The Hidden Struggle: Masking in Girls AND WOMEN with AUTISM
Children dressed in costume, girls with autism masking.
I often work with bright, sensitive girls and young women who’ve spent years “holding it together” in school, friendships, or family life—only to melt down in private or struggle with anxiety, exhaustion, or identity confusion. This experience is common among neurodivergent individuals who engage in masking—a coping strategy that often goes unnoticed, especially in females.
What is Masking?
Masking (or camouflaging) refers to the conscious or unconscious suppression of one’s natural behaviors and the imitation of neurotypical norms in social situations. This might include:
Forcing eye contact
Mimicking facial expressions or speech patterns
Rehearsing conversations
Hiding stimming behaviors
Suppressing personal interests or sensory needs
For many individuals with ASD, masking helps them “pass” in social situations—but at a significant cost to mental health and self-identity.
Why Is Masking More Common in Females?
Research shows that girls and women with Autism Spectrum Disorder (ASD) are more likely to mask than their male counterparts, which can delay diagnosis and increase vulnerability to anxiety, depression, and burnout (Hull et al., 2020). Cultural expectations often teach girls to prioritize social harmony, empathy, and emotional regulation—skills that girls with ASD may overcompensate for by mimicking their peers.
Girls with ASD also tend to have:
Stronger observational learning, enabling them to imitate social behavior (Dean et al., 2017)
Narrow interests that are more socially acceptable, like animals or reading (as opposed to trains or machines)
Higher internalizing symptoms, such as anxiety or perfectionism, rather than disruptive behavior
Because these behaviors don’t align with traditional autism diagnostic criteria, many girls with ASD are missed entirely—or misdiagnosed with anxiety, depression, ADHD, or borderline personality disorder (Lai et al., 2015).
The Cost of Camouflaging
While masking can help an individual navigate complex social environments, it often comes at a price. Prolonged camouflaging has been linked to:
Increased mental health difficulties, including anxiety, suicidality, and low self-esteem (Cage & Troxell-Whitman, 2019)
Identity confusion and difficulty knowing one’s authentic self
Autistic burnout, a state of emotional, physical, and sensory exhaustion
Parents often report that their daughters seem to "hold it together" all day at school and fall apart at home—an experience rooted in the energy it takes to mask for hours on end.
How to Support Girls Who May Be Masking
If you suspect your child or teen is masking, here are some ways to provide support:
Create safe, judgment-free spaces where they can unmask and be themselves
Use identity-affirming language around neurodivergence and celebrate their unique strengths
Collaborate with a neurodiversity-affirming psychologist who can assess and support their needs through a compassionate lens
Adjust expectations in school or social settings, including offering breaks, reducing sensory overload, and validating their social fatigue
Getting an Accurate Assessment
At SLO Psychological Services, we specialize in neurodivergence-affirming evaluations that take masking into account. Our process looks beyond surface behavior and includes:
Detailed parent and teacher interviews
Self-report tools that screen for camouflaging and internal experiences
Observations across structured and naturalistic settings
Gold-standard autism and ADHD assessment tools
Trauma-informed, gender-sensitive interpretation of results
If your daughter is bright, kind, sensitive, and struggling beneath the surface, she deserves to be understood—not overlooked.
References
Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders, 49(5), 1899–1911. https://doi.org/10.1007/s10803-018-03878-x
Dean, M., Harwood, R., & Kasari, C. (2017). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder. Autism, 21(6), 678–689. https://doi.org/10.1177/1362361316671845
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M. C., & Mandy, W. (2020). “Putting on My Best Normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 50(7), 2209–2220. https://doi.org/10.1007/s10803-019-03935-9
Lai, M.-C., Lombardo, M. V., Pasco, G., Ruigrok, A. N. V., Wheelwright, S. J., Sadek, S. A., ... & Baron-Cohen, S. (2015). Behavioral and neural signatures of atypical social processing in autism spectrum disorder: A comparison of male and female participants. JAMA Psychiatry, 72(12), 1205–1213. https://doi.org/10.1001/jamapsychiatry.2015.1852
