Disclaimer: I do not consider my experiences to be an exemplar of all autistic experiences.
I would like to state that I’m a firm believer in the neurodiversity paradigm. That I am not proposing that autistic people do not mask. This post is by a white, cishet male. For other autistic folk there will be systemic power dynamic oppressions, racism, gender bias, homophobia, transphobia and prejudice towards other lived gender identities. And, crucially, the oppressive structures of capitalism/neoliberalism. All of these are not specific to the autistic population.
I was diagnosed as autistic in 2018 following a spell in a psychiatric unit to which I had been sectioned. I was 61. Only a few months before this had I begun to wonder if I maybe autistic. I had previously compared myself to someone in my family who had been diagnosed decades before and thought, ‘I’m different to them.’ It was only on researching contemporary accounts that I realised my life-long difficulties and struggles matched what is currently called level 1 autism. A formal diagnosis confirmed this.
I was placed on high doses of both venlafaxine and mirtazapine. Although I know people for whom anti-depressants have been enabling, unfortunately, my experiences were not so good. I have co-occurring Alice in Wonderland Syndrome (AIWS). Episodes of AIWS increased in intensity and duration. Hypnagogic and hypnopompic hallucinations have been a lifelong feature for me. When, during my time on ADs, my hypnopompic hallucinations changed from a vague sensation of a presence in the room on awakening to the hallucination of a malevolent child in Victorian garb floating in mid-air, I decided to come off anti-depressants. These perturbing experiences quickly decreased.
It was during the time following the crisis that lead to my being sectioned and while experiencing adverse effects of AD meds that I discovered autistic Twitter, which, at the time, was a hub of autistic autism researchers and advocates. Here I came across the masking narrative. A narrative that proposes a direct causal relationship between masking and mental health problems and suicidality. I initially assumed this must be the reason for my crisis. I even tweeted so. Eventually. As I recovered, I realised this wasn’t my narrative.
I’m intensely annoyed with myself for believing this narrative as it hindered and delayed my recovery. I console myself that, ‘such was the state I was in’ it lead me to trust that this narrative applied to me. Whether it applies to others is another matter. I then began a process of retrospection and exploring the difference between social identity, identity and the self. I also explored the origins of this narrative within autistic research.
Around 40 years ago a girlfriend told me that when someone smiles at you, you are supposed to smile back. This was news to me. I was further informed that it is best just to return a smile, because if you smile first at a woman she may well think you’re being creepy. I resolved to try and remember this. However, to this day, when walking towards someone if they smile at me, by the time I have remembered to smile back they’ve often walked by and I’m left smiling at thin air. This, to me, demonstrates not an internalising mechanism that would result in a pre-reflective response of smiling. My act of smiling was reflective resulting in a temporal gap that left me smiling at no-one. I struggle to interpret facial and gestural expressions. I also struggle to understand emojis and have learnt as many as possible by heart. If you’d like a discussion about whether the Mona Lisa is smiling or not, I ain’t your guy. I have no idea and, frankly, don’t give a fuck.
I spent a lot of time observing other people trying to figure out the rules and protocols of social interaction. Unsuccessfully in the main, but my point is that it was always a conscious act. There is no way I was going to subconsciously absorb this information. One could argue that I was subconsciously driven to make these observations, I would reply that I was simply driven by an impulse to not give offence or appear impolite. I suspect everyone does this to some greater or lesser extent.
One part of the identity discourse that is often omitted is that of class. I am a working class man who was born (1956) and raised in a village. At this time anyone who behaved differently was said to be ‘a bit of a character.’ For autistic women I’m sure this would have been different. This, imv, points to systemic gender bias more than anything else.
I left education after A levels. I have trouble with writing. First drafts always include the muddling of letter and word order and the occasional random word appears. I have to rewrite, often a number of times. I figured university would mean writing even longer pieces and there was no way I was going to subject myself to that level of boring repetition.
