Gender Health Gap Update and ADHD Diagnosis In Women
Published: September 10, 2024 (Tuesday)
Everything stands or falls in closing the women’s health gap worldwide.
I was recently reading an article from the World Economic Forum when I was surprised to see a four-letter word:
ADHD.
It stands for Attention-Deficit Hyperactivity Disorder.
I was surprised because the article’s title was “6 Conditions That Highlight The Women’s Health Gap.”
I didn’t expect ADHD to be part of that list considering the many health issues women face.
The complete list of six conditions that highlight the women’s health gap according to the Forum’s article are these:
Heart Attack
Endometriosis
Autism
ADHD
Autoimmune Conditions
Antimicrobial resistance
I’m glad ADHD is part of this list.
And this is why.
According to the US Census, as of 2022, there were 168 Million women.
The updated prevalence rate of ADHD in adults is 3.1%, according to the Psychiatry Research Review Article in 2023.
That's 5.8 Million women with ADHD in the United States alone who could be misdiagnosed, underdiagnosed, late diagnosed, and undiagnosed with ADHD.
I’m one of these women.
Since my ADHD diagnosis over 20 years ago, I experienced firsthand the Women’s Health Gap.
I now share some of my insights about this critical issue.
Your Key Takeaways from this article:
The Meaning and Reasons for the Women’s Health Gap
Why Gender-Specific Research is Lacking
5 Self-Advocacy Strategies YOU can use to improve your health
What Does The Term “Women’s Health Gap” Mean?
Women’s Health Gap means a lack of fairness and equality for women’s healthcare.
The gap in women’s health can take the form of unequal:
Access to healthcare
Treatment
Research
The World Economic Forum’s article listed these six health conditions as highlighting the unequal access, treatment, and research for women’s care:
Heart Attack
Endometriosis
Autism
ADHD
Autoimmune Conditions
Antimicrobial resistance
What Happens To Women Because Of The Gender Health Gap?
Regardless of the medical condition…
Failure to recognize or correctly diagnose a medical condition means women cannot receive proper and timely treatment.
Without a diagnosis for these women, sex-specific data from research are incomplete.
Without accurate sex-specific data, we cannot have truly inclusive policies.
Without inclusive policies, the cycle of gender bias continues generation after generation.
[Self-Test: Could You Have ADHD?]
Shocking Numbers To Consider:
According to the Forum’s article, women spend 25% more of their lives in poor health compared to men because of under-diagnosis, misdiagnosis, later diagnosis, and medical bias.
Without the women’s health gap, 3.9 Billion (with a “B”) women worldwide could gain an average of 500 days or 1.4 years over a lifetime.
Numbers usually have less meaning to my ADHD brain unless I give it relatable context.
So, let me put 1.4 years into perspective with these questions:
What if you could spend over a year more with the woman you love?
What if you could have over a year more with your mom, sister, grandmother, daughter, niece, aunt, cousin, and friend?
What if you have over a year more to live?
That number - 1.4 years - feels more meaningful now.
If that’s not enough, let’s talk about money, too, since that resonates louder for some.
Here are some key numbers the article emphasized:
Every $1 invested in women's health generates $3 in economic growth.
The global economy could gain $1 Trillion (with a “T”) by 2040 if the women’s health gap is closed.
You might be asking why such a significant economic boost would happen worldwide when the women’s health gap is closed. Because closing the gap means:
Fewer early deaths for women
Fewer health conditions
Increased women's contribution to the economy and society
These reasons seem common sense.
“But, common sense is not that common, especially regarding women’s issues.”
Why Do Significant Gender Gaps In Health Care Exist?
Not surprisingly, gender bias - bias against girls and women - is the main reason for the gender health gap among the six medical conditions mentioned here.
What is surprising for me is this…
While health providers, medical researchers, and society display gender bias (unconsciously or consciously),
Certain medical conditions themselves show gender bias!
Let’s unpack some of these main reasons for the gender health gap.
Pain is treated differently for women and men.
Healthcare providers treat men and women differently when it comes to pain, whether they acknowledge it or not.
Healthcare professionals view women as exaggerating or hysterical when women complain of pain, while men are considered more tolerant of pain.
Healthcare providers often tell girls and women that their pain or symptoms are only “in your head” or “it’s part of being a woman,” such as the case with endometriosis, where the uterus lining grows unnaturally and painfully in other parts of a woman’s reproductive organs.
I’ve heard this shaming language myself.
This persistent, unfair treatment causes girls and women to suffer in silence with their physical and mental conditions.
When they do seek medical help, their experience is similarly troubling:
When they arrive at the hospital, women’s pain levels are 10% less likely than men's to be assessed.
Women wait about 30 minutes longer than men to be seen by a doctor.
Women are less likely to be given pain medication or pharmacological treatment (even medication for future heart attacks) than men.
