Autism Masking: What It Costs and How to Unmask Safely

The two parts of autistic masking

Masking autism means holding back autistic traits and putting learned, non-autistic behaviors in their place so you blend in. Autism masking can be deliberate, or so automatic that the person stops noticing it. Pearson and Rose’s 2021 analysis of autistic masking defines it as “the conscious or unconscious suppression of natural autistic responses and adoption of alternatives.”

Researchers also call this camouflaging, an umbrella term for keeping autistic traits from showing. Hull and colleagues’ 2017 study of camouflaging in autistic adults, drawing on 92 adults, described three stages: motivations, techniques and consequences.

The techniques come in two kinds. Suppression means holding something back, such as stimming (repetitive movements, like rocking, that autistic adults describe using to self-regulate). Compensation means adding something that does not come naturally, like memorized small talk or forced eye contact.

Either way, masking hides autistic traits and can take effort you have to recover from later. Cage and Troxell-Whitman note that research suggests camouflaging behaviors are common in autistic people. Masking has also been related to late or missed diagnosis. The CDC notes some autistic people are not diagnosed until adolescence or adulthood.

Why autistic people mask

Autistic people mask to fit in and connect with others (Hull, 2017) and to get by in formal settings such as work (Cage and Troxell-Whitman, 2019). Those are sensible goals, and researchers describe masking as a response to stigma, where the choice to mask is constrained by what happens when you don’t.

Hull’s 2017 study named two motivations, “assimilation” and “to know and be known.” In Cage and Troxell-Whitman’s 2019 survey of 262 autistic adults, both women and men rated getting by at work above making friends as a reason.

Pearson and Rose call masking “an unsurprising response to the … stigma that has developed around autism.” It says nothing bad about the person’s character. In a 2024 study of 342 autistic adults, higher masking was associated with more past interpersonal trauma. The design cannot show which came first. One adult in Hull’s study said, “If I had known how to camouflage earlier, perhaps I wouldn’t have been such an outcast as a child.”

How do I know if I am masking autism?

Social time that takes effort and leaves you drained, needing solitude to recover, is one sign of masking that autistic adults describe. You might also feel like a different person in public than at home, or recognize these autism masking examples: rehearsing conversations, forcing eye contact, copying other people’s expressions and holding back stims until you are alone.

Examples reported by autistic adults (Hull, 2017; Miller, 2021):

Cage and Troxell-Whitman report that adults in their 2019 survey found camouflaging both physically and mentally exhausting. That recovery cost, plus a gap between your public and private self, is what sets masking apart from ordinary politeness.

Recognizing yourself here is not a diagnosis, and the CDC notes a brief screening tool does not provide one either. Heavy masking can hide these signs from other people.

High masking autism and why it gets missed

High masking autism describes autistic people who mask so heavily and effectively that they seem fine to the people around them. They may hold down a job and keep up friendships. High masking describes how someone comes across to others, and it can influence adult autism assessments as well.

A high-masking adult can come across as capable, maybe a little anxious or perfectionistic, while privately feeling worn out and unsure who they are without the performance. The DSM-5 autism criteria, from the diagnostic manual clinicians use to help diagnose autism, allow for this, noting that symptoms “may be masked by learned strategies in later life.”

In a 2026 study of autistic adults and clinicians, most of the 141 autistic adults and 41 clinicians agreed that camouflaging influences adult autism assessments. Most clinicians also said they routinely assess for camouflaging, and a smaller share of the autistic adults recalled being asked about it, which is why a masking-aware assessment asks about effort and camouflaging directly.

The label “high-functioning” can make this worse. It’s usually based on IQ, but IQ says little about how someone copes with daily life. In a large study of 2,225 autistic children and teens, IQ was only weakly linked to everyday skills like self-care and managing routines, and the authors called “high functioning autism” a misleading label for that reason. A bright, verbal person who masks well can look like they’re managing while struggling with the basics in private.

Masking in autistic women and girls

Research on masking in autism females points to sex and gender differences in camouflaging, based on a 2021 systematic review of camouflaging research covering 29 studies. Hull and colleagues describe camouflaging as proposed to explain why autistic females are diagnosed later or missed.

In the 2019 Cage and Troxell-Whitman survey, autistic women were more likely to choose conventional reasons for camouflaging, such as getting by at work. Hull’s 2017 paper notes that females are less likely than males with similar autistic traits to receive a diagnosis. For a woman looking back on her teen years, that gap may explain why no one noticed. Men mask too: Hull’s 2017 study of camouflaging included 30 men and 7 adults of other genders alongside 55 women.

Our article on women diagnosed with autism later in life goes further into the women’s side.