I worked in a number of manual jobs, always avoiding any public facing jobs. I suspect had I worked in any middle class/professional job my difficulties would have been highlighted and proved problematic. Here, I suspect, social mores would have resulted in a far higher levels of unfavourable judgement. That, imv, is as much a class problem as it is a wholly being autistic problem. These days, of course, many working class autistic folk find themselves in far more controlled, surveilled and emotionally demanding jobs. I am not advocating solely a class-based way forward here, after all, history tells us that class-based approaches can give rise to just as socially conservative an administration as other political systems. Whether one calls it intersectionality, multiple jeopardy, or multiple consciousness, these need to be incorporated. I am detailing how class played a role in my life such that a desire, or need, to mask played little role in my breakdown.
I went travelling for a few years. I thought navigating some difficult territories would make social life on my return easy by comparison. A life long interest in the Middle East resulted in me dodging rubber bullets in Gaza and steering myself round Lebanon and Sudan during civil wars and unrest. As everyone who is autistic will have guessed, my social difficulties remained firmly in place.
On my return I thought I’d better get some sort of qualification or trade. I learnt an old country craft working in hazel coppice and did that until retirement. No need to mask working in woodland. Nor did I ever really attempt mask when socialising. I accept there is a huge element of white, cishet male privilege at play here.
On realising that the masking to mental health problems and suicidality narrative wasn’t appropriate to me, it began to dawn on me it was more of a self problem than an identity problem. Not a mere assigned social identity problem. On reading some literature on solitary confinement the phrase ‘ontological disbelief’ struck a chord. I’m not claiming equivalence with a prisoner in solitary confinement. I chose to think of my own experience as ontological fragmentation – a gradual erosion of my sense of self that cumulated in rendering the question “to be, or not to be” of ever decreasing import and salience. I may expand on this process in another post, here I’m more interested in exploring why the masking narrative, and more particularly its claims of causal effect, is so prevalent and not placed in context of the many other reasons autistic folk experience mental ill health and suicidality.
When I speak of autistic folk I’m thinking us holistically, not just the one diagnosis of autism. The majority of autistic people have both attending psychiatric and physiological/somatic conditions. These should also be taken into consideration if one is going to make any sort of balanced judgement about autistic people and mental health. For me, for example, the body schema issues that come with AIWS contributed to the erosion of my sense of self, one can “risk losing our sense of self and suffer from depersonalisation. We might even end up experiencing the world itself as being unreal, a process known as derealisation” (1), ADHD (a common co-occurrence) particular when unsupported “is associated with higher risks” of “early entry into the criminal justice system, family breakdown, chronic mental health problems, self-harm, suicide, substance misuse, obesity, chronic physical illnesses (e.g. cardiovascular disease) and premature mortality” (2); autistic people are over represented within the homeless statistics; many autistic women experience SA, DV, controlling and abusive behaviour; most autistic people experience bullying; problems with the DWP and benefits are well-documented as are the knock-on ill-effects on mental health; many autistic people experience chronic pain, chronic pain has been associated with a fragmentation of identity (3), “people with chronic pain may learn to suppress or mask their expressions of discomfort” (4), “we have learnt to mask our pain.”(5), a number of autistic people have joint hypermobility here “autonomic dysfunction mediates the association between joint hypermobility and clinical anxiety status”. (6), apraxia, epilepsy, many other conditions.
Current autistic theory has turned full circle back to a mind/body dichotomy. The modular cognitive deficits of the past have been replaced by a core cognitive account of attentional scope. All attending diagnoses and conditions have been pushed to the periphery, even though these are known occasion mental health problems and are part of a person’s identity. The self is an intertwining of body and mind and the self is intertwined with the world (7). Failure to recognise this introduces a barren landscape, a vacuum, into which the masking narrative has rushed wrt the mental health of autistic folk.
There are some key figures in the masking literature, I’ll look at three. W.E.B. Du Bois’ concept of “double consciousness” from his book “The Souls of Black Folk”. Here Du Bois describes how viewing oneself via the eyes of a discriminatory society leads to a fragmented identity. Du Bois wrote this book during the Jim Crow Era and black people in the US have the history of four centuries of enslavement following their forced transferral from Africa. For me, a white guy in 2025, to claim that level of historical violent oppression would obviously be a false claim of equivalence and a gross act of appropriation.
