Spotting the Signs – Neurodivergence in Girls

ADHD and autism often go undetected in girls. But what is neurodivergence – and why does it so often go unnoticed? Dr Sanveen Kang, lead clinical psychologist and founder of Psych Connect in Singapore, explains why neurodivergence in girls is frequently overlooked, why so many women with ADHD are only diagnosed in adulthood, and what needs to change to better support neurodiverse girls earlier.

Dr Sanveen Kang of Psych Connect sheds light on neurodivergence in girls

What is neurodivergence – 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 women with ADHD and neurodiversity.

Why are girls still being missed?

Even now, girls remain under-diagnosed due to gender-biased diagnostic models and outdated cultural assumptions.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”.

There is growing momentum to change this. Clinicians are increasingly trained to recognise how neurodivergence presents differently in girls, using approaches that factor in emotional regulation, masking and hormonal influences.

What should we look out for?

Parents, teachers and healthcare providers need to look past the old stereotypes. Most neurodivergent girls aren’t disruptive. Instead, they might be perfectionists, people-pleasers or quietly anxious. They may perform well at school, only to unravel at home.

Take six-year-old Amelia. She spends hours in what appears to be imaginative play – but her dolls follow strict, repetitive scripts lifted from TV shows or books. If another child tries to change the story, she becomes distressed or shuts down. Her play seems typical, but it lacks the flexibility and back-and-forth of neurotypical pretend play – an early sign of autism often missed in girls.

Girls with inattentive ADHD may seem “lazy” or disengaged – but beneath the surface, they’re often battling brain fog, poor focus and internal chaos. Without hyperactivity, they rarely get flagged.

Diagnosing girls with neurodivergence means going beyond a checklist. It calls for clinicians who are trained and experienced in recognising how gender can shape the presentation of neurodiversity. Skilled clinicians know how to gather detailed developmental histories, assess functioning across different settings and, crucially, hold awareness of the mental load and emotional toll of long-term masking.

Why are so many women with ADHD only diagnosed in adulthood?

In my practice, I see a growing number of adult women who arrive feeling “not quite right,” but unsure why. They’re often competent, high-achieving and outwardly holding it all together, but inside they feel overwhelmed, misunderstood or burnt out.

This isn’t surprising when we consider how our diagnostic tools have historically been developed around male presentations of ADHD. Meanwhile, women with ADHD tend to be creative and resourceful, too, developing hacks through their lives that serve as coping mechanisms. But continuous hacking leads to burnout rather than resolution.

A diagnosis later in life can be a powerful moment. “I thought I was just lazy” or “Now everything makes sense” are things I hear often. What many feel is not despair, but relief – followed by grief for all the years spent struggling without answers.

This late discovery is often prompted by burnout. The coping strategies that worked before – overachieving, perfectionism, staying hyper-organised – start to break down under the pressure of careers, parenting or midlife changes. Finally, they seek support.

What is the hidden emotional cost of late diagnoses?

The emotional toll of being missed can be profound. I’ve spoken to women who’ve spent decades believing they were broken. They masked their challenges, overcompensated and exhausted themselves trying to be “normal” – while never understanding why things felt so hard.

This quiet trauma chips away at self-worth. These women often internalise shame, self-doubt and loneliness. And because their struggles weren’t obvious, they rarely received the support they needed. When a diagnosis finally comes, it’s not just about labelling – it’s about finally being seen. Naming what was always there allows them to make peace with themselves, sometimes for the first time.

What’s missing from traditional therapy models?

As we learn more about neurodivergence and women with ADHD, we must rethink how we offer support. Traditional therapy approaches – rooted in male-centred models – often miss the emotional labour and masking common in women. That’s why Psych Connect has launched retreats tailored specifically for women with neurodivergence.

The next retreat will take place in November 2025. If you’re interested in joining, please get in touch.

Can you tell us more about these retreats?

At our recent Boldly You retreat, we created the kind of space many neurodivergent women have rarely, if ever, experienced: connection without performance, a shared language and a real, deep relief. It’s not about fixing, but rather about unmasking and stepping into environments where they are understood and do not have to explain themselves. And that kind of recognition – that moment of finally feeling seen – is profoundly healing. We also explore various intervention approaches that have been shown to be effective in supporting women with ADHD.

Common signs of neurodivergence in girls:

• Emotional exhaustion or meltdowns after school
• Perfectionism or very low self-esteem
• Shutdowns or fatigue in overstimulating environments
• Masking or imitating peers to blend in

Want to find out more?

Get in touch with Dr Sanveen Kang or a member of the Psych Connect team.

Psych Connect is at 10 Winstedt Road, #03-13
6493 0244 | psychconnect.sg

This article on neurodivergence in girls first appeared in the June 2025 edition of Expat Living. You can purchase the latest issue or subscribe so you never miss a copy!

To make the most of living in Singapore, read our latest City Guide here for free!

Liked this article? Visit our Health & Fitness section for more.