Autistic masking

There is no universally agreed-upon terminology for the concept.{{Rp|pages=16–17}}{{Cite journal |last1=Cook |first1=Julia |last2=Hull |first2=Laura |last3=Crane |first3=Laura |last4=Mandy |first4=William |date=2021 |title=Camouflaging in autism: A systematic review |url=https://www.sciencedirect.com/science/article/pii/S0272735821001239 |journal=Clinical Psychology Review |language=en |volume=89 |pages=102080 |doi=10.1016/j.cpr.2021.102080 |pmid=34563942 |s2cid=237942158 |issn=0272-7358}} While some use the terms masking and camouflaging synonymously,{{Cite journal |last1=Pearson |first1=Amy |last2=Rose |first2=Kieran |date=2021 |title=A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice |journal=Autism in Adulthood |volume=3 |issue=1 |pages=52–60 |doi=10.1089/aut.2020.0043 |pmc=8992880 |pmid=36601266}}{{Rp|pages=16–17}} others distinguish between masking (the suppression of behaviors) and compensation (of social difficulties) as the two main forms of camouflaging.{{Cite journal |last1=Livingston |first1=Lucy Anne |last2=Shah |first2=Punit |last3=Happé |first3=Francesca |author-link3=Francesca Happé |date=2019 |title=Compensatory strategies below the behavioural surface in autism: a qualitative study |url=https://doi.org/10.1016/s2215-0366(19)30224-x |url-status=live |journal=The Lancet Psychiatry |volume=6 |issue=9 |pages=766–777 |doi=10.1016/s2215-0366(19)30224-x |pmc=6706698 |pmid=31350208 |archive-url=https://web.archive.org/web/20240803152545/https://linkinghub.elsevier.com/retrieve/pii/S221503661930224X |archive-date=2024-08-03 |access-date=2023-05-05}} Among autistic people, masking is the most commonly used umbrella term.{{Rp|page=16}}{{Cite web |last=Cassidy |first=Elizabeth |date=2018-08-16 |title=Autistic Adults Start Campaign to Put an End to This 'Harmful' Behavior |url=https://themighty.com/topic/autism-spectrum-disorder/take-the-mask-off-campaign-autism-masking/ |access-date=2023-05-08 |website=The Mighty |language=en |archive-date=2023-04-26 |archive-url=https://web.archive.org/web/20230426173233/https://themighty.com/topic/autism-spectrum-disorder/take-the-mask-off-campaign-autism-masking/ |url-status=live }} Cited as an example in {{Cite journal |last1=Petrolini |first1=Valentina |last2=Rodríguez-Armendariz |first2=Ekaine |last3=Vicente |first3=Agustín |date=2023 |title=Autistic camouflaging across the spectrum |url=https://linkinghub.elsevier.com/retrieve/pii/S0732118X22000629 |journal=New Ideas in Psychology |language=en |volume=68 |pages=100992 |doi=10.1016/j.newideapsych.2022.100992 |hdl=10810/59712 |s2cid=253316582 |hdl-access=free |access-date=2023-05-05 |archive-date=2023-07-20 |archive-url=https://web.archive.org/web/20230720013850/https://linkinghub.elsevier.com/retrieve/pii/S0732118X22000629 |url-status=live }} Autistic researcher Wenn Lawson has proposed that adaptive morphing is a more fitting term.{{Cite journal |last=Lawson |first=Wenn B. |date=2020 |title=Adaptive Morphing and Coping with Social Threat in Autism: An Autistic Perspective |journal=Journal of Intellectual Disability - Diagnosis and Treatment |volume=8 |issue=3 |pages=519–526 |doi=10.6000/2292-2598.2020.08.03.29 |doi-access=free}}

{{Rquote |1=right |2=I camouflage by putting on a character… I treat my clothes rather like costumes, and certain items of clothing help me to uphold certain personality characteristics of which character I am on that occasion. I have a repertoire of roles for: cafe work, bar work, uni, various groups of friends, etc. They are all me at the core, but they are edited versions of me, designed to not stand out for the "wrong" reasons.|3=(Female, 22)|4=}}

