Background: Autistic masking refers to some autistic individuals' tendency to hide, suppress, or camouflage their autistic traits, autistic identity, or autism diagnosis. Autistic masking also may include unconscious or conscious attempts to mimic the behavioral, cognitive, or sensory styles of nonautistic neurotypical people and to suppress natural forms of autistic behavior, cognition, and reactions to sensory experiences. Since autistic people are a stigmatized minority in many neurotypical dominated societies, passing as nonautistic through autistic masking may be an attempt to avoid autism stigma and a reaction to previous interpersonal trauma. Increased autistic masking behaviors are associated with reports of increased depression, anxiety, burnout, and exhaustion in autistic people, and thus, exploring the roots and impact of autistic masking is an important mental health topic.
Methods: This study investigated the relationships between autistic masking and depression, anxiety, gender identity, sexual orientation, interpersonal trauma, self-esteem, authenticity, and autistic community involvement. Participants were autistic adults (n = 342) recruited through autistic social media groups.
Results: This study found that higher self-reported autistic masking behaviors were associated with higher reports of past interpersonal trauma, greater anxiety and depression symptoms, lower self-esteem, lower authenticity, and lower participation within the autistic community. Autistic masking was not associated with gender identity or sexual orientation.
Conclusions: The results of this study highlight the relationship between autistic masking and past interpersonal trauma, finding that autistic masking behavior is associated with mental health, self-esteem, and authenticity risks for autistic adults. We call into question the teaching of autistic masking strategies in therapies and education programs for autistic people based on the negative associations with autistic masking presented in this study and other research in this field.
Keywords: camouflaging; interpersonal trauma; masking; mental health; self-esteem.
Why is this an important issue? Autistic masking refers to autistic people suppressing their natural autistic traits, responses, and behaviors, in an attempt, consciously or unconsciously, to hide or reduce the visibility of their autistic traits, autistic identity, or autism diagnosis. High levels of autistic masking are associated with negative mental health, authenticity challenges, and burnout for autistic people. Interpersonal pressuring, past traumatic social experiences, and autism stigma potentially fuel autistic masking. What is the purpose of this study? This study aimed to investigate relationship between autistic masking and depression, anxiety, interpersonal trauma, self-esteem, authenticity, autistic community involvement, gender identity, and sexual orientation. What did the researchers do? We recruited 342 autistic adult participants through autistic social media groups on Facebook to complete a 30-minute anonymous survey online comprising validated scales to measure autistic masking, depression, anxiety, interpersonal trauma, self-esteem, and authenticity. Additional questions were asked about demographic factors, such as gender identity and sexual orientation, and we asked open-ended questions about past social trauma and intersectional issues. What were the results of the study? We found that higher self-reported autistic masking behaviors were associated with higher reports of past interpersonal trauma, specifically being shamed and teased about autistic traits, and broader experiences of emotional and physical abuse. Masking was also associated with greater anxiety and more depression symptoms, lower self-esteem, lower authentic living, greater accepting of external influence, higher self-alienation, and lower participation within the autistic community. Autistic masking was not found to be associated with gender identity or sexual orientation. Participants who reported involvement in previous applied behavior analysis therapy reported higher past interpersonal trauma than participants involved in some other forms of therapy such as cognitive behavior therapy. What do the findings add to what was already known? This study supports previous research associating autistic masking with depression and anxiety symptoms, and lower reported authenticity, such as autistic people feeling they were not being true to themselves, or revealing their genuine selves to others. This study is the first to quantitatively investigate relationships between autistic masking and past interpersonal traumas, self-esteem, authenticity, and autistic community involvement. What are potential weaknesses in the study? Our sample is not representative of the U.S. population when it comes to race, educational level, gender, and sexual orientation. It was very White, highly educated, had few cisgender men, and sixty three percent were members of sexual minority groups. The majority of participants reported late diagnosis of autism. This sample potentially contained an overrepresentation of people with high levels of autistic masking or who more recently realized they were autistic masking in comparison with the general autistic population. We did not analyze differences between early-diagnosed and late-diagnosed cohorts. How will these findings help autistic adults now or in the future? This research calls into question the teaching of autistic masking strategies in parenting, education, and therapy programs for autistic people based on the negative associations of autistic masking. Our findings should be utilized as a strong call to action to push back against practices that encourage autistic masking and autistic trait shaming. Instead we advocate for promoting forms of parenting, education, and therapy that respect autistic people's traits, communication styles, sensory needs, and autistic identity.
Copyright 2023, Mary Ann Liebert, Inc., publishers.