What masking costs autistic adults

The effects of masking autism reported in research include exhaustion (Hull, 2017), anxiety and depression symptoms and lower self-esteem (Evans, 2024), and not feeling like your true self (Cage and Troxell-Whitman, 2019). These findings come from surveys and interviews, which can only show associations. A 2021 systematic review found higher self-reported camouflaging associated with worse mental health outcomes.

“It’s exhausting! I feel the need to seek solitude so I can be myself,” one participant told Hull and colleagues.

In Cage and Troxell-Whitman’s 2019 survey of 262 autistic adults, both camouflaging highly across contexts and switching between contexts related to poorer mental health. In a 2024 study of 342 autistic adults, higher masking was associated with greater anxiety and depression symptoms, lower self-esteem, lower authenticity and more past interpersonal trauma.

The costs add up because the mask hides the need for support: Hull’s participants described “failing to receive adequate support or allowances” because difficulties “were often hidden behind the mask of camouflaging.”

Pearson and Rose list burnout among the outcomes linked to masking. When we say autism masking burnout, we mean autistic burnout where masking adds to the load. Research defining autistic burnout names its main features as chronic exhaustion, loss of skills and reduced tolerance to stimulation. Our guide to autistic burnout covers signs and recovery.

Cassidy and colleagues’ 2018 study of suicidality risk markers, a survey study, identified camouflaging, alongside unmet support needs, as a risk marker for suicidality in autistic adults. It is a reason to take masking seriously, not a prediction about any one person.

Any thought of suicide, including passive thoughts such as wishing you would not wake up, is on its own a reason to reach the 988 Suicide & Crisis Lifeline now by calling or texting 988 (chat is at 988lifeline.org), or to call 911 or go to the nearest emergency room if you might act on those thoughts or are in immediate danger. The 988 Lifeline is free, confidential and available 24/7.

Persistent low mood and burnout that will not lift also call for prompt care, covered below.

Masking beyond autism in ADHD and other neurodivergent adults

People who are not autistic mask too. Neurodivergent masking covers people with differences in brain function and behavior, as with autism or ADHD. In a 2024 Dutch study comparing adults with autism and ADHD, with 105 adults per group, adults with ADHD camouflaged more than the comparison group, and autistic adults camouflaged more than both. In Miller, Rees and Pearson’s 2021 survey, all groups said masking disconnected them from their identity, and sensory suppression seemed more specific to autistic people.

ADHD masking can cover traits like inattention or impulsivity, and autistic masking covers social and sensory traits, including stimming. Autism and ADHD can occur together, and our page on ADHD masking covers the ADHD side.

How to stop masking autism safely

Stopping masking safely means choosing where, and how much, to stop hiding. In a 2019 survey of 262 autistic adults, heavy masking and switching between settings were both tied to poorer mental health, so switching may carry its own cost. Over time, the aim is fewer settings that demand a mask.

Surveys cannot test whether any unmasking method works. Going one setting at a time is a practical way to limit risk where unmasking isn’t safe yet. Steps that keep change gradual:

We won’t coach anyone to mask better. The 2024 study’s authors “call into question the teaching of autistic masking strategies in therapies,” and burnout researchers warn of “the potential dangers” of teaching masking.

When keeping the autistic mask on makes sense for now

Some settings make unmasking unsafe or too costly, like a job where disclosure could put your income at risk, a school where you could be bullied, a family where being visibly different is not safe, or housing that depends on fitting in. Keeping the mask on there is a protective choice you can revisit, and disclosure is a decision to make on your own timeline. If you are being bullied or feel unsafe at home, tell a trusted adult such as a school counselor.

When an autism evaluation is the next step

If you suspect you mask and have never had an autism evaluation, or had one that did not ask about masking, an evaluation can help sort out whether autism, ADHD or both explain what you notice. Autism is diagnosed through a clinical evaluation, since there is no medical test for autism. Not sure the traits underneath are autistic? Start with the signs of autism in adults. At Zellig Psychiatry, we offer an adult autism evaluation and treatment for co-occurring anxiety or depression. If you are under 18, talk with a parent or guardian about an evaluation.

Getting help now for distress linked to autistic masking

See a clinician promptly if low mood persists, if you have thoughts or urges to harm yourself, or if burnout is not lifting. Self-harm thoughts or urges are also a reason to call or text 988, or to call 911 or go to the nearest emergency room if you might act on those thoughts or are in immediate danger. If you are under 18, also tell a parent or another trusted adult.

Any thought of suicide, including passive thoughts such as wishing you would not wake up, is on its own a reason to reach the 988 Suicide & Crisis Lifeline now by calling or texting 988 (chat is at 988lifeline.org), or to call 911 or go to the nearest emergency room if you might act on those thoughts or are in immediate danger.