Typical examples of autistic masking include the suppression of stimming (in general or in public{{Cite journal |last1=Miller |first1=Danielle |last2=Rees |first2=Jon |last3=Pearson |first3=Amy |date=2021-12-01 |title="Masking Is Life": Experiences of Masking in Autistic and Nonautistic Adults |journal=Autism in Adulthood: Challenges and Management |volume=3 |issue=4 |pages=330–338 |doi=10.1089/aut.2020.0083 |issn=2573-959X |pmc=8992921 |pmid=36601640}}) and reactions to sensory overload. To compensate for difficulties in social interaction with neurotypical peers, autistic people might maintain eye contact despite discomfort{{cite journal | doi=10.1371/journal.pone.0188446 | doi-access=free | title=How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts | date=2017 | last1=Trevisan | first1=Dominic A. | last2=Roberts | first2=Nicole | last3=Lin | first3=Cathy | last4=Birmingham | first4=Elina | journal=PLOS ONE | volume=12 | issue=11 | pages=e0188446 | pmid=29182643 | pmc=5705114 | bibcode=2017PLoSO..1288446T }}{{cite journal | doi=10.1007/s10803-024-06296-4 | title=Deliberate and Self-Conscious Adaptation of Eye-Contact by Autistic Adults | date=2024 | last1=Garvey | first1=Alison | last2=Ryan | first2=Christian | last3=Murphy | first3=Mike | journal=Journal of Autism and Developmental Disorders | pmid=38728003 | doi-access=free }} or mirror the body language and tone of others.{{Cite journal |last1=Hull |first1=Laura |last2=Petrides |first2=K. V. |last3=Mandy |first3=William |date=2020 |title=The Female Autism Phenotype and Camouflaging: a Narrative Review |journal=Review Journal of Autism and Developmental Disorders |language=en |volume=7 |issue=4 |pages=306–317 |doi=10.1007/s40489-020-00197-9|s2cid=256402443 |doi-access=free }}

Autistic people with conversational difficulties may also use more complex strategies, such as scripting a conversation outline, developing conscious "rules" for conversations, and carefully monitoring if these are being followed. Many autistic people learn conversational rules and social behaviors by watching television shows and other media and by observing and mimicking a character's behavior. Masking may also include refraining from talking about passionate interests.

Masking requires an exceptional effort. It is linked with adverse mental health outcomes {{Cite journal |last1=Klein |first1=Jessica |last2=Krahn |first2=Rachel |last3=Howe |first3=Stephanie |last4=Lewis |first4=Jessi |last5=McMorris |first5=Carly |last6=Macoun |first6=Sarah |date=2024 |title=A systematic review of social camouflaging in autistic adults and youth: Implications and theory |journal=Development and Psychopathology |pages=1–15 |doi=10.1017/S0954579424001159 |pmid=39370528 |doi-access=free}}{{Cite journal |last1=Zhuang |first1=Sici |last2=Tan |first2=Diana Weiting |last3=Reddrop |first3=Susan |last4=Dean |first4=Lydia |last5=Maybery |first5=Murray |last6=Magiati |first6=Iliana |date=2023 |title=Psychosocial factors associated with camouflaging in autistic people and its relationship with mental health and well-being: A mixed methods systematic review |journal=Clinical Psychology Review |volume=105 |pages=102335 |doi=10.1016/j.cpr.2023.102335 |pmid=37741059 |doi-access=free}}{{Cite journal |last1=Khudiakova |first1=Valeria |last2=Russell |first2=Emmeline |last3=Sowden-Carvalho |first3=Sophie |last4=Surtees |first4=Andrew D. R. |date=2024 |title=A systematic review and meta-analysis of mental health outcomes associated with camouflaging in autistic people |journal=Research in Autism Spectrum Disorders |volume=118 |pages=102492 |doi=10.1016/j.rasd.2024.102492 |doi-access=free}} such as stress,{{Cite journal |last=Radulski |first=Elizabeth M. |date=2022 |title=Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of Neurodiversity |url=https://doi.org/10.1159/000524122 |journal=Human Development |volume=66 |issue=2 |pages=113–127 |doi=10.1159/000524122|s2cid=248864273 |url-access=subscription }} anxiety, depression, and other psychological disorders, loss of identity, and suicidality.{{Cite journal |last1=Cassidy |first1=Sarah |last2=Bradley |first2=Louise |last3=Shaw |first3=Rebecca |last4=Baron-Cohen |first4=Simon |author-link4=Simon Baron-Cohen |date=2018 |title=Risk markers for suicidality in autistic adults |journal=Molecular Autism |volume=9 |issue=1 |pages=42 |doi=10.1186/s13229-018-0226-4 |issn=2040-2392 |pmc=6069847 |pmid=30083306 |doi-access=free }}{{Cite journal |last1=Cassidy |first1=S. A. |last2=Gould |first2=K. |last3=Townsend |first3=E. |last4=Pelton |first4=M. |last5=Robertson |first5=A. E. |last6=Rodgers |first6=J. |date=2020 |title=Is Camouflaging Autistic Traits Associated with Suicidal Thoughts and Behaviours? Expanding the Interpersonal Psychological Theory of Suicide in an Undergraduate Student Sample |url=https://doi.org/10.1007/s10803-019-04323-3 |journal=Journal of Autism and Developmental Disorders |language=en |volume=50 |issue=10 |pages=3638–3648 |doi=10.1007/s10803-019-04323-3 |pmc=7502035 |pmid=31820344}}{{cite journal |last1=Cage |first1=Eilidh |year=2017 |title=Experiences of Autism Acceptance and Mental Health in Autistic Adults |journal=Journal of Autism and Developmental Disorders |volume=49 |issue=2 |pages=473–484 |doi=10.1007/s10803-017-3342-7 |pmc=5807490 |pmid=29071566 |doi-access=free}} According to a recent meta analysis, the association between masking and depression, general anxiety, and social anxiety appear consistent across different age groups (children, adolescents, and adults). Some studies find that compensation strategies are seen as contributing to leading a successful life. Since many studies on masking focus on autistic adolescents or adults without cognitive impairments, the generalizability of such findings across the autism spectrum is uncertain.

