I chased my ADHD assessment referral today. Turns out they’re even further behind than before. I might have another year to wait. That’s five years. Five years of knowing, and waiting, and having to get on with it anyway.
My Story
As with many older women who realise they are neurodivergent, it’s when menopause hits, and everything falls apart, that it becomes obvious. For me, my journey began with my children’s diagnoses, and as menopause took hold, things really began to fall apart. The referral was fairly straightforward, as my GP was obviously aware of the boys’ journeys, so completely supported my self-referral.
When I received the forms to complete, I thought that looking back on childhood would be quite hard. But suddenly things began to fall into place and make sense. My referral was triaged and accepted, and the wait began. In the four years since, I’ve navigated my three boys’ diagnoses, supported my youngest through almost 3 years of EBSA (emotionally based school avoidance) and an EHCP transfer, become L3 SEND Law Qualified with IPSEA Charity, managed -kinda- perimenopause, moved house and started a renovation.
The Gender Diagnosis Gap
We know that historically, ADHD was seen as the ‘naughty white boy disorder’ and something that they grow out of as they reach adulthood. There are three ‘types’ of ADHD: Hyperactive, Inattentive, and Combined. Generally, boys are likely to display the hyperactive/impulsive symptoms of ADHD, whereas girls and women tend to display more inattentive behaviour. This is one of the reasons historically the gender diagnosis gap originated. Clinical studies show that the gender diagnosis gap is 4:1 male to female. However, wider studies within the community show that this ratio may be nearer to 2:1. 1
Reasons for the gender gap are generally thought to be:
- Historical bias – research was carried out on males, so the diagnostic criteria are still very much focused on male-dominated symptoms, focusing on hyperative type.
- Presentation type – typically, the ‘male’ behaviours are much more external and visible, whilst ‘female’ behaviours are typically internal and much less visible, so tend to go unnoticed by parents & professionals.
- GP Training – because of the above GPs are vastly undertrained in the presentation of females with ADHD, and therefore it can be harder for females to be considered for assessment.
- Societal Expectations – Again, because the male behaviours are visible and go against expected behaviours in public, it is accepted more readily that this may be due to ADHD, and diagnosis sought. Whereas, within females, a lot of the time, it is initially put down to a personality trait.
- Diagnosis Procedure – Girls are much less likely to be noticed and referred for assessments throughout their lives. Still, studies show that even when they are referred and assessed, women are more likely to be misdiagnosed or not diagnosed at all.
NHS vs Private (and Right To Choose)
As of early 2026, typical waiting times for adult ADHD assessment through the NHS range from 12 months to over 5 years depending on your area. Some regions have waiting lists so long that services have temporarily closed to new referrals.2
Right to Choose wait times range from as little as 1 week to up to 78 weeks, so they are significantly shorter than NHS wait times. However, many GPs are unaware of the RTC avenues, making referral difficult. And as more patients ask for RTC, providers are struggling under the pressure and are also closing their waiting lists to new referrals.3
Private ADHD assessment in the UK can be scheduled in as little as 3 weeks, but does come with a cost of between £500 and £1200.4 GPs can also refuse to accept private diagnoses and therefore the prescription of any advised medication. 5
What the Wait Costs
The cost of waiting years for a diagnosis is not only financial, though the financial reality is stark enough on its own. It is the cost of navigating life without the framework that would explain so much of it.
It is the cost of sitting with three neurodivergent boys — each at different points in their own diagnostic journeys, each needing me to advocate fiercely and knowledgeably for them — while simultaneously trying to understand a brain that nobody has yet formally confirmed as my own. The irony of holding a Level 3 SEND Law qualification, of knowing how to fight a system on behalf of my children, while being failed by that same system myself is not lost on me.
It is the cost of perimenopause landing on top of undiagnosed AuDHD with no clinical acknowledgement of how the two interact. The hormonal crash that completely disrupts dopamine regulation. The brain fog that sits on top of existing executive dysfunction. The emotional dysregulation that increases as oestrogen drops. And the total absence of any professional joining those dots in a way that might actually help.
It is the cost of the Maternal Mental Health crisis I wrote about earlier this year — the PND that went unrecognised as the neurodivergent crisis it also was, because nobody was looking for it.
And it is the quieter, more cumulative cost — the one that is hardest to quantify. The years of wondering why everything feels harder for me, than it looks for everyone else. The self-doubt that fills the space where a diagnosis should be. The energy spent masking, compensating, and holding it all together in ways that are invisible to everyone except the person doing it.
That is what the wait costs. Not just time. Everything that happens inside it.
What Needs to Change
None of what needs to change is complicated. None of it is beyond the capacity of a healthcare system that, when it chooses to, moves quickly and decisively.
Earlier screening for girls in education. The signs of ADHD in girls are present in classrooms every day — in the daydreamer who is written off as quiet, in the people-pleaser who is exhausted by the effort of appearing fine, in the girl who is bright but inconsistent in ways that confuse teachers. Catching ADHD earlier in girls means fewer women arriving at adulthood — and motherhood — without the tools to understand themselves.
Better training for GPs in how ADHD presents in women. A woman who presents to her GP with anxiety, exhaustion, difficulty concentrating, and emotional dysregulation should not leave with only an antidepressant, as I did for decades. She should leave with a conversation about whether something else might also be worth exploring. That conversation costs nothing. The absence of it costs everything.
Reduced NHS waiting times. Four years — potentially five by the time I am seen — is not a waiting list. It is a barrier. For women in crisis, for mothers in the postnatal period, for women in perimenopause when the hormonal shifts make everything harder, a four-year wait is not a delay. It is a denial.
The women waiting for these changes are not waiting quietly. They are working, parenting, advocating, and getting on with it — as women always have. But getting on with it is not the same as being supported. A system that relies on women’s ability to cope is not a system that is working. It is a system that is failing, and calling the failure resilience.
The Wait Continues. So do I…
We deserve better. We have always deserved better. And after four years, I am running out of polite ways to say so.
So, I’m still waiting. I’m still here. I’ll continue renovating the farmhouse, raising the boys, and advocating for women’s health rights. The diagnosis will come. And when it does, it will confirm what I already know.
You are not imagining it. You never were.
Fay x
- ADHD Symptoms in Women vs. ADHD Symptoms in Men: What’s the Difference? – Private ADHD & Autism UK – Online Assessments ↩︎
- ADHD Waiting Times UK 2026 | NHS Assessment Waits · neurobetter ↩︎
- Right to Choose – ADHD UK – Your NHS options ↩︎
- Private ADHD Diagnosis UK Cost: Everything You Need to Know | Private Psychiatry ↩︎
- Right to Choose, Private ADHD Assessments and Shared Care – Tarleton Group Practice ↩︎
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