High-Masking Autism

What is high-masking autism?

Masking, also called camouflaging, is hiding or compensating for autistic traits to appear non-autistic. In a 2017 study of 92 autistic adults, researchers described camouflaging as a mix of masking (hiding traits) and compensation (using learned strategies to get through social situations), driven by wanting to fit in and connect with others.

"High-masking" is a community term, not a diagnosis, for people who do this so effectively that their autism goes unnoticed. The DSM-5 recognizes the pattern: it says autistic traits must be present in early development but may be masked by learned strategies in later life. That is why many high-masking autistic people are identified late, a path our guide to late autism diagnosis walks through.

Signs of high-masking autism

Masking happens inside a person, so the signs are often things only they notice, or that show up later at home. Commonly described experiences include:

• Rehearsing conversations in advance and replaying them afterward
• Using scripts, stock phrases or jokes copied from other people or media
• Forcing eye contact, or looking near the eyes so it passes
• Mirroring other people's facial expressions, tone and body language
• Holding back stims in public, or swapping them for less noticeable ones
• Monitoring yourself constantly for anything that might seem odd
• Being a noticeably different person at home than at school or work
• Needing long recovery time alone after social events, even enjoyable ones
• Being told you do not look autistic, or that you are too social to be autistic
• Years of anxiety, depression or burnout that never fully made sense

Relating to these does not confirm autism, since many people do some of them some of the time. What tends to stand out in autistic masking is the constant effort and the cost afterward. For a first-person account, read what masking feels like.

Who masks?

Any autistic person can mask, at any age. Research does show a gender pattern: in a 2020 study of 306 autistic adults, autistic women reported more camouflaging than autistic men, with no gender difference among non-autistic adults. The study included too few non-binary people to draw conclusions about them. This is one reason autism in girls can be missed.

Autistic men and boys mask too, and they can be missed for the same reasons. Masking is also shaped by environment: people who have been bullied, corrected or punished for autistic behavior may learn to mask harder.

The costs of masking: burnout and mental health

• Exhaustion and identity. Autistic adults in the 2017 camouflaging study described exhaustion and a threatened sense of self as consequences. The National Autistic Society notes that masking can lead to mental and physical exhaustion and a loss of identity.
• Autistic burnout. A 2020 study defined autistic burnout as chronic exhaustion, loss of skills and reduced tolerance to stimulus, caused by a load that outweighs a person's capacity. Participants named unmasking, acceptance and reduced expectations as part of recovery.
• Anxiety and depression. A 2021 study of autistic adults found camouflaging was associated with more generalized anxiety, social anxiety and depression, regardless of gender, though only to a small extent beyond autistic traits and age.
• Later diagnosis. Masking hides autism from teachers and clinicians, which delays support and understanding.

Masking and suicide risk

This is a hard topic, and it matters. In a 2018 study of 164 autistic adults, Cassidy and colleagues found that camouflaging, along with unmet support needs and non-suicidal self-injury, predicted suicidality. A 2020 study of university students found that camouflaging autistic traits was linked to feeling like you do not belong and to lifetime suicidality.

None of this means masking will lead to harm for any one person. It does mean the effort of hiding deserves to be taken seriously, and that acceptance and real support can make a real difference.

How to unmask safely

Unmasking means gradually letting go of concealment that costs more than it gives. It is not all or nothing, and masking can sometimes be a reasonable choice for safety, for example in a hostile workplace. The goal is choice rather than constant performance.

1. Start where it is safe. Begin with one trusted person or one place, such as home, before anywhere else.
2. Notice what drains you. Track which situations cost the most energy, then reduce, shorten or plan recovery around them.
3. Let one thing go at a time. Stim when you need to, skip forced eye contact, or stop rehearsing every phone call.
4. Use accommodations. Written communication, quieter spaces and breaks lower the need to mask at work or school. See workplace accommodations for autistic adults.
5. Find autistic community. Time with other autistic people is often where unmasking feels easiest.
6. Allow for grief. Unmasking can bring up sadness for years spent hiding. That is common, and it tends to ease with time.

Parents can help children avoid learning to mask in the first place: do not demand eye contact, let stims happen, treat meltdowns as overwhelm rather than misbehavior, and plan quiet time after school.

Getting assessed when you mask

Masking can hide autism during an assessment too. Tell the assessor that you mask, and bring written examples of what happens on the inside and at home, not just what others see. Look for a clinician experienced with adults and with masking. Our guide to getting assessed as an adult covers the routes, and self-identification is widely respected in autistic communities when assessment is out of reach.

Frequently Asked Questions

Sources

• Hull L, et al. "Putting on My Best Normal": Social Camouflaging in Adults with Autism Spectrum Conditions. J Autism Dev Disord, 2017
• Hull L, et al. Gender differences in self-reported camouflaging in autistic and non-autistic adults. Autism, 2020
• Hull L, et al. Is social camouflaging associated with anxiety and depression in autistic adults? Molecular Autism, 2021
• Hull L, Petrides KV, Mandy W. The Female Autism Phenotype and Camouflaging: a Narrative Review. Review Journal of Autism and Developmental Disorders, 2020
• Cassidy S, et al. Risk markers for suicidality in autistic adults. Molecular Autism, 2018
• Cassidy SA, et al. Is Camouflaging Autistic Traits Associated with Suicidal Thoughts and Behaviours? J Autism Dev Disord, 2020
• Raymaker DM, et al. Defining Autistic Burnout. Autism in Adulthood, 2020
• CDC: Clinical Testing and Diagnosis for Autism Spectrum Disorder (DSM-5 criteria)
• National Autistic Society: Masking
• 988 Suicide and Crisis Lifeline