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.

Lay summary: Why is this topic important?: Autistic masking is a complicated topic. We currently think that masking includes things such as making eye contact even if it makes you feel uncomfortable, or not talking about your interests too much for fear of being labeled "weird." There is a lot about masking that we do not know yet, but it is important to understand masking as we think that it might have a negative effect on autistic people.What was the purpose of this article?: The purpose of this article was to look at current explanations of masking, and try to figure out what is missing.What do the authors conclude?: We conclude that work on masking needs to think about autistic people in a different way. Autistic people grow up in a social world and experience a lot of negative views about autism and autistic people. We argue that we need to understand how this social world and the trauma that can come from being part of it contributes toward masking. We also argue against the idea that masking is a "female" thing that occurs as a result of there being a "female-specific" subtype of autism, because this might make it harder for some people to get a diagnosis (e.g., nonbinary people, and men and women who do not fit with any of the current criteria). Instead we argue that people need to recognize that autism does not look like one "type" of person, and try to separate ideas about masking from ideas about a person not fitting a stereotype.What do the authors recommend for future research on this topic?: Though masking is called a "social strategy," there has not been a lot of social theory applied to masking research. We recommend that researchers use theories about how people try to fit in, and theories about how people exclude and hurt people who are different. This can help us to understand why autistic people mask. We also stress the need to understand that masking is not necessarily a choice, and that there are many unconscious aspects. We argue that researchers should try to find out when masking starts to happen (e.g., in childhood) and what makes people feel like they need to keep up the mask. We also recommend lot more research into autistic identity, and how different parts of identity (including things such as gender, race, and co-occurring conditions) might mean that someone has to mask more (or less), or in different ways.How will this analysis help autistic adults now and in the future?: We hope that this analysis will help researchers to understand that some aspects of masking might be unique to autistic people, but some aspects might be like other kinds of "pretending to be normal" that other people who are socially excluded use to try and fit in. We hope that our suggestions can help to improve our understanding of masking, and lead to research that makes life better for autistic people.

Keywords: autism; camouflaging; masking.

FIG. 1.

Potential model for considering the relationship between masking and autistic burnout. The figure displays a linear relationship from stressor to masking response to presentation (which is effortful for a person to sustain). The masking response feeds separately into disconnection from internal cues, which then leads to an internal stress increase and difficulty regulating associated stress. In addition, the effortful presentation feeds directly into internal stress increase. Together, these flow into what we term “breaking point.” This includes a textual description of the image for those who are using screen-readers.