Autistic masking, also known as camouflaging, is a coping strategy used by autistic individuals to navigate social situations and fit in with neurotypical expectations.
It involves suppressing or hiding autistic traits and behaviors while mimicking or adopting neurotypical social norms and communication styles.
Autistic people may mask to avoid stigma, discrimination, and negative social consequences associated with their autism diagnosis. Masking can also be a way to form connections with others and to be accepted in social settings.
Masking is not exclusive to autism. It is also common for people with ADHD to engage in masking behaviors to appear more neurotypical. However, anyone may mask to some degree.
Imagine you are attending a job interview; you are probably going to put on a professional mask and hold back on some of your more casual behaviors to make a good impression. People who work in retail or customer service likely put on a mask to appear more approachable, smiley, and helpful.
The difference with masking in autistic individuals is that they may mask their traits of autism in most or all settings to appear ‘normal.’ They are hiding who they really are, whether intentionally or unintentionally. This can result in many unwanted consequences.
Common masking behaviors
Masking can take many forms and may vary from person to person. Some common masking behaviors include:
- Forcing eye contact during conversations
- Suppressing stimming behaviors (e.g., hand flapping, rocking, verbal stims)
- Scripting or rehearsing social interactions beforehand
- Mimicking facial expressions, gestures, and tone of voice
- Hiding special interests or pretending to be interested in topics others enjoy
- Avoiding social situations that cause discomfort or anxiety
- Repeating phrases that other people have used (either people they know or from TV shows/movies)
- Putting on a ‘performance’ in social situations
- Thinking about the impression that is made on others and adjusting accordingly
- Forcing social situations and conversations
- Researching ‘social rules’ to better cope in interactions
My experience with masking
One of my masking behaviors is that I try to force myself to make eye contact even though this feels very uncomfortable and too intense for me. I also pay close attention to the facial expressions of the other person and mimic what they do. For example, if my friend is telling a funny story and they are smiling, I will make sure to mirror that smile back to them. If they seem frustrated or sad, I will make sure to alter my expressions and words to match their vibe. I think I have learned to do this so that I do not appear rude or disinterested in the other person. I am very much interested in what they are saying, but it is not natural for me to show this in my face. I don't want the other person to think I do not care, so I make sure to show the appropriate expressions.
Who is more likely to mask autism?
Research suggests that certain groups within the autistic community may be more likely to mask than others.
Girls and women are often better at masking than boys and men, possibly due to societal expectations and gender norms that pressure females to be more socially adept.
For example, people may be more likely to criticize a girl for behaving in ways that are not seen as ‘ladylike’ and so they may be more likely to learn that there are expectations they must meet to avoid scrutiny.
The types of play that girls may typically engage in (e.g., playing house), as well as chatting to each other in groups (as opposed to running about/ rough and tumble play), may mean that girls are more experienced in social and relational skills, which further promotes masking.
Autistic people of color may also mask more frequently to avoid the added stigma and discrimination associated with being a double minority. They may feel pressure to conform to both neurotypical and cultural norms, leading to a greater need to mask their autistic traits.
For instance, if an autistic person of color displays neurodiverse behaviors (e.g., a meltdown from being overstimulated), they may be subjected to harsher criticism than white autistic individuals, and so they learn they must suppress these behaviors.
Additionally, transgender and gender-diverse individuals may use masking as a way to conform to societal expectations and to avoid drawing attention to themselves.
For instance, an autistic transgender man may mask his stimming behaviors and train himself to speak in a lower pitch to better align with traditional masculine norms and to avoid being outed as both autistic and transgender, which could lead to further discrimination and marginalization.
Furthermore, autistic individuals with low support needs, often referred to as “high-functioning,” may also be more likely to mask. These individuals may have the cognitive and verbal abilities to learn and implement masking strategies effectively.
They may feel a greater need to mask to maintain their independence, succeed in their personal and professional lives, and avoid being seen as “less capable” due to their autism diagnosis.
For example, an autistic adult with low support needs may script their conversations, force themselves to make eye contact, and suppress their special interests in the workplace to appear more neurotypical and avoid potential discrimination or negative judgments from colleagues.
