A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice, by Amy Pearson and Kieran Rose.

ABSTRACT

Autistic masking is an emerging research area that focuses on understanding the conscious or unconscious suppression of natural autistic responses and adoption of alternatives across a range of domains. It is suggested that masking may relate to negative outcomes for autistic people, including late/missed diagnosis, mental health issues, burnout, and suicidality. This makes it essential to understand what masking is, and why it occurs. In this conceptual analysis, we suggest that masking is an unsurprising response to the deficit narrative and accompanying stigma that has developed around autism. We outline how classical social theory (i.e., social identity theory) can help us to understand how and why people mask by situating masking in the social context in which it develops. We draw upon the literature on stigma and marginalization to examine how masking might intersect with different aspects of identity (e.g., gender). We argue that although masking might contribute toward disparities in diagnosis, it is important that we do not impose gender norms and stereotypes by associating masking with a “female autism phenotype.” Finally we provide recommendations for future research, stressing the need for increased understanding of the different ways that autism may present in different people (e.g., internalizing and externalizing) and intersectionality. We suggest that masking is examined through a sociodevelopmental lens, taking into account factors that contribute toward the initial development of the mask and that drive its maintenance.

CONCLUSION

We suggest that future research considers masking as a multidimensional fully interactive construct. To start, masking research needs to be fully grounded in social theory that acknowledges the role that the social environment and collective norms have upon the autistic person. Applying a social lens acknowledges that autistic people are social beings that do not develop in a vacuum. Moreover, masking should be considered in terms of its process; we might think of masking like the process of rock formation. What we see is the rock face, akin to the externally visible strategies that one might use to mask, for example, making eye contact and mimicking facial expressions. But these strategies have been molded over time, transformed by pressure, building up layer upon layer to create what is seen by the observer. Future research should consider the role of environment and context in masking, the outside pressures that led to the initial development, and the impact that this has had upon the individual. It should also take into account the developmental trajectory of masking, and the role that time and trauma play in the development of the mask, as well as the intersection between autism and other aspects of a person's identity (such as gender or race/ethnicity). The interaction between these processes and outcomes is likely to be an essential factor in understanding what can be done to provide better support for those whose mental health is negatively impacted by masking.

https://www.liebertpub.com/doi/full/10.1089/aut.2020.0043