Behind Her Eyes: Masking in Women with ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental difference that is often marginalised and subjected to stigma, particularly among women and girls. In women, ADHD characteristics are frequently misattributed to emotional difficulties, learning difficulties, low motivation, negative gender stereotypes or personal flaws. To ‘fit in’ and reduce criticism, girls and women with ADHD may engage in masking, which involves intentionally or unintentionally concealing aspects of oneself that are negatively evaluated or stigmatised by others. This can involve disconnecting and suppressing or altering the expression of one’s authentic self to avoid stigma and maintain relationships. While it is suggested that masking may delay the identification of ADHD in women and girls, little is known about how masking may affect the presentation of ADHD characteristics or their experience and the personal impact of masking. Underpinned by Leong and Graichen’s (2024) Masking-Authenticity Triangle, this thesis consists of two qualitative papers relating to experiences of masking in women with ADHD. A systematic literature review exploring retrospective experiences of masking of women with ADHD as students in school applies thematic synthesis to 9 qualitative papers and illustrates how early experiences of difficulties ‘fitting in’ and meeting environmental, academic and social expectations in school, along with relational experiences of misattunement and criticism, contribute to enduring core negative beliefs about the self. Using semi-structured, qualitative interviews, the empirical study, Masking in Women with ADHD explores the lived experiences of masking in 10 women identified with ADHD in adulthood, the reported consequences of masking and experiences of (neuro)inclusivity in clinical, educational and occupational settings. Reflexive thematic analysis demonstrates the efforts taken to conceal the authentic self, the motivations for doing so, contexts and situations which enforce masking and the consequences of masking on well-being, relationships, and academic and occupational functioning. Implications for educational psychology practice and suggestions for further research are discussed.