Why are girls under diagnosed with ADHD? Is it because of their presenting symptoms?

According to the literature, ADHD is diagnosed in females 1:3 compared to males. This does not show that ADHD is present lesser in females, but due to the presenting symptoms not being disruptive or hyperactive (Sayal et al., 2018), parents tend to not seek evaluation or treatment, thus prolonging suffering and difficulties with emotional dysregulation and within academics. Most studies which had focused on males with ADHD, it has been known that there are other domains which are unique to females with ADHD. These are sleep dysregulation, which is more prevalent compared to males, along with symptoms of internalizing disorders (Beckers et al., 2018).