It is important to recognize that while these groups may be more likely to mask, masking can occur across the entire autistic spectrum, regardless of age, gender, race, or support needs. The pressure to conform to societal norms and the desire to avoid stigma and discrimination can lead many autistic individuals to adopt masking behaviors to navigate the neurotypical world.
How can masking impact a diagnosis?
Masking can have significant implications for the diagnosis of autism. Here are several ways in which masking can affect the diagnostic process:
Misdiagnosis or Delayed Diagnosis
Autistic individuals who mask may be misdiagnosed or have a delayed diagnosis because their autistic traits are not as apparent to professionals. They may not exhibit the stereotypical behaviors associated with autism, leading to a missed or incorrect diagnosis.
For example, an autistic individual who masks may be misdiagnosed with social anxiety disorder or a personality disorder instead of autism. It may be the case that they do have co-occurring disorders alongside autism, but these may be diagnosed first, and anything other than that may not be considered.
If you attend an autism assessment, it would be helpful to discuss with the professional any prior diagnoses you may have had or suspected you had. This can give them a better understanding of the struggles you have had and whether autism may have played a part.
I was always very socially anxious through childhood and into adulthood and received therapy for social anxiety. While this did help me feel less anxious in social situations, I still felt like I was putting on a performance and not being myself when speaking to others, so I was still struggling. Now I have an autism diagnosis, I know why I had additional social challenges.
If you attend an autism assessment, it would be helpful to discuss with the professional any prior diagnoses you may have had or suspected you had. This can give them a better understanding of the struggles you have had and whether autism may have played a part.
Gender Bias in Diagnostic Rates
The ability to mask can lead to a lack of recognition of autism in females, resulting in a gender bias in diagnostic rates.
Girls and women are often diagnosed later in life than boys and men. This delay in diagnosis can be attributed to the fact that females are often better at masking their autistic traits, leading to a higher likelihood of being overlooked or misdiagnosed.
A meta-analysis found that the male-to-female ratio in autism diagnoses was 4:1, suggesting a significant underdiagnosis of females. The study also highlighted that this gender bias was more pronounced in individuals without intellectual disabilities, possibly due to their increased ability to mask.
Challenges for Professionals in Recognizing Autism
Masking can make it challenging for professionals to assess and diagnose autism accurately. Autistic individuals who mask may not display the stereotypical behaviors associated with autism during diagnostic assessments, leading to missed or incorrect diagnoses.
This can be particularly challenging in short clinical encounters where the individual may be able to maintain their mask for the duration of the assessment.
Moreover, the diagnostic criteria for autism are based on a male-centric understanding of the condition, which may not capture the unique presentation of autism in females or those who mask.
The male-biased conceptualization of autism can lead to a lack of recognition of the different manifestations of autism across genders.
My autism assessment is probably one of the first places where I had to consciously try NOT to mask, which felt very difficult. Luckily, my assessor seemed to pick up on the fact that I was partially masking during the assessment and made sure to ask me questions related to that.
If you think you are someone who resonates with masking behaviors discussed in this article, I think it's helpful to describe these experiences of masking in your autism assessment. I told my assessor that I had researched masking and I related to most behaviors others had described.
If you catch yourself masking during the assessment, don't be afraid to tell the assessor that you believe you may be masking and the specific things you are doing e.g., You can tell them, 'I am trying to consciously make eye contact with you so that I appear more engaged.' This honesty can help to make sure you are recieving an accurate diagnosis.
Lack of Support and Interventions
A delayed or missed diagnosis due to masking can lead to a lack of access to appropriate support and interventions.
Without a timely diagnosis, autistic individuals may not receive the necessary accommodations and services in educational and occupational settings. This can further exacerbate the challenges they face and negatively impact their mental health and well-being.
Misunderstanding of Autistic Experiences
Masking can lead to a misunderstanding of the true experiences and challenges faced by autistic individuals.
Individuals who think they could be autistic may be faced with disbelief from others or accused of lying because they ‘do not seem autistic’ as a result of masking.
Without an understanding that masking is common in autism, support, and empathy may not be given by others.