Masking may conceal the person's need for support. It can complicate a diagnosis of autism spectrum disorder (ASD), for example, under-diagnosis for females, particularly past childhood, as relevant symptoms are suppressed or compensated for.{{cite journal | url=https://doi.org/10.1177/13623613241295318 | doi=10.1177/13623613241295318 | title=A qualitative exploration of the experience of autistic females in Hong Kong | date=2024 | last1=Lam | first1=Gary Yu Hin | last2=Chow | first2=Constance Kit Ching | last3=Chan | first3=Sibyl Wai | journal=Autism | volume=29 | issue=4 | pages=1047–1057 | pmid=39704367 | url-access=subscription }}{{Cite book |last=American Psychiatric Association |title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision |publisher=American Psychiatric Association |year=2022 |isbn=978-0-89042-575-6 |location=Washington, DC |doi=10.1176/appi.books.9780890425787 |s2cid=249488050}}{{Rp|pages=60–62}} The diagnostic criteria for ASD in the DSM-5 published in 2013 explicitly state that while symptoms "must be present in the early developmental period", these "may be masked by learned strategies in later life", allowing for a diagnosis even if autistic behaviors and difficulties are successfully masked.{{Rp|page=57}}{{Citation |last1=Kapp |first1=Steven K. |title=Lobbying Autism's Diagnostic Revision in the DSM-5 |date=2020 |work=Autistic Community and the Neurodiversity Movement: Stories from the Frontline |pages=167–194 |editor-last=Kapp |editor-first=Steven K. |url=https://link.springer.com/content/pdf/10.1007/978-981-13-8437-0_13.pdf |access-date=2023-06-08 |archive-url=https://web.archive.org/web/20230608195531/https://link.springer.com/content/pdf/10.1007/978-981-13-8437-0_13.pdf |archive-date=2023-06-08 |url-status=live |place=Singapore |publisher=Palgrave Macmillan |language=en |doi=10.1007/978-981-13-8437-0_13 |isbn=978-981-13-8437-0 |s2cid=209465381 |last2=Ne'eman |first2=Ari |author-link2=Ari Ne'eman |doi-access=free}} Addition of such a formulation was proposed to the workgroup drafting the criteria by representatives of the Autistic Self Advocacy Network including Ari Ne'eman and Steven Kapp.{{Citation |last1=Kapp |first1=Steven K. |title=Lobbying Autism's Diagnostic Revision in the DSM-5 |date=2020 |work=Autistic Community and the Neurodiversity Movement: Stories from the Frontline |pages=167–194 |editor-last=Kapp |editor-first=Steven K. |url=https://link.springer.com/content/pdf/10.1007/978-981-13-8437-0_13.pdf |access-date=2023-06-08 |archive-url=https://web.archive.org/web/20230608195531/https://link.springer.com/content/pdf/10.1007/978-981-13-8437-0_13.pdf |archive-date=2023-06-08 |url-status=live |place=Singapore |publisher=Palgrave Macmillan |language=en |doi=10.1007/978-981-13-8437-0_13 |isbn=978-981-13-8437-0 |s2cid=209465381 |last2=Ne'eman |first2=Ari |author-link2=Ari Ne'eman |doi-access=free}} The diagnostic criteria for ASD in the ICD-11 (2022) contain a similar provision.{{Cite web |date=2023 |title=6A02 Autism spectrum disorder. |url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/437815624 |url-status=live |archive-url=https://archive.today/20180801205234/https://icd.who.int/browse11/l-m/en%23/http://id.who.int/icd/entity/294762853#/http://id.who.int/icd/entity/437815624 |archive-date=2018-08-01 |access-date=2023-05-05 |website=ICD-11 for Mortality and Morbidity Statistics |publisher=World Health Organization}}

