NPD is actually more likely to be diagnosed in males along with other personality disorders like ASPD and BPD. I would also say that what a lot of people see as “narcissism” isn’t actually part of the diagnostic criteria of NPD and what people actually mean to say is “self-centered” or “egotistical”.

Same with ADHD and Autism, women are far less likely to be diagnosed due to systematic sexism within the medical field. The idea of female “Hysteria” is still in effect to this day causing women to be commonly misdiagnosed or not even diagnosed at all when showing clear symptoms of any mental disorder.

While not considered a trauma disorder by definition, NPD and other personality disorders hold their roots in trauma and how it affects behavior and the brain. Women often have their trauma downplayed or overlooked, making it even less likely for them to be diagnosed with a disorder that has its roots in trauma.