How to identify masking
The Camouflaging Autistic Traits Questionnaire (CAT-Q), is frequently used to identify masking behaviors in autism. It identifies three key features of masking: compensation, masking, and assimilation.
Compensation involves developing strategies to overcome social and communication difficulties, such as using learned phrases or scripts in social situations.
Masking refers to hiding autistic characteristics, presenting a non-autistic persona, and being aware of the impression made on others, such as monitoring and adjusting facial expressions.
Assimilation involves trying to fit in with others, feeling the need to put on an act around others, and feeling like conversations are not natural.
The CAT-Q may be used in the autism diagnostic process to help professionals identify whether individuals are intentionally or unintentionally hiding their autistic traits. More people may be diagnosed as autistic in recent years due to more of an understanding of autistic masking.
Other consequences of masking
There are many other potential consequences of masking, including:
Burnout
Masking is mentally and emotionally exhausting, often leading to burnout and fatigue. The constant effort to suppress one’s natural behaviors and to adopt a neurotypical persona can be incredibly draining.
Autistic individuals may feel the need to be “on” all the time, constantly monitoring their behavior and adjusting their actions to fit in with neurotypical expectations.
A study found that autistic adults reported feeling exhausted, isolated, and experiencing poor mental and physical health due to the amount of time spent masking. Participants described masking as “an automatic response in order to survive” but one that came at a significant cost to their well-being.
When I was living with housemates, I didn't feel like I could be 100% authentic with them, which meant I was constantly 'on.' I struggled with depressed feelings during this time, which looking back, could well have been burnout from masking.
Mental health challenges
Masking has been associated with an increased risk of mental health problems, such as anxiety, depression, and low self-esteem.
Research has found that autistic adults who reported higher levels of camouflaging also reported higher levels of anxiety and depression. The study suggested that the pressure to conform to neurotypical norms and the constant effort to mask one’s true self can have detrimental effects on mental health.
People-pleasing
Masking can lead to people-pleasing behaviors and a fear of rejection, as autistic individuals may prioritize the needs and expectations of others over their own.
Autistic individuals may feel pressured to agree with others, avoid conflict, and maintain a certain image to be accepted and liked.
Dr. Devon Price in his book ‘Unmasking Autism‘ explains that a core feature of masking is setting one’s own feelings aside so we can focus on pleasing others or conforming to social norms. He adds that it can be “damaging to put social approval and ‘passing’ as neurotypical above our actual needs.”
A study found that autistic adults reported engaging in people-pleasing behaviors as part of their camouflaging strategies.
Participants described agreeing with others even when they disagreed, avoiding expressing their own opinions, and prioritizing others’ needs over their own to maintain social relationships and avoid rejection.
Substance-use
Some autistic individuals may turn to substance use as a way to cope with the stress and anxiety associated with masking.
The constant pressure to fit in and the exhaustion that comes with masking may lead some individuals to seek relief through alcohol or drugs. Using substances can also be a way to dull sensory sensitivities.
While research specifically linking masking to substance misuse in autistic individuals is limited, studies have shown higher rates of substance use disorders in the autistic population compared to the general population. The added stress and mental health challenges associated with masking may contribute to an increased risk of substance misuse.
Dr. Price explains:
“Social norms are loosened when people are drinking… If you say something weird at a party, drunk people might forget it ever happened. The ease of being around other drunk people can itself be kind of intoxicating. Unfortunately, relying on substances in order to feel at ease or connected can rapidly become self-destructive.”
Identity issues
Masking can lead to identity issues and a sense of not knowing one’s true self. Autistic individuals who spend significant time and energy masking may feel like they are living a double life, constantly switching between their authentic autistic self and their neurotypical persona.
For myself, I felt like I had a different mask for each person I socialized with. Then when these people came together in a group setting, I would feel overwhelmed from not knowing which mask to put on to please everyone.
Researchers argue that masking can be seen as a form of identity suppression, where autistic individuals feel pressured to hide their true selves to fit in with societal norms. This constant suppression of one’s identity can lead to feelings of self-doubt, confusion, and a lack of self-acceptance.
Is masking ever a good thing?
While there are a lot of downsides to masking autism, many may find benefits to masking from time to time.
