Masking

Masking, also called camouflaging, is a set of strategies some autistic people use in social situations to hide autistic traits or to work around differences in social communication.^1,2 A critical review of 389 studies found the two words used inconsistently, sometimes for the same thing and sometimes for different things.³ The word itself has critics: in an editorial, Fombonne argued that "camouflage" fits autism poorly because it suggests intended deception.⁴ Letting the mask drop has its own topic, Unmasking.

A review of 58 studies, most of them interviews, concluded that camouflaging is "primarily a socially motivated response", and grouped what goes with it under three themes: the norms and pressures of a largely non-autistic world, being accepted or rejected, and self-esteem and identity.⁵ The first large interview study, of 92 autistic adults, found two motives: fitting in, which the authors called assimilation, and connecting with others.² In that study many people also said they camouflaged to stay safe, and many described being shut out or verbally attacked when they had not.² The review's 4,808 autistic participants were mostly white, female and diagnosed late.⁵

Methods fall broadly into two approaches: questionnaires that ask people how much they camouflage, and discrepancy methods, which compare how autistic a person seems to an observer with a measure of their underlying traits or abilities.¹ The most used questionnaire, the CAT-Q, has 25 items in three subscales: compensation, masking and assimilation.⁶ A critical review of 389 studies rated its reliability excellent and the evidence for its validity mixed.³ In 59 autistic 13 to 18-year-olds, a self-report questionnaire and a discrepancy score were only weakly related, and not significantly.⁷

In a 2024 meta-analysis of studies mostly of autistic adults without intellectual disability, self-reported camouflaging had moderate correlations with anxiety, depression and social anxiety, and a small negative correlation with well-being.⁸ Almost every study measured camouflaging and mental health at the same time, so which comes first is still unknown.^9,10 The only study in the full entry that followed people over time tested 332 Dutch autistic adults twice, about two years apart: people who camouflaged more at the start showed a small decrease in mental health difficulties, and the authors found no strong evidence that camouflaging is followed by worse mental health.¹¹

On average, autistic women report more camouflaging than autistic men: a meta-analysis of 11 studies, mostly of adults and adolescents without intellectual disability, found this on the CAT-Q, a small effect.¹² How strongly autistic traits go with camouflaging is similar in both sexes.¹³ Autistic men camouflage too, and researchers warn against treating masking as a "female autism phenotype".^14,15,16 A critical review of 389 studies notes that the samples overrepresent women diagnosed in adulthood and underrepresent autistic people with intellectual or language disabilities or higher support needs.³

In a UK study of families where children harmed their parents, many of the children neurodivergent, parents described a "coke bottle effect", distress building through the school day and released at pickup or at home, and the author observed that children who masked their needs at school tended to react later.¹⁷ The popular name for this pattern, "after-school restraint collapse", comes from parenting writing, not autism research: Andrea Loewen Nair, a Canadian counselor and parenting educator, introduced it in a 2016 blog post.^c1 Of 131 employed autistic adults in a 2026 US survey, 86% camouflaged often or sometimes at work.¹⁸ Thirteen UK autistic people over 50 described, before their diagnosis, a deliberate effort to make their difference less visible.¹⁹