It has been hypothesized that masking may play an important role in explaining why autistic women and non-binary persons are significantly less often recognized and diagnosed as autistic compared to men. This hypothesis was put forward by Lorna Wing as early as 1981{{Rp|page=20}}{{Cite journal |last=Wing |first=Lorna |author-link=Lorna Wing |date=1981 |title=Sex ratios in early childhood autism and related conditions |url=https://linkinghub.elsevier.com/retrieve/pii/0165178181900433 |journal=Psychiatry Research |language=en |volume=5 |issue=2 |pages=129–137 |doi=10.1016/0165-1781(81)90043-3 |pmid=6945608 |s2cid=41912698 |access-date=2023-05-07 |archive-date=2022-04-14 |archive-url=https://web.archive.org/web/20220414111452/https://linkinghub.elsevier.com/retrieve/pii/0165178181900433 |url-status=live |url-access=subscription }}{{Rp|page=134}} and is recognized in the DSM-5-TR published in 2022.{{Rp|page=65}}

While masking was written about and discussed among autistic people, it has only become a focus of academic research since the 2010s.{{Rp|page=18}} The Camouflaging Autistic Traits Questionnaire (CAT-Q), the first self-report measure for camouflaging, was published in 2018.{{Cite journal |last1=Hull |first1=Laura |last2=Mandy |first2=William |last3=Lai |first3=Meng-Chuan |last4=Baron-Cohen |first4=Simon |author-link4=Simon Baron-Cohen |last5=Allison |first5=Carrie |last6=Smith |first6=Paula |last7=Petrides |first7=K. V. |date=2019 |orig-date=Published 25 October 2018 |title=Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q) |journal=Journal of Autism and Developmental Disorders |language=en |volume=49 |issue=3 |pages=819–833 |doi=10.1007/s10803-018-3792-6 |pmc=6394586 |pmid=30361940}}{{Cite journal |last=Williams |first=Zachary J. |date=2022 |title=Commentary: The construct validity of 'camouflaging' in autism: psychometric considerations and recommendations for future research - reflection on Lai et al. (2020) |journal=Journal of Child Psychology and Psychiatry |language=en |volume=63 |issue=1 |pages=118–121 |doi=10.1111/jcpp.13468 |pmc=8678389 |pmid=34145574}} Across 25 items, it measures the extent to which a person utilizes strategies to actively compensate for difficulties in social situations (Compensation, 9 items), uses strategies to hide autistic characteristics or portray a non-autistic persona (Masking, 8 items), and employs strategies to fit in with others in social situations (Assimilation, 8 items). Other researchers have criticized the use of self-report measures, arguing that self-report may exclude understudied groups within autism, such as individuals with linguistic disabilities.{{Cite journal |last1=Petrolini |first1=Valentina |last2=Rodríguez-Armendariz |first2=Ekaine |last3=Vicente |first3=Agustín |date=2023-01-01 |title=Autistic camouflaging across the spectrum |journal=New Ideas in Psychology |volume=68 |pages=100992 |doi=10.1016/j.newideapsych.2022.100992 |s2cid=253316582 |issn=0732-118X |doi-access=free |hdl=10810/59712 |hdl-access=free }}

