADHD/Autism

Plain-language summary

Research suggests that women and girls with co-occurring ADHD and autism often mask their symptoms, which can lead to delayed or missed diagnoses. This masking involves internalizing behaviors and using coping strategies to fit societal expectations, particularly in cultures with strong social norms. The concept of "AuDHD" (combined autism and ADHD) is emerging, but it is not yet formally recognized in diagnostic systems, leading to conflicted feelings and fragmented identities among those with this diagnosis. Evidence is still emerging due to limited research in this specific area.

Key findings

• Women and girls with both ADHD and autism often camouflage their symptoms, making diagnosis difficult.
• Societal expectations and cultural norms can significantly influence how ADHD symptoms are expressed and perceived in women, leading to diagnostic delays.
• The combined presentation of ADHD and autism, sometimes called 'AuDHD,' is not yet a formal diagnosis, causing challenges for individuals seeking recognition and understanding.
• Many women with AuDHD report feeling a sense of ambivalence about their diagnoses, leading to fragmented identities shaped by societal views rather than personal understanding.

Studies cited (5)

1. Being a Woman Is 100% Significant to My Experiences of Attention Deficit Hyperactivity Disorder and Autism: Exploring the Gendered Implications of an Adulthood Combined Autism and Attention Deficit Hyperactivity Disorder Diagnosis — E. Craddock (2024, Qualitative Health Research, other)

   This article provides original insight into women’s experiences of adulthood diagnoses of attention deficit hyperactivity disorder (ADHD) and autism. Research exploring experiences of adulthood diagnoses of these conditions is emerging. Yet, there is no research about the gendered experiences of an adulthood combined ADHD and autism (AuDHD) diagnosis. This article addresses this gap through interpretative phenomenological analysis of email interviews with six late-diagnosed AuDHD women revealing the complex interplay between late diagnosis, being a woman, and combined diagnoses of ADHD and aut

2. Raising the voices of AuDHD women and girls: exploring the co-occurring conditions of autism and ADHD — E. Craddock (2024, Disability & Society, other)

   This is a Current Issue because neurodivergent women and girls have been left behind, missed by the medical profession for decades. ADHD and autism have historically been considered to be male conditions, with diagnosis being 4 times more likely for males than females. The tides are changing with more women becoming aware of, diagnosed with, and seeking a diagnosis of conditions such as ADHD and autism. The media response to this surge in diagnoses has often been disparaging, although attempts to widen awareness exist (including recent BBC documentary Unmasking My Autism) . However, women face

3. Navigating residual diagnostic categories: The lived experiences of women diagnosed with autism and ADHD in adulthood — E. Craddock (2025, Health, other)

   This article conceptualises a combined autism and ADHD (AuDHD) diagnosis as a residual category not formally represented in diagnostic systems, addressing a critical gap in neurodiversity research. Using Interpretative Phenomenological Analysis of email interviews with six women diagnosed in adulthood, it examines the ambivalence arising from inhabiting this liminal diagnostic space. Residuality generates conflicting feelings about autism, ADHD, and the self, resulting in fragmented identities shaped more by societal narratives than by interpersonal perceptions. Themes include the contradictio

4. Diagnosis acceptance, masking, and perceived benefits and challenges in adults with ADHD and ASD: associations with quality of life — Wurth P, Fuermaier AB, Strand AH (2025, Frontiers in psychiatry, other)

   DOI: 10.3389/fpsyt.2025.1668780 PMCID: PMC12568611

5. Finding Clues to Role Conflict Experience and Support in the Life of Adult Women With ADHD in the Korean Society: A Qualitative Research Protocol — Sohyeon Ryu, Sunjoong Kim, Do-Eun Lee (2025, International Journal of Qualitative Methods, other)

   Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that can last until adulthood and the diagnosis is often delayed in women due to internalizing symptoms, masking, and compensation strategies. The stigma of the disease and its cultural characteristics can make it difficult to diagnose and accept mental disorders, particularly in the Korean society. Hence, this study aims to explore how the expectations and norms of social roles in the Korean society affect the recognition of symptoms, diagnosis processes, and daily life experiences of women with ADHD. In particul