Are Girls Really ‘Masking’ Their Autism?

‘Masking’, whereby people with autism are said to successfully hide their condition, is gaining more traction amongst teenage girls within the increasingly confused ‘neurodiversity community’. According to the NHS, ‘masking’ –

Refers to an autistic person’s management of their social presentation to try and minimise or mask autistic traits from others. Not all autistic people mask, but those who do may not always be aware they are engaging in masking behaviour. Some may struggle not to engage in masking even when consciously trying.

How this manifests in real life is perplexing to the uninitiated. Perfectly well and ordinary teenage girls insist they have autism in spite of there being no behavioural evidence of any neurological or developmental condition. In many cases they have been privately diagnosed at around £2,250 with ‘ASD (Autism Spectrum Disorder) with masking tendencies’. If these charming girls detect your quizzical look as they bounce around with a big group of friends, they flick their hair and say: “Dur – I mask.” If further elaboration is required, they say: “I’m just so good at masking. I’ve done it for years. I mask all the time. I completely hide my autism by masking, it’s really sad. I wish I could be more typically neurodiverse but it’s impossible because I mask so well.”

In a recent Triggernometry interview, Simon Baron Cohen, who has run the Autism Research Centre at Cambridge since 1997, explained that autism is harder to detect in girls but often manifests in

reading obsessively, or collecting books, or becoming very detailed in their knowledge of stories. … Masking is just trying to fit in, trying to copy what other people are doing socially, trying to kind of hide your difficulties. … Yeah, so the girls, it’s not that they don’t have autism, it’s that it’s harder to detect because they’re masking, and so they might be missed in terms of getting a diagnosis.

Another more non-scientific view is that the business of becoming a well-rounded human adult involves a lot of fitting in, personality control, trying to overcome your difficulties and a willingness to act reasonably in society.

Distilled within ‘masking’ is the real danger of the over-expansion of neurodevelopmental diagnoses: it creates rigidly deterministic mindsets. In the rare instance where teenage girls attempt to overcome their ‘condition’, their perfectly sensible actions are once again diagnosed with a medical label. What was once ‘learning how to play your part in civic society’ is now medicalised as ‘masking’.

When taking one autistic 14 year-old girl out for a council-funded wellbeing session, her mother handed over some headphones saying, “Your psychiatrist recommended you wear them so traffic noises don’t overwhelm you.” The girl threw them on the floor and said, “Not wearing them, I don’t want to look like a sped [special education needs kid].” Her Mum shrugged her shoulders: “That’s her masking. She hates having autism. What can I do?” I took the ear defenders in case of emergency, but the girl was not aroused by traffic noises – nor has any other obvious or indeed subtle signs of autism.

I work with many such girls, and my beef is certainly not with them. They tend to fall into two camps: perfectly ordinary teenagers going through that usual phase of developing a personality by experimenting with current trends. Or girls who have legitimate often familial reasons for being sad and are seeking an explanation via the latest mental health movement. My beef is with those professionals who have over a number of decades expanded out the definition of what it is to be autistic from those boys who prefer pattern recognition to social interaction, to perfectly healthy teenage girls. It is no kindness to anyone to tell her she has a neurodevelopmental condition when she does not. Yet the scooping up of these girls into medicalised categories has a number of real-world consequences: one in five children are now said to have a special educational need, EHCPs [Education healthcare plans] have risen 140% (i.e., more than doubled) since 2015 (to 576,000 in 2024) and the SEN budget is £11 billion.

However, scepticism about the usefulness of the spectrum theory of autism is beginning to grip the academia. There are two camps: the groupers and the splitters, who argue respectively whether autism should be considered as a unitary condition or divided into distinct sub-categories. Light has been shed on the issue by a recent paper, ‘Polygenic and developmental profiles of autism differ by age at diagnosis‘, released on October 1st in Nature, which found that “earlier and later diagnosed autism have different developmental trajectories and genetic profiles”. That is, children who are diagnosed with autism very early in life have a different presentation of the condition to those diagnosed later in childhood. This confirms what anyone with half a brain has been able to observe: a non-verbal incontinent young man, and a girl who likes reading yet is able to fit in socially, cannot both be autistic. Autism is less a ‘spectrum’ more an unscientific mess.

Professor Uta Frith, a retired specialist in cognitive development at University College London, put it thus:

It is time to realise that ‘autism’ has become a ragbag of different conditions. If there is talk about an ‘autism epidemic’, a ‘cause of autism’ or a ‘treatment for autism’, the immediate question must be, which kind of autism?

Does this also include the sort of autism that is so successfully masked it should no longer be understood to exist?

Mary Gilleece is an education support worker and her name is a pseudonym.