Because women’s pain is not taken seriously, female patients are 50% more likely than males to receive the wrong diagnosis (even after a heart attack!).
A wrong diagnosis means a lack of and untimely proper treatment.
A startling example involves women in the UK who are about 33% less likely to receive a coronary angiogram even after a heart attack. This does not make sense because a coronary angiogram allows doctors to see blockages or narrowing in blood vessels after a heart attack.
Certain health conditions affect more women than men.
Of the six medical conditions in the article, autoimmune diseases and antimicrobial resistance (AMR) significantly fall into this category.
Autoimmune Diseases
Women account for the majority of people (80%) with autoimmune diseases, such as lupus, psoriasis, multiple sclerosis, rheumatoid arthritis, and thyroid diseases.
Autoimmune diseases occur when the body’s immune defenses attack itself.
A molecule called Xist exists only in women and triggers a chemical response to autoimmune disease, which could explain why women tend to suffer from these conditions. More research is needed about this.
Antimicrobial Resistance
In updating their article in August 2024, the World Economic Forum added antimicrobial resistance to the list of medical conditions highlighting the gender health gap.
Women are more exposed to antimicrobial resistance than men.
Antimicrobial resistance is when parasites, bacteria, and viruses evolve to resist drugs.
Antimicrobial resistance could be responsible for about 10 million deaths per year. The majority of these deaths are women.
Why are women more likely to be exposed to antimicrobial resistance than men?
Imposed gender roles and reproductive health are significant reasons.
In low- and middle-income countries, women are more likely to be exposed to bacteria in dirty water when doing household chores (washing clothes and dishes, cleaning, etc.).
Women are at risk of exposure to pathogens during childbirth.
Women lack adequate sanitation, especially during their menstrual cycle.
Women are more likely to take care of sick people.
These gender roles increase women’s exposure and contact with more parasites, bacteria, and viruses.
So, women are more likely to get sick and take antibiotics in their lifetime, making women resistant to these superbugs.
Symptoms present differently in women than men for specific health conditions.
Certain medical conditions show symptoms that “look” differently in women than men.
“For millennia, medicine has functioned on the assumption that male bodies can represent humanity as a whole. As a result, we have a huge historical data gap when it comes to female bodies.”
- by British journalist Caroline Criado Perez in her book, Invisible Women: Exposing Data Bias In A World Designed For Men.
This sentiment has resonated for several decades with ADHD and autism.
Historically, previous studies focused on boys’ and men’s ADHD symptoms only.
Also, the Diagnostic and Statistical Manual of Mental Disorders (DSM) used by doctors to diagnose ADHD was based solely on boys’ criteria.
And not much has changed even in 2024!
But, girls and women often show less hyperactivity and more inattentiveness or internalized symptoms, which can be overlooked, leading to female underdiagnoses, misdiagnoses, and late-in-life diagnoses.
I fall under these categories, being diagnosed late in life, as an adult, and after college. I was first misdiagnosed and underdiagnosed as having depression only. After years of mental health challenges and after having the proper health insurance coverage, I finally received the correct diagnosis: ADHD. My life changed drastically for the better after the accurate diagnosis and treatment.
Autism, a common comorbidity with ADHD, also has limited gender-specific research. That means data analysis didn't account for any sex difference at all.
This leads to girls and women being either misdiagnosed or underdiagnosed, even though they struggle with symptoms of autism daily.
Notably, recent studies reveal that later-in-life ADHD diagnosis in young women can lead to low self-esteem, increased impulsivity, risky sexual behaviors, depression, and suicidal ideations, among others.
[Read: ADHD In Adult Women: The Good, The Bad, and The Ugly]
Statistical Highlights For Women With ADHD
Only less than 1% of women have an ADHD diagnosis in the United States, even though the prevalence rate of ADHD in adults is 3.1%.
In 2010, males were 133% more likely to be diagnosed with ADHD than females. The good news is in 12 years, that number decreased significantly.
In 2022, males were 28% more likely to receive a diagnosis of ADHD than females.
In only two years between 2020 and 2022, the diagnosis rate among women aged 23 to 49 almost doubled. This means ADHD diagnoses often happen later in life or to older women than their male counterparts.
Disheartening Research Efforts
Women live longer than men but spend more of their lives in poor health, according to the Bill & Melinda Gates Foundation-funded study published in The Lancet in May 2024.
Yet…
Only 1% of healthcare research and innovation was invested in female-specific conditions beyond oncology in 2020, according to a McKinsey Health Institute Report.
Men outnumbered women by 3:1 in 31 medical trials for congestive heart failure over 15 years, according to Journalist Caroline Criado Perez in her book, Invisible Women: Exposing Data Bias In A World Designed For Men. (affiliate link)
You might be asking what can be done.
I propose 3 action plans echoed by others.
3 Simplified Action Plan For Gender-Sensitive Research:
Fund exponentially gender-sensitive research to obtain sex-specific and age-specific data.
