The gender bias in Autism research leaves many Autistic women overlooked, underserved, and undiagnosed. These women are social chameleons, hiding in plain sight, because they have become experts at masking their Autistic traits.
What is Masking?
To some degree, everyone engages in “masking” behaviors. If you have ever smiled when you did not mean it or hid some part of yourself to fit in with your peers, you have engaged in masking. But for many Autistic people, especially Autistic women, masking is more than just faking a smile on a bad day – it is a social survival strategy which involves suppressing one’s Autistic traits to fit in. It is modifying one’s true self to become more palatable to neurotypical society’s standards.
Masking can take on many forms. Autistic people may practice conversations or facial expressions when alone, or mirror the expressions, phrases, and tone of the person they are speaking to. They might research charisma and social cues or learn them from media so they can mask better. Since eye contact is usually uncomfortable for autistic people, they might adapt by looking somewhere else on the face so that others will not notice. For others, masking might mean suppressing stims (self-stimulatory behavior which might help them focus, process sensory information, or cope with anxiety) or it can mean replacing “abnormal” stims such as hand-flapping or rocking with ones which are more socially acceptable, such as hair-twirling or cracking knuckles.
The cost of Camouflage
Studies show that while both Autistic men and women may mask, Autistic women may mask more frequently. Neurobiologists theorize that masking is part of the reason that for every four males diagnosed with Autism, only one female receives a diagnosis. The other reason is that, originally, Autism was considered a “male condition,” and the diagnostic criteria was written based on the characteristics of Autistic males. Although newer research suggests that Autism manifests differently in the brains of girls and women, many doctors are only familiar with the male stereotype, so Autistic women, especially those with low support needs, frequently slip through the cracks of our health care system.
Although masking may help Autistic women “succeed” in neurotypical society and protect them from stigma in some cases, long-term masking can be damaging to one’s mental health. Masking can contribute to depression, stress, anxiety, exhaustion, and eventually “autistic burnout,” which is a feeling of overload which can deteriorate an Autistic person’s quality of life and capacity for independent living.
Often, the result of a lifetime of masking is loss of sense of self. Masking can mean changing one’s hobbies, interests, way of thinking, even the way they dress, so that they might camouflage better into a neurotypical world. After doing that for so long, it can be easy for someone to lose sight of who they were before the world told them different meant “bad.”
The need to mask can be reinforced by trauma, so it may be hard for someone to stop masking, even when they are completely alone. Autistic people often learn the hard way the importance of fitting in, through rejection, bullying, or even violence, so unmasking becomes associated with fear and guilt.
“Autistic people are the ultimate square pegs, and the problem with pounding a square peg into a round hole is not that the hammering is hard work. It’s that you’re destroying the peg.”
– Paul Collins
Autism is not a tragedy, just a different type of brain. The real tragedy is the prejudice and stigma surrounding the Autistic label, perpetuated by neurotypical people who think that different means less. Moreover, Autism is not a problem that needs to be “fixed.” Autistic lives can be as full as any neurotypical person’s, whether or not they subscribe to the neurotypical model of behavior. Neither should Autistic people have to change themselves in order to feel safe or accepted by society.
Therein lies the problem with the most common therapy for Autism today, ABA therapy, the goal of which is rooted in ableist rhetoric: making Autistic kids more “normal” through what is basically conversion therapy. Many Autistic adults have spoken out about ABA, calling it harmful, even traumatizing. The use of electric shock therapy in ABA was not banned by the FDA until 2020, so it is no wonder many adults today have bad memories associated with the treatment.
It can take a long time, and a lot of practice, to train yourself to stop masking. Part of the journey involves unlearning the biases you have internalized, which is not easy. Try to be patient and kind with yourself through this process of self-re-discovery, even when other people are not.
You can start getting to know your authentic self by listing things that make you happy, things that make you feel excited and passionate, including the things others might see as “unusual”. Engage in those things which make you happy more often. Move intuitively: allow yourself to stim, if not all the time, at least when you are alone and safe from judgmental eyes. Find clothes that you feel comfortable in and throw out those clothes that cause you stress or sensory overload. If you take these baby steps, you should start to feel more connected with your true self and more in tune with the wants and needs you might have been neglecting before, so you can begin to heal.
A nice thing I heard once is this: “the great thing about being unapologetically yourself is that by doing so, you may unwittingly give others permission to do the same.”