In light of rising awareness of the adverse mental health outcomes of masking and insight into the double empathy problem, therapies and interventions with implicit or explicit targets of instilling neurotypical social behavior and suppressing autistic traits that can be adaptive in autistic people are controversial and often criticized by some researchers, neurodiversity proponents, and autistic self-advocates from the autism rights movement.{{cite journal | url=https://onlinelibrary.wiley.com/doi/pdf/10.1002/eahr.500188 | doi=10.1002/eahr.500188 | title=A Passing Problem: Evaluating Harm and Benefit in Autism Research | date=2023 | last1=Ne'Eman | first1=Ari | last2=Richman | first2=Kenneth A. | last3=McCarthy | first3=Allison M. | last4=Wilkenfeld | first4=Daniel | journal=Ethics & Human Research | volume=45 | issue=6 | pages=2–18 | pmid=37988276 | url-access=subscription }}{{cite journal | pmc=8957386 | date=2021 | last1=Ne'Eman | first1=A. | title=When Disability is Defined by Behavior, Outcome Measures Should Not Promote "Passing" | journal=AMA Journal of Ethics | volume=23 | issue=7 | pages=E569–E575 | doi=10.1001/amajethics.2021.569 | pmid=34351268 }}{{Cite journal |last1=Schuck |first1=Rachel K. |last2=Tagavi |first2=Daina M. |last3=Baiden |first3=Kaitlynn M. P. |last4=Dwyer |first4=Patrick |last5=Williams |first5=Zachary J. |last6=Osuna |first6=Anthony |last7=Ferguson |first7=Emily F. |last8=Jimenez Muñoz |first8=Maria |last9=Poyser |first9=Samantha K. |last10=Johnson |first10=Joy F. |last11=Vernon |first11=Ty W. |date=2022 |title=Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework |url=https://doi.org/10.1007/s10803-021-05316-x |journal=Journal of Autism and Developmental Disorders |language=en |volume=52 |issue=10 |pages=4625–4645 |doi=10.1007/s10803-021-05316-x |pmc=9508016 |pmid=34643863 |access-date=2023-05-05 |archive-date=2024-08-03 |archive-url=https://web.archive.org/web/20240803153050/https://link.springer.com/article/10.1007/s10803-021-05316-x |url-status=live }}{{Cite journal |last1=Dawson |first1=Geraldine |last2=Franz |first2=Lauren |last3=Brandsen |first3=S. |date=2022 |title=At a Crossroads—Reconsidering the Goals of Autism Early Behavioral Intervention From a Neurodiversity Perspective |journal=JAMA Pediatrics |volume=176 |issue=9 |pages=839–840 |doi=10.1001/jamapediatrics.2022.2299 |pmc=10069446 |pmid=35816341 }}{{Cite journal |last1=Leadbitter |first1=Kathy |last2=Buckle |first2=Karen Leneh |last3=Ellis |first3=Ceri |last4=Dekker |first4=Martijn |date=2021-04-12 |title=Autistic Self-Advocacy and the Neurodiversity Movement: Implications for Autism Early Intervention Research and Practice |journal=Frontiers in Psychology |volume=12 |doi=10.3389/fpsyg.2021.635690 |issn=1664-1078 |pmc=8075160 |pmid=33912110 |doi-access=free}} Some autistic adults who experienced applied behavior analysis therapy as children describe being forced to behave like neurotypical peers with detrimental effects on their mental and overall well-being.{{Cite journal |last1=McGill |first1=Owen |last2=Robinson |first2=Anna |date=2020 |title="Recalling hidden harms": autistic experiences of childhood applied behavioural analysis (ABA) |url=https://strathprints.strath.ac.uk/73753/1/McGill_Robinson_AA_2020_autistic_experiences_of_childhood_Applied_Behavioural_Analysis.pdf |url-status=live |journal=Advances in Autism |volume=7 |issue=4 |pages=269–282 |doi=10.1108/AIA-04-2020-0025 |s2cid=225282499 |archive-url=https://web.archive.org/web/20220703114012/https://strathprints.strath.ac.uk/73753/1/McGill_Robinson_AA_2020_autistic_experiences_of_childhood_Applied_Behavioural_Analysis.pdf |archive-date=2022-07-03 |access-date=2023-05-12 |via=Strathprints (University of Strathclyde)}}{{Cite journal |last=Anderson |first=Laura K |date=2023 |title=Autistic experiences of applied behavior analysis |journal=Autism |volume=27 |issue=3 |pages=737–750 |doi=10.1177/13623613221118216 |pmid=35999706 |s2cid=251766661}}{{cite journal | url=https://link.springer.com/content/pdf/10.1007/s10803-022-05644-6.pdf | doi=10.1007/s10803-022-05644-6 | title='If I don't do It, I'm Out of Rhythm and I Can't Focus as Well': Positive and Negative Adult Interpretations of Therapies Aimed at 'Fixing' Their Restricted and Repetitive Behaviours in Childhood | date=2023 | last1=McCormack | first1=Lynne | last2=Wong | first2=Sze Wing | last3=Campbell | first3=Linda E. | journal=Journal of Autism and Developmental Disorders | volume=53 | issue=9 | pages=3435–3448 | pmid=35781855 | pmc=10465631 }} In response to these concerns and accounts regarding risks of harm, some forms of ABA interventions have been reforming to mitigate risks of encouraging masking.