Masking can help autistic individuals navigate social situations more smoothly, potentially leading to increased social acceptance and opportunities in education and employment.
It can also serve as a protective mechanism in situations where autistic people would feel unsafe showing their true selves. For example, it can help with avoiding being bullied or discriminated against.
While masking may provide short-term benefits in certain situations, it is not a sustainable or healthy long-term strategy for autistic individuals. Instead, the focus should be on creating more accepting and inclusive environments that embrace neurodiversity.
Unmasking and embracing autistic identity
It can be important for autistic individuals to have the opportunity to unmask and embrace their autistic identity. Building awareness and understanding of autism can help reduce the stigma and discrimination that often leads to masking.
Benefits of Unmasking
Unmasking and being true to oneself can have significant benefits for mental health and well-being.
If low self-esteem, anxiety, and depression are increased when autistic people mask, it then makes sense that dropping the mask can help improve these issues. Autistic individuals who feel accepted and valued for who they are may experience a greater sense of belonging.
Researchers suggest that unmasking can lead to a more authentic sense of self and improved relationships with others. When autistic individuals feel safe to be their true selves, they can form deeper connections with those around them and experience a greater sense of belonging and acceptance.
Moreover, unmasking can help reduce the cognitive and emotional burden associated with constantly suppressing one’s natural behaviors and traits. By embracing their autistic identity, individuals can conserve the energy previously spent on masking and redirect it towards more fulfilling pursuits and self-care.
How to Start Unmasking
Starting the process of unmasking can be challenging, especially for those who have been masking for most of their lives.
Dropping the mask is not as simple as flicking a switch to turn it off. Remember, masking is a behavior that has been learned and reinforced for many years for some people. Unmasking is a gradual process and may take time and patience.
Here is a step-by-step guide to help start your unmasking journey:
- Reflect on your masking behaviors: Take time to identify the specific ways in which you mask, such as suppressing stimming, forcing eye contact, or scripting social interactions.
- Identify safe spaces and people: Start by finding supportive environments and relationships where you feel comfortable being your authentic self. It may be best to start with a trusted friend or family member.
- Set small goals: Begin by setting small, achievable goals for unmasking, such as stimming openly in a safe space or sharing a special interest with a trusted friend.
- Reflect on what happened: After the social situation, consider how it went. Did the other person respond well? Did they even notice that you were stimming?
- Gradually increase unmasking: As you become more comfortable, gradually increase your unmasking behaviors in different settings and with more people. Remember to go at your own pace.
- Practice self-compassion: Unmasking can be emotionally challenging, so it’s important to practice self-compassion and be kind to yourself throughout the process. Celebrate your progress and recognize that setbacks are a normal part of the journey.
- Seek support: Don’t hesitate to seek support from friends, family, therapists, or support groups as you navigate the unmasking process. Remember that you are not alone.
I have found that when I mention to people that I am autistic, I feel I can be more myself around them. While this may not work for everyone (only people I feel safe around), I've found that this disclosure helps break down that barrier for me. Most people I have told have been very understanding and have asked interesting and respectful questions and it has opened up exciting discussions. I've found that people are also more open to sharing about themselves when I am honest with them. As someone who has a strong interest in the brain and human behavior, I really enjoy getting into these conversations!
It is crucial to remember that unmasking is a personal journey and may look different for everyone. Some individuals may choose to unmask in certain settings or with specific people, while others may feel comfortable unmasking more broadly. The key is to find a balance that feels safe and authentic to the individual.
Celebrating Neurodiversity
Celebrating neurodiversity and recognizing the strengths and unique perspectives of autistic individuals can help create a more inclusive society.
By embracing autistic identity and challenging societal norms, we can work towards a world where autistic individuals feel empowered to be themselves without the need to mask.
This involves promoting a more diverse understanding of autism and challenging stereotypes and misconceptions. It means recognizing that autistic individuals have valuable contributions to make and that their differences should be celebrated rather than stigmatized.
On an individual level, we can work to educate ourselves and others about autism and challenge our own biases and assumptions. On a systemic level, we can advocate for policies and practices that support the inclusion and empowerment of autistic individuals in all aspects of society.
