Understanding Autism Masking and Its Consequences

Masking, which is also called camouflaging or compensating, is a social survival strategy. How it looks will vary from person to person, but masking can include behaviors like these:

• forcing or faking eye contact during conversations
• imitating smiles and other facial expressions
• mimicking gestures
• hiding or minimizing personal interests
• developing a repertoire of rehearsed responses to questions
• scripting conversations
• pushing through intense sensory discomfort including loud noises
• disguising stimming behaviors (hiding a jiggling foot or trading a preferred movement for one that’s less obvious)

People may mask autism for a variety of reasons, such as:

• feeling safe and avoiding stigma
• avoiding mistreatment or bullying
• succeeding at work
• attracting a romantic partner
• making friends and other social connections
• fitting in or feeling a sense of belonging

Although masking can look different from person to person, one study has described a basic three-stage model of the process: motivation, masking, and consequences.

Masking begins when a neurodivergent person recognizes that something important hinges on being perceived as neurotypical. Maybe it’s friendship. Maybe it’s a job opportunity. Maybe it’s personal safety.

Whatever the motivation, an autistic person may feel they must hide differences or change the way they naturally act — often because their living or working environment doesn’t tolerate, support, or respect neurodivergent behaviors.

When people feel they have to compensate for autism characteristics, they have to invest a lot of time and energy in trying to “pass” as neurotypical. They might:

• learn social cues from various forms of media
• observe social interactions between people around them
• monitor their own facial expressions and body language
• research social rules and norms
• practice appearing interested or relaxed
• adjust their tone of voice to match other people’s vocal patterns

Equipped with these observations and skills, an autistic person can then use them in social situations to varying effects. Some people are so effective at masking that no one can tell they’re pretending or performing. Others are less effective at masking.

Either way, the cognitive and emotional effort affects people’s mental and physical health. People who camouflage regularly often say they feel drained and exhausted by the effort of trying to conform to neurotypical standards of behavior.

People across the entire gender spectrum engage in masking, studies show, but people who identify as women may mask more often than people who identify as men.

There’s been some debate about why girls and women may mask autistic traits more than boys and men do. Some research suggests that autistic girls and women may be more inclined to develop friendships than autistic boys and men.

Although there has been more research recently on autism masking, more studies need to be done to understand how sex and gender shape masking, as well as what masking looks like across the full gender spectrum.

Masking may be common in places where there’s little support for neurodiverse people, or where people on the autism spectrum are under direct threat. But while camouflaging may have certain benefits, it’s important to note that there are significant costs.

Time spent learning neurotypical behaviors is time not invested in other kinds of personal development. And the effort used to copy neurotypical interactions can quickly lead to social overload.

Here are some of the effects of regular masking:

• Stress and anxiety. In a 2019 study, researchers found that stress and anxiety were higher in people who routinely masked autistic traits, compared to those who used masking less often.
• Depression. In 2018, researchers interviewed 111 autistic adults, finding that those who reported camouflaging their autistic traits had symptoms of depression and felt unaccepted by people in their social sphere.
• Exhaustion. Masking consumes huge amounts of energy. In a 2016 study, women who used masking to satisfy neurotypical standards said they felt exhausted by the constant effort.
• Delayed identification of autism. Some people are so successful with masking that their autism isn’t identified until they are much older. That delay can lead to mental health issues because people don’t get the support or understanding they need.
• Loss of identity. Some people who mask their identity, interests, and traits end up feeling that they no longer know who they really are. Some have said masking feels like self-betrayal; others have said masking makes them feel they’re deceiving other people.
• Risk of autistic burnout. When people push themselves to behave in ways that don’t feel authentic, the result can be an overwhelming feeling of overload, sometimes called autistic burnout. Masking may require an extended period of quiet withdrawal and recovery.
• Increased risk of suicidal thoughts. In a recent study, prolonged camouflaging was linked to “lifetime suicidality.” The study was relatively small (160 students) and involved primarily women (89.6 percent). However, it showed that camouflaging led to feeling like a burden, which in turn led to more suicidal thoughts over the course of a lifetime.

If you’re experiencing suicidal thoughts, help is always available. The National Suicide Prevention Lifeline is available 24 hours a day at 800-273-8255. You can also call or visit your nearest emergency room or psychiatric care center to speak with a mental health professional.

Autism spectrum condition (ASC) encompasses a wide range of neurological differences that affect the way people communicate, learn, and interact with others. The Centers for Disease Control and Prevention (CDC) lists some of these differences as:

• preferring not to have eye contact or physical contact with other people
• having difficulty recognizing or talking about emotions
• being less aware of social cues
• feeling stressed by changes to routines
• repeating certain physical gestures or movements
• using rehearsed or repetitive phrases

The CDC reports that there is no cure for autism yet, and many in the autism community contend that neurodiverse people don’t need to be cured.

In fact, some autism advocates think the best way to prevent the damaging health effects of masking is to make the world a safer and more supportive place for people who function differently — in short, to reduce the need to pretend and camouflage.

One important benefit to identifying autism early is that it gives families a chance to learn about their child’s needs and to create an environment in which their child can feel accepted and supported.

Masking is a complex and costly survival strategy for autistic people. It generally involves intentionally learning neurotypical behaviors and mimicking them in social situations.

Sometimes masking focuses on hiding behaviors that people feel won’t be accepted. In other cases, it focuses on preparing scripts and strategies to compensate for communication differences.

People may mask their autism characteristics for many reasons — to boost their careers, connect with others, or avoid being stigmatized by other people. Masking may help at times, but regular camouflaging can have serious effects on mental and physical health. This may include anxiety, depression, exhaustion, a loss of identity, and suicidal thoughts.

One way to minimize the harmful effects of masking autism is to work toward a world in which neurodiverse people are accepted as they are, and people are treated with respect and kindness whether they communicate in neurotypical ways or not.