{{Cite journal |last1=Schuck |first1=Rachel K. |last2=Tagavi |first2=Daina M. |last3=Baiden |first3=Kaitlynn M. P. |last4=Dwyer |first4=Patrick |last5=Williams |first5=Zachary J. |last6=Osuna |first6=Anthony |last7=Ferguson |first7=Emily F. |last8=Jimenez Muñoz |first8=Maria |last9=Poyser |first9=Samantha K. |last10=Johnson |first10=Joy F. |last11=Vernon |first11=Ty W. |date=2022 |title=Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework |url=https://doi.org/10.1007/s10803-021-05316-x |journal=Journal of Autism and Developmental Disorders |language=en |volume=52 |issue=10 |pages=4625–4645 |doi=10.1007/s10803-021-05316-x |pmc=9508016 |pmid=34643863 |access-date=2023-05-05 |archive-date=2024-08-03 |archive-url=https://web.archive.org/web/20240803153050/https://link.springer.com/article/10.1007/s10803-021-05316-x |url-status=live }}{{cite journal | url=https://journals.sagepub.com/doi/pdf/10.1177/27546330241266718 | doi=10.1177/27546330241266718 | title=A qualitative investigation into autistic adults' perspectives on intervention goals for autistic children | date=2024 | last1=Schuck | first1=Rachel K. | last2=Geng | first2=Alicia | last3=Doss | first3=Yvette | last4=Lin | first4=Florence | last5=Crousore | first5=Hannah | last6=Baiden | first6=Kaitlynn M. P. | last7=Dwyer | first7=Patrick | last8=Williams | first8=Zachary J. | last9=Wang | first9=Mian | journal=Neurodiversity | volume=2 | url-access=subscription }}{{cite journal | url=https://link.springer.com/content/pdf/10.1007/s40617-024-00918-0.pdf | doi=10.1007/s40617-024-00918-0 | title=Neurodiversity-Affirming Applied Behavior Analysis | date=2024 | last1=Allen | first1=Lauren Lestremau | last2=Mellon | first2=Leanna S. | last3=Syed | first3=Noor | last4=Johnson | first4=Joy F. | last5=Bernal | first5=Armando J. | journal=Behavior Analysis in Practice }} Additionally, some researchers and/or practitioners have called for reforms in some other forms of interventions, such as social skills training, speech-language therapy, and occupational therapy to mitigate such risks, with some therapists implementing such reforms.https://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=2244&context=ojot{{cite journal | url=https://www.liebertpub.com/doi/abs/10.1089/aut.2023.0136 | doi=10.1089/aut.2023.0136 | title="Just Ask What Support We Need": Autistic Adults' Feedback on Social Skills Training | date=2024 | last1=Hull | first1=Laura | last2=Rane | first2=Shravani | last3=Lee | first3=Samman Hang-Lai | last4=Sedgewick | first4=Felicity | journal=Autism in Adulthood | volume=7 | issue=3 | pages=283–292 | url-access=subscription }}{{cite journal | url=https://pubs.asha.org/doi/abs/10.1044/2023_PERSP-23-00106 | doi=10.1044/2023_PERSP-23-00106 | title=A Primer on Neurodiversity-Affirming Speech and Language Services for Autistic Individuals | date=2023 | last1=Gaddy | first1=Caroline | last2=Crow | first2=Hillary | journal=Perspectives of the ASHA Special Interest Groups | volume=8 | issue=6 | pages=1220–1237 | url-access=subscription }}{{cite journal | doi=10.1177/15257401221120937 | title=Camouflaging in Developmental Language Disorder: The Views of Speech and Language Pathologists and Parents | date=2023 | last1=Hobson | first1=Hannah M. | last2=Lee | first2=Annabel | journal=Communication Disorders Quarterly | volume=44 | issue=4 | pages=247–256 | pmid=37476025 | pmc=10354791 }}{{cite journal | doi=10.1044/2023_LSHSS-23-00037 | title=Ableism, Code-Switching, and Camouflaging: A Letter to the Editor on Gerlach-Houck and DeThorne (2023) | date=2024 | last1=Roberts | first1=Julie | journal=Language, Speech, and Hearing Services in Schools | volume=55 | issue=1 | pages=217–223 | pmid=38127805 | doi-access=free }}{{cite journal | pmc=11354006 | date=2024 | last1=Harker | first1=S. A. | last2=Baxter | first2=L. C. | last3=Gallegos | first3=S. M. | last4=Mitchell | first4=M. M. | last5=Zerga | first5=L. | last6=Matthews | first6=N. L. | last7=Braden | first7=B. B. | title=Adapting the PEERS® for Young Adults Program for Autistic Adults across the Lifespan | journal=Healthcare | volume=12 | issue=16 | page=1586 | doi=10.3390/healthcare12161586 | doi-access=free | pmid=39201145 }}