By celebrating neurodiversity and creating a more accepting world, we can help reduce the pressure to mask and allow autistic individuals to thrive as their authentic selves.
How do I know if I am masking autism?
If you are considering whether you are masking autism, it may be helpful to review the following advice:
Consider these reflective questions
Ask yourself the following questions to help you understand if you may be masking autism:
- Do you find social situations exhausting?
- Do you feel like you have to hold back on talking about your interests for fear of looking ‘weird’?
- Do you spend much of a social interaction hyperfocused on the impression you are making?
- Do you speak and behave differently around different people?
- Do you tend to match the energy of people you are talking to?
- Do you ever feel like no one knows the real you?
- Do you make a conscious effort to sit still and not fidget when around others?
- Do you pretend to understand (e.g., a joke someone has made) so that you do not look foolish?
- Do you watch other people ‘master’ social interactions and wish you could do that too?
While answering ‘yes’ to any one of these questions may not 100% mean you are masking autism, if you answer ‘yes’ to most or all of them, it could indicate that you are. If you suspect that you could be autistic, it is recommended to speak to a professional or do further research into this.
Complete the CAT-Q
Take the CAT-Q to see whether you might be masking autistic traits. This should only take around 5-10 minutes to read and respond to the 25 statements included in the questionnaire.
At the end, it will give you a total score as well as score breakdowns for compensation, assimilation, and masking. You can see how your score compares to other autistic individuals and those of your gender too.
Look into the lived experiences of other autistic individuals
The most experienced people who can tell you about masking autism are autistic people themselves!
There are helpful communities online and in-person for autistic individuals where they share their first-hand experiences of living as an autistic person.
Try listening to podcasts or watching videos of people who are autistic to get a better understanding of how they mask and what it feels like.
It really helped me to listen to other autistic people’s experiences of masking when I was considering if I may be autistic. It didn’t take me that long to realize, ‘Oh, this is literally describing my life!’
Likewise, you can read books by autistic authors. I really enjoyed reading ‘Unmasking Autism‘ by Dr. Devon Price, who gives a great overview of what masking looks like, accounts from other autistic individuals, and a discussion of ways in which we can drop the mask and embrace neurodiversity.
References
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Butwicka, A., Långström, N., Larsson, H., Lundström, S., Serlachius, E., Almqvist, C., … & Lichtenstein, P. (2017). Increased risk for substance use-related problems in autism spectrum disorders: A population-based cohort study. Journal of autism and developmental disorders, 47, 80-89. https://doi.org/10.1007/s10803-016-2914-2
Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of autism and developmental disorders, 49(5), 1899-1911. https://doi.org/10.1007/s10803-018-03878-x
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Fung, W. K., & Cheng, R. W. Y. (2017). Effect of school pretend play on preschoolers’ social competence in peer interactions: Gender as a potential moderator. Early Childhood Education Journal, 45, 35-42. https://doi.org/10.1007/s10643-015-0760-z
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M. C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of autism and developmental disorders, 47, 2519-2534. https://doi.org/10.1007/s10803-017-3166-5
Lai, M. C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Auyeung, B., Szatmari, P., … & MRC AIMS Consortium. (2017). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690-702. https://doi.org/10.1177/13623613166710
Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474. https://doi.org/10.1016/j.jaac.2017.03.013
Mandy, W. (2019). Social camouflaging in autism: Is it time to lose the mask?. Autism, 23(8), 1879-1881. https://doi.org/10.1177/136236131987855
Pearson, A., & Rose, K. (2021). A conceptual analysis of autistic masking: Understanding the narrative of stigma and the illusion of choice. Autism in Adulthood, 3(1), 52-60. https://doi.org/10.1089/aut.2020.0043
Price, D. (2022). Unmasking autism: discovering the new faces of neurodiversity (First edition.). Harmony Books.
Strang, J. F., Powers, M. D., Knauss, M., Sibarium, E., Leibowitz, S. F., Kenworthy, L., … & Anthony, L. G. (2018). “They thought it was an obsession”: Trajectories and perspectives of autistic transgender and gender-diverse adolescents. Journal of autism and developmental disorders, 48, 4039-4055. https://doi.org/10.1007/s10803-018-3723-6
