Wrapping up the importance of support for female adolescent ADHDers

This post is the fourth of four in a miniseries addressing how some female aADHDers use sex to improve social standing.

Sexual vulnerability in female adolescent ADHDers (aADHDers) develop through three interlinked cycles that begin early in life with ADHD Baseline Trauma (Underhill, 2025a). The Risky Sexual Behavior cycle often begins as the ADHDer enters adolescence and social environments increase in scope and complexity. Interactions and relationships gain additional importance in social standing, and many female aADHDers are prone to make entry into social groups in any way possible, including the utilization of risky sexual behavior. The resultant shame and reduced sexual and relationship esteem then extend into and throughout adult life.

Figure 1: the three interlinked cycles of female aADHD sexuality.

Cycle 4: Conclusion

ADHD can be defined by a spider web of interdependent neurophysiological states, social traits, and interpersonal qualities which exist within and around a complex inner world filled with subtle executive dysfunction which neurotypicals have probably never experienced and generally cannot understand (Underhill, 2025b). The inner ADHD world forms a coherent, culturally-distinct set of values, communication patterns, and behavioral norms that diverge from neurotypical norms. When a therapist views ADHD through this cultural lens, differences in lifespan and sexual development, relational functioning, and self-esteem and identity often become apparent.

The need to be accepted puts all aADHDers at greater risk of RSB. When not addressed through a holistic therapeutic lens, the consequences of minimizing the affects of sexuality and sexual peer pressure often fail to address the implications of shame, regret, or emotional confusion. Acknowledging sexuality in female aADHDers is not about adultizing or sexualizing them—it is about supporting their right to understand their bodies, express curiosity, and stay socially, physically, and emotionally safe within a larger culture where most ADHDers struggle to fit in.

Tommy will be presenting this research at the 2026 International Symposium on Sex Therapy in Budapest, Hungary.

Sources

Underhill, T. (2025a). ADHD Baseline Trauma in Romantic Relationships. International Journal of Psychosexual Therapists, 1(1). doi:10.64207/x41fc649

Underhill, T. (2025b). Minimizing the impact of executive function in relationships with ADHD. In C. Jacobson (Ed.), Bridging Theory and Practice in Psychosexual Therapy: Global Insights into Cultural and Clinical Dynamics. Cambridge Scholars Publishing.