There are some research studies centered around the experiences of masking by comparing different groups of neurotypes. In 2021, researchers conducted an online survey comparing masking experiences between autistic, non-autistic neurodivergent, and neurotypical groups. They found that the behavior of masking is shared across all types of people, but some aspects of masking are more specific to autism, such as sensory suppression and suppression of stimming. Researchers also recreated this study in a workplace context and examined workplace masking experiences for autistic, non-autistic, and neurotypical adults in the UK. They reported large overlap amongst the three groups. Both neurodivergent and neurotypical people adopted masking strategies to achieve social goals, indicating that masking is a common experience, rather than one exclusive to autistic individuals.

There has also been qualitative research focused on the autistic experiences of masking. A study in 2022 conducted semi-structured interviews with twenty autistic teenagers and observed that masking is associated with mental health (but not necessarily in linear relationship) and how both of them are affected by social and environmental factors. Researchers stressed the need to approach masking, authenticity, and mental health through the context of people's identities and the environment, providing implications for diagnostic services and interventions.{{Cite journal |last1=Chapman |first1=Louise |last2=Rose |first2=Kieran |last3=Hull |first3=Laura |last4=Mandy |first4=William |date=2022-11-01 |title="I want to fit in… but I don't want to change myself fundamentally": A qualitative exploration of the relationship between masking and mental health for autistic teenagers |journal=Research in Autism Spectrum Disorders |volume=99 |pages=102069 |doi=10.1016/j.rasd.2022.102069 |s2cid=253495529 |issn=1750-9467 |doi-access=free }} There have been comparisons between masking and passing.

In addition to masking, researchers investigated the "authenticity" autistic people feel while socializing and observed that supportive environments, such as being around people who accept and understand them, can lead to self-awareness and create more positive socializing experiences than camouflaging.{{Cite journal |last1=Cook |first1=Julia M |last2=Crane |first2=Laura |last3=Mandy |first3=William |date=2023-07-05 |title=Dropping the mask: It takes two |journal=Autism |volume=28 |issue=4 |pages=831–842 |language=en |doi=10.1177/13623613231183059 |pmid=37403917 |s2cid=259335250 |issn=1362-3613 |doi-access=free |pmc=10981180 }} However, this doesn't imply that autistic "masking" is equivalent to non-authenticity. Researchers proposed that the focus should not be encouraging masking but promoting autistic authenticity, creating a more positive self-image and better mental health.

{{More citations needed section|date=May 2025}}

{{Confusing section|date=May 2025}}

There are criticisms of the methodologies used in studies of autistic masking. It is argued that studies on self-reported experiences on the internet lack diagnostic rigor,{{Cite journal |last1=Fombonne |first1=Eric |date=2020-07-13 |title=Camouflage and autism |journal=Journal of Child Psychology and Psychiatry |volume=61 |issue=7 | pages=735–738 |language=en |doi=10.1111/jcpp.13296 |pmid=32658354 |doi-access=free }} and that comparisons between self-reported behavior and a diagnostic classification is not an accurate measure of masking due to a number of confounds. These confounds include the possibility of learning skills later than population average without being stressed by using the skills, especially since there is not any one single genetic mutation underlying all diagnoses of autism, making generalizations about the effects of learning social skills to etiologically different types of autism biologically unsound, that self-reporting is not an accurate measure of the degree of a condition that has difficulties in understanding problems with one’s behavior in its definition, and that a difference in the scores of two measures of one construct is not a validation of another construct.

