Autistic masking, also referred to as camouflaging or neurodivergent masking, is the conscious or subconscious suppression of autistic behaviors and compensation of difficulties in social interaction by autistic people with the goal of being perceived as neurotypical.[1][2] Masking is a learned coping strategy[3][4] that can be successful from the perspective of autistic people, but can also lead to adverse mental health outcomes.[1][5]
There is no universally agreed-upon terminology for the concept.[1][5]: 16–17 [6] While some use the terms masking and camouflaging synonymously,[1][2][5]: 16–17 others distinguish between masking (the suppression of behaviors) and compensation (of social difficulties) as the two main forms of camouflaging.[1][3][7] Among autistic people, masking is the most commonly used umbrella term.[5]: 16 [8]
The process of consciously giving up masking, which some autistic people see as a desirable goal, is referred to as unmasking.[2][9][10] Motivations for unmasking include no longer hiding one's true identity and avoiding adverse mental health outcomes.[2][8][9]
Typical examples of autistic masking include the suppression of stimming and reactions to sensory overload.[3] To compensate difficulties in social interaction with neurotypical peers, autistic people might maintain eye contact despite discomfort or mirror the body language and tone of others.[1][2][3][11]
Autistic people with conversational difficulties may also use more complex strategies such as scripting a conversation outline, developing conscious "rules" for conversations, carefully monitoring if these are being followed.[3] 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.[11] Masking may also include refraining from talking about passionate interests.[2][3]
Autistic people have cited social acceptance, the need to get a job, and the avoidance of ostracism or verbal or physical abuse as reasons for masking.[12]
Masking requires an exceptional effort[3][13] and is a main cause of autistic burnout.[14][15] It is linked with adverse mental health outcomes[16][17] such as stress,[18] anxiety, depression, and other psychological disorders,[18] loss of identity,[18] and suicidality.[19][20][21] Some studies find that compensation strategies are seen as contributing to leading a successful and satisfactory life.[1][7][13] Since many studies on masking focus on autistic adults without cognitive impairments only, it is questionable whether their findings generalize across the autism spectrum.[1]
Masking may conceal the person's need for support.[12] It can complicate a diagnosis of autism spectrum disorder (ASD), particularly past childhood, as relevant symptoms are suppressed or compensated for.[22]: 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.[22]: 57 [23] Addition of such a formulation was proposed to the workgroup drafting the criteria by representatives of the Autistic Self Advocacy Network.[23] The diagnostic criteria for ASD in the ICD-11 (2022) contain a similar provision.[16]
It has been hypothesized that masking may play an important role in explaining why autistic women and non-binary persons[2] are significantly less often recognized and diagnosed as autistic compared to men.[2][3][11] This hypothesis was put forward by Lorna Wing as early as 1981[5]: 20 [24]: 134 and is recognized in the DSM-5-TR published in 2022.[22]: 65
While masking was written about and discussed among autistic people, it has only become a focus of academic research since the 2010s.[5]: 18 The Camouflaging Autistic Traits Questionnaire (CAT-Q), a first self-report measure for camouflaging, was published in 2018.[25][26] 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).[25]
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 behavior in autistic people and suppression of autistic traits are controversial.[27][28] Some autistic adults subjected to applied behavior analysis therapies as children describe being forced to behave like neurotypical peers, contrary to their true identity, with detrimental effects on their mental and overall well-being.[29][30]