Implement treatment and interventions for girls and women already suffering from these conditions based on these sex-specific and age-specific data.
Transform sex-specific and age-specific data into inclusive policies.
As you can see, each step builds upon the former.
But it starts with having gender-sensitive research and data.
If you are in a position to fund these gender-specific research, this is your sign to do so.
If you are in a position to conduct and gather sex-specific and age-specific data, I invite you to act now.
What Can You Do To Advocate For Better Healthcare?
For girls and women (like me), I’d like to share what I do in managing my ADHD with my healthcare providers.
These strategies can be used for any health condition, not simply the six conditions we discussed here.
All genders can also use these self-advocacy strategies.
Implementing these strategies has been effective and empowering for me.
May they support you as well.
Are you ready?
5 Self-Advocacy Strategies For Women’s Health:
#1 - Track Your Symptoms.
Start a health journal to write down your ADHD or other health-related symptoms, as well as your ADHD medication, if any.
You can do it on your phone or a notebook, whichever is easiest for you.
Write dates and times when your symptoms started and ended.
Be specific in describing how you feel, especially your pain level.
Write down what you were doing before your symptoms started to find out any connection.
Having this documentation helps support your complaints when you visit your health professional.
Show your doctor your journal if they doubt your complaints and symptoms.
Your journaling shows your doctors that you are taking your symptoms seriously and monitoring them methodically, meaning your symptoms are not “just in your head.”
#2 - Recognize Invisible Pain and Bias.
Knowing health care professionals tend to dismiss or misjudge girls’ and women’s pain, remember this fact the next time you have your appointment with your primary care physician or any medical expert.
For girls and women with ADHD, keep in mind that this extends to your emotional and mental health problems.
Be ready to hear from even medical experts shaming and stigmatizing language such as: “It’s all in your head,” “You’re oversensitive or exaggerating,” or “It’s part of being a girl or woman.”
Sadly, it's likely they said these same hurtful words to other female patients.
So, it’s not about you.
Instead, it’s about them and their gender biases.
This is a shift in mindset that can save your life, literally.
#3 - Speak Up In Medical Appointments.
When you hear shaming and judgmental words during your medical appointments, this is the time that you advocate for yourself even if your healthcare providers dismiss your concerns.
Take an active role in your physical and mental health concerns.
It's hard, I know.
They know more about the medical field than you do; they're the doctors.
But, a key learning for me in my 20-year journey managing and thriving with my ADHD is this:
You know one vital area way more than any doctor - YOURSELF!
Be clear and assertive when discussing your ADHD, pain, or other health issues with your doctor.
You can show your medical journal (Self-Advocacy Strategy Number 1 above) to your doctor so they can see clearly how your pain and symptoms changed over time.
And remember: It’s okay to fight harder for better recognition of what you are feeling physically and mentally.
Promoting self-advocacy is okay so YOU receive better care, treatment, and medication from your healthcare providers.
#4 - Practice Self-Compassion.
Self-compassion is an essential coping strategy for girls and women to advocate effectively for their health.
When anyone dismisses your symptoms, show yourself compassion even if others won’t.
Acknowledge that your struggles are valid and not a reflection of weakness.
Give yourself the grace to seek help and prioritize your mental and physical well-being.
Reject their biases and stigma.
Remember: You have no control over others’ reactions, but you have control over yours.
#5 - Empower Through Collective Knowledge.
Surround yourself with other women who understand the struggles of ADHD, especially in motherhood.
A supportive, non-judgmental community offers encouragement, resources, and shared experiences.
Research communities in your local areas or online.
Our community for moms with ADHD, is one of them.
Once you’re part of a community, cultivate the courage to share up-to-date research and real-life strategies inside the community.
Remember: Knowledge liberates.
We can better support each other by managing our health collectively and thriving with ADHD together.
Closing Reflections
I began this blog post with my firm belief that "Everything stands or falls in closing the women's health gap worldwide."
When we close the women's health gap, we uplift not just individual women but entire families, the core of all communities.
That's why closing the women's health gap is our collective responsibility.
I invite you to rise above our biases and advocate for gender-sensitive care and research.
Lastly, when others show you their biases, remind yourself to advocate for YOU the hardest. With every journal entry, conversation, and act of self-compassion, you bring yourself and us closer to equal care.
Journal Prompt:
What has your experience been with the women’s health gap? Share your story. Your response might support another girl or woman looking for validation with a similar experience.
I appreciate you, 🙏
~ Katherine
P.S. Connect with me inside our community for in-depth discussions about this and similar topics.
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Sources:
“6 Conditions That Highlight The Women’s Health Gap,” by Kate Whiting, The World Economic Forum, August 15, 2024.
“Prevalence of attention deficit hyperactivity disorder in adults: Umbrella review of evidence generated across the globe,” by Getinet Ayano, et al., Psychiatry Research 328 (2023) 115449.