The assumption that later development of an ability in early childhood necessarily entails lifelong lowering of the ability is argued to contradict the premise of different developmental trajectories,{{Cite journal |last1=Fombonne |first1=Eric |date=2020-07-13 |title=Camouflage and autism |journal=Journal of Child Psychology and Psychiatry |volume=61 |issue=7 | pages=735–738 |language=en |doi=10.1111/jcpp.13296 |pmid=32658354 |doi-access=free }} as brains that develop along different lines can and in some cases do display variations in which one variant develop an ability fast and early while another variant develops it slower but to a higher degree later on. The fact that many of the specific behaviours in neurotypical control samples differ between cultures is also cited as an argument against the claim that stress caused by the extent of use of these behaviors later in life can be linked to childhood delays of their acquisition associated with autism somehow making them "unnatural" to autistic people.

It is argued that the assumption that camouflaged autism in women must be the cause of lower rates of diagnosed autism in women than in men is circular reasoning, and that it skews research on camouflaged autism towards female samples{{Cite journal |last1=Fombonne |first1=Eric |date=2020-07-13 |title=Camouflage and autism |journal=Journal of Child Psychology and Psychiatry |volume=61 |issue=7 | pages=735–738 |language=en |doi=10.1111/jcpp.13296 |pmid=32658354 |doi-access=free }} which further confounds the applicability of research that appears to show harmful effects of learned social skills to male cases of autism. The construct of camouflaged autism is argued to follow a tradition of unfruitful constructs that made quantitative testing more difficult when similarly applied to depression and schizophrenia in the past, and that allegations of stress-related harmful effects of acquiring social skills may discourage both persons formally diagnosed with autism and formally undiagnosed persons who self-diagnose with autism from learning social skills or encouraging such people to exaggerate their symptoms, similar to allegations that learning social skills would destroy special abilities in past decades. It is also cited that studies that appear to show harmful effects of learned social skills in people with autism are qualitative, and that quantitative studies do not support the allegations of harmful effects.

• Minority stress

{{Reflist}}

• {{Cite book |last1=Sedgewick |first1=Felicity |url=https://www.worldcat.org/oclc/1287133295 |title=Autism and Masking: How and Why People Do It, and the Impact It Can Have |last2=Hull |first2=Laura |last3=Ellis |first3=Helen |publisher=Jessica Kingsley Publishers |year=2021 |isbn=978-1-78775-580-2 |location=London |language=en |oclc=1287133295}}
• {{Cite book |last=Price |first=Devon |url=https://www.worldcat.org/oclc/1321047301 |title=Unmasking Autism: The Power of Embracing Our Hidden Neurodiversity |date=2022 |publisher=Monoray |isbn=978-1-80096-054-1 |location=London |oclc=1321047301 |author-link=Devon Price}}
• {{Cite book |last1=Hull |first1=Laura |title=Encyclopedia of Autism Spectrum Disorders |last2=Mandy |first2=William |publisher=Springer |year=2020 |isbn=978-1-4614-6435-8 |editor-last=Volkmar |editor-first=Fred R. |editor-link=Fred Volkmar |place=New York, NY |pages= 1–5|chapter=Social Camouflaging in Adults with ASD |doi=10.1007/978-1-4614-6435-8_102389-1|s2cid=241947187 }}
• {{Cite journal |last1=Petrolini |first1=Valentina |last2=Rodríguez-Armendariz |first2=Ekaine |last3=Vicente |first3=Agustín |date=2023 |title=Autistic camouflaging across the spectrum |url=https://linkinghub.elsevier.com/retrieve/pii/S0732118X22000629 |journal=New Ideas in Psychology |language=en |volume=68 |pages=100992 |doi=10.1016/j.newideapsych.2022.100992|hdl=10810/59712 |s2cid=253316582 |hdl-access=free }}

• Eva Silvertant: [https://embrace-autism.com/autism-and-camouflaging/ Autism & camouflaging] Embrace Autism, 2020.
• Francine Russo: [https://www.spectrumnews.org/features/deep-dive/costs-camouflaging-autism/ The costs of camouflaging autism] Spectrum. Simons Foundation, 2018

{{Pervasive developmental disorders}}

Category:Autism

Category:Passing (sociology)