People with autism have real, observable symptoms. If you're on the spectrum, you know these symptoms. If you love someone who is on the spectrum, you've seen these signs.
Hand flapping, avoiding eye contact, and experiencing meltdowns due to routine changes are all common parts of life with autism.
Autism masking involves spotting those symptoms and working desperately to hide them. It's common in people who don't have an autism diagnosis, and sometimes, masking keeps people from getting the help they need.
Women are especially prone to autism masking. Researchers discovered the discrepancy recently, and their insights could be critical for women who need help.
What Is Autism Masking?
We all use some type of mask in our everyday lives. We behave professionally at work, for example, but we unleash silliness with our children at home. Autism masking is different.
Experts say autism masking involves constant and elaborate effort. People work very hard throughout the day to ensure that their behavior conforms to societal norms. Every impulse that seems unusual is suppressed, and conformity and sameness are the overarching goals.
Women are experts at autism masking, experts say. Society demands social interactions between girls, where boys are allowed to develop a loner persona. The more time girls spend with their neurotypical peers, the more so-called "micro-rejections" they experience, including:
- Quizzical looks. Girls who stim are often given open stares from their peers.
- Laughter. Discussing a favorite topic at length can end with mocking giggles.
- Isolation. Girls who are different aren't invited to parties or lunch dates.
As these insults add up, girls learn to attenuate their behavior. They stop doing things that others comment on, and they may even find a role model to copy. They spend most of their school hours learning how to be just like their peers while stripping away anything that makes them even slightly different.
As these girls grow into adults, their habits become entrenched. They're experts at mimicking peers and flying just below the radar.
Girls are so good at autism masking that they even hid their symptoms from researchers. Only recently, says Autism Speaks, did researchers discover that women are on the spectrum. Today, researchers are learning more and more about how women mask autism symptoms to evade detection.
Consequences of Masking
Autism masking isn't helpful; it's detrimental to mental health. People adept at masking may not get the help they need to understand their minds and explain them to others.
Researchers suggest that experts in masking, including those who have several different faces they use depending on circumstances, have poor mental health. People who don't mask at all tend to have better mental health.
Conditions associated with masking include:
Autism masking can also delay an accurate diagnosis. No autism blood tests or brain scans exist, so doctors use observations to spot potential patients. Children who hide those symptoms may get no help at all or may be diagnosed with conditions they don't have. Either way, researchers say, masking can keep people from being both understood and helped.
Researchers say autism masking can come with benefits, including:
- Social integration. People who hide traits that make others uncomfortable face less shunning.
- Employment. People who mask may seem more appropriate for work environments. They may get hired faster than those who don’t mask their symptoms.
- Independence. With jobs and friends, people may feel they are living their best life.
But advocates say masking can deny communities the opportunity to know and accept people as they really are. People with autism don't deserve to hide and lie and mask their desires. They deserve to be accepted as they are. Masking prevents that.
Gender & Autism
For years, experts thought women and girls simply couldn't develop autism. Now we know that isn't quite true. However, women and girls experience challenges on the road to an accurate diagnosis.
Autism survey tools were developed with boys in mind, and autism in females can look a bit different. For example, experts say boys with autism often develop hyperactivity and conduct problems. Girls, on the other hand, are more likely to keep their feelings inside and develop depression and anxiety instead.
Issues like this can lead doctors to skim over girls with autism, even when they have equal levels of autistic characteristics, researchers say. If girls are diagnosed, they frequently get the label later in life than boys do.
There's little parents can do to amend the discrepancy. Doctors must give the diagnosis for treatment to be covered by insurance and for schools to provide it. Parents can’t diagnose their daughters, but they can advocate for them. You can:
- List characteristics. Write down all of the behaviors you have noticed. Include dates and times of major episodes, including crying spells and tantrums.
- Use video. Your daughter may express her true self at home, while she keeps her mask fully on at school. Tape episodes to show your doctor what's happening in the home.
- Ask for referrals. If your doctor won't listen to your suggestions or offer accurate testing, look for a professional who specializes in autism. That person may see things your doctor misses.
- Talk to your child. Remind your daughter that you care about her. Encourage her to be herself in her appointments, and make sure she knows that truthful answers won't disappoint you or her doctor.
Girls can have other conditions that look like autism but stem from something else. Anxiety disorders can spark similar symptoms, for example. Ensure that your daughter works with someone who can identify the signs and provide an accurate diagnosis.
What Happens After Diagnosis?
Autism masking involves hiding who you really are from the world you live in. You may feel like an imposter in your own skin, and you may think no one will love you for who you really are.
An autism diagnosis gives you critical information about who you are and how your mind works. You'll realize that you're not strange or freaky or alone. You're part of a community of people who think and act much like you do.
A diagnosis can also help you tap into therapy. The goal of autism therapy is to help you develop new skills to improve relationships authentically. You can use therapy to:
- Expand communication skills. Learn how to explain your autism to others, so they can understand who you are and what you need.
- Handle basic tasks. Autism can make it difficult to complete complex tasks. In therapy, you can repeat the steps in sequence until they become part of your muscle memory.
- Soothe distress. You can learn how to spot signs of upset, and your therapist can teach you how to handle those feelings rather than suppressing them.
- Deepen relationships. Your family may join some therapy sessions and help you build skills. Your bond with these important people in your life may grow.
Without a proper diagnosis, it's hard to get this kind of help. With a diagnosis, you can move forward and live your best life.
Learning to Unmask
While masking tends to affect women more, men can also mask their autism symptoms.
Regardless of your gender, if you’ve been masking symptoms of autism, know that you don’t have to anymore. A clinician can provide a safe space where you can talk freely about the symptoms you’ve likely been dealing with your whole life.
If you never received an autism diagnosis in childhood, you may be able to get an accurate diagnosis in adulthood. Your doctor will ask about symptoms that presented in childhood since autism doesn’t develop in adulthood. They may want to talk to your parents, teachers, or other important people in your life to get a broader picture of your symptoms and your history.
If you have a loved one who you believe is masking symptoms of autism, you can help them. Connect them with a clinician who can assess their symptoms and, if appropriate, diagnose them.
A diagnosis is the first step toward therapy that can alleviate the difficulties of autism, helping you or your loved one to embrace a fuller, more satisfying life.
- The Costs of Camouflaging Autism. (February 2018). Spectrum.
- Masking and Micro-Rejections: Autistic Girls Often Go Undiagnosed. (November 2019). South Florida Media Network.
- Women on the Autism Spectrum and Stress. (August 2019). Autism Speaks.
- Understanding the Reasons, Contexts, and Costs of Camouflaging for Autistic Adults. (May 2019). Journal of Autism and Developmental Disorders.
- Social Camouflaging in Autism: Is It Time to Lose the Mask? (September 2019). Autism.
- Compensatory Strategies That Mask Autism May Impede Diagnosis. (July 2019). Lancet Psychiatry.
- What Masking Is Not. (February 2019). Spectrum Women Magazine.
- "Putting On My Best Normal": Social Camouflaging in Adults With Autism Spectrum Conditions. (2017). Journal of Autism and Developmental Disorders.
- The Female Autism Phenotype and Camouflaging: A Narrative Review. (January 2020). Review Journal of Autism and Developmental Disorders.