A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice

Abstract

Autistic masking is an emerging research area that focuses on understanding the conscious or unconscious suppression of natural autistic responses and adoption of alternatives across a range of domains. It is suggested that masking may relate to negative outcomes for autistic people, including late/missed diagnosis, mental health issues, burnout, and suicidality. This makes it essential to understand what masking is, and why it occurs. In this conceptual analysis, we suggest that masking is an unsurprising response to the deficit narrative and accompanying stigma that has developed around autism. We outline how classical social theory (i.e., social identity theory) can help us to understand how and why people mask by situating masking in the social context in which it develops. We draw upon the literature on stigma and marginalization to examine how masking might intersect with different aspects of identity (e.g., gender). We argue that although masking might contribute toward disparities in diagnosis, it is important that we do not impose gender norms and stereotypes by associating masking with a ''female autism phenotype.'' Finally we provide recommendations for future research, stressing the need for increased understanding of the different ways that autism may present in different people (e.g., internalizing and externalizing) and intersectionality. We suggest that masking is examined through a sociodevelopmental lens, taking into account factors that contribute toward the initial development of the mask and that drive its maintenance.

Understanding Camouflaging as a Response to Autism-Related Stigma: A Social Identity Theory Approach

“…For gender, we found only suggestive to null findings, which overall suggest little to no relationship between gender and camouflaging in our statistical models. This support previous work which has also not found a relationship between camouflaging and gender (Cage & Troxell-Whitman, 2019;Cassidy et al, 2020) and calls to use caution when discussing camouflaging in relation to gender (Pearson & Rose, 2021).…”

Autistic Adults' Experiences of Camouflaging and Its Perceived Impact on Mental Health

“…Associating camouflaging with a ''female specific'' presentation of autism could lead to disparities in diagnosis with nonbinary people and males not being diagnosed, because they do not fit the ''female phenotype.'' 25 It is crucial that we better understand autistic adults' experiences of camouflaging (regardless of gender), the impact of camouflaging on mental health, and how this impact could be reduced. The current study, therefore, aimed to qualitatively explore autistic adults' experiences of camouflaging and the impact on their mental health.…”

Self-reported camouflaging behaviours used by autistic adults during everyday social interactions

“…Given that autistic people commonly experience devaluation, rejection and misunderstanding (Kinnear et al, 2016;Milton et al, 2018;Sasson et al, 2017) as well as the central role autism often plays in the identity of autistic people, it has been argued that autistic people represent an identity-based minority group subjected to social stigma and disadvantaged social status (Botha, Dibb, & Frost, 2020;. As such, masking behaviours could be understood within a stigma framework, as an attempt to prevent prejudice and discrimination by concealing or strategically attenuating autistic identity Cage & Troxell-Whitman, 2020;Pearson & Rose, 2021;Perry et al, 2021).…”

“…In a similar manner to masking behaviours, modelling neurotypical communication behaviours could be understood within a stigma framework as an attempt to reduce prejudice or discrimination by signalling proximity to neurotypicality (Pearson & Rose, 2021;Perry, Mandy, Hull, & Cage, 2021). In addition, using the normative expressions of the culture, subculture or family one is interacting with likely improves clarity and ease in communication (Halberstadt, Denham, & Dunsmore, 2001).…”

“…Autistic people commonly encounter negative reactions to their personal characteristics and behaviours during social interactions (Kinnear, Link, Ballan, & Fischbach, 2016;Milton, 2012;Milton, Heasman, & Sheppard, 2018;Sasson et al, 2017;. As a result of such reactions, some autistic people modify their innate or instinctive social behaviour (Hull et al, 2017;Lawson, 2020;Livingston, Shah, & Happé, 2019;Pearson & Rose, 2021). In modifying their behaviour, autistic people likely engage multiple cognitive functions involving monitoring the social environment, monitoring of personal behaviours and social reasoning (or proxy social reasoning via non-social cognitive routes; Livingston & Happé, 2017).…”