In one of the best, imv, books of the C20th, Frantz Fanon’s Black Skin/White Masks, Fanon explores the effects of colonialism and racism that lead to self-criticism and alienation. Again, I cannot claim to have been subjected to this level of oppression. Where would it leave black autistic folk if I made this claim?
Erving Goffman’s Dramaturgy plays a large role in autistic accounts of masking. A theatrical metaphor where individuals assume different roles during social interactions in different social settings. The component of Goffman’s Dramaturgy often quoted in the masking literature is Impression Management, how people manage the the impressions they may make on others to modify how they are perceived by others. Here the masking literature adopts Goffman’s notion of a “Spoiled Identity”, an identity that is subject to prejudice and discrimination, where masking is to present oneself as someone not subject to this discrimination and prejudice. I have a number of reservations about this account and how it applies to autistic folk in 2025.
Goffman’s account focuses on the microsociological processes of interpersonal social interaction. Macrosociological processes are neglected, those that are systemic and structural in capitalist/neoliberal societies, ie power dynamics are absent. Although Goffman clearly provides useful understanding of unequal social interaction, and as such is regarded in high esteem in sociology and elsewhere, we should, imv, place him in his socio-historical context. Goffman’s last book was published just under half a century ago. We now live in an age when autistic people are, literally, queuing for years to receive a diagnosis and are comfortable with self-diagnosing on social media. Those I know who were diagnosed decades ago experienced far more discrimination and prejudice than I do in 2025. I also strongly suspect that level 2 and level 3 autistic folk experience more discrimination and prejudice than I do. I can only offer my lived experience. It would not, imo, be right or accurate to appropriate the lived experience of discrimination and prejudice as it is applied to others and those in the past.
It is important to note that I am not claiming I have never experienced discrimination, nor that the process of masking is never arduous. I am questioning why it is assumed to play a leading role in mental ill health and suicidality when so many other material, bodily/psychological factors and a macroeconomic system that applies negative value to disability are at play. There are a number of reasons for this assumption, imv.
The rather rudimentary application of a social model that has been adopted, whereby the process of depathologising the biomedical narrative is presumed to necessitate the ideological necessity that every instance of perturbation and injurious process should, consequentially, entail the pathologisation of the environment when, in reality for neurodivergent folk, our multiply diagnoses/conditions should be placed in dialectical/interpenetrative/dynamic relationship, body and mind, person and environment.
A mimicking of the biomedical presumption that researching autism is the same as researching autistic people. That we must propose a core cognitive difference to be valid chroniclers of autistic experience. This impels us to jettison all attendant/concomitant diagnoses/conditions to the periphery, even though many clearly generate psychological and physiological harms that will have an effect on mental health outcomes. This runs the real risk of producing a disembodied narrative. I would suggest neurodivergent studies would be a more appropriate and collective enterprise.
A, what I call ne(ur)oliberal, approach that focuses on individual flourishing rather than collective flourishing.
The masking/identity narrative, imv, decontextualises a socio-historical exploration of discrimination and also makes claims of equivalence and commits acts of appropriation it cannot cash out. It omits the multiply determinants that lead to mental health problems and fragmentation of self. For me, alienation and isolation yes, masking, no. Without the friction of meaningful social engagement one’s self recedes and fragments.If one is going to propose a theory of masking and identity then please put clear water between your narrative and those who seek to weaponise it in the name of a anti-trans narrative. Compare the following:
“The relationship between masking, interoception and alexithymia.” (The Autistic Advocate) 8
“5.44 Difficulties with interoception (making sense of what is going on in their bodies) and alexithymia (recognising and expressing their emotions) can sometimes make it hard for these young people to express how they are feeling about their internal sensations, their gender identity and their sexual identity. (Cass Review) 9
- The mystery of Alice in Wonderland syndrome.
https://www.bbc.co.uk/future/article/20230313-the-mystery-of-alice-in-wonderland-syndrome
- Report of the independentADHD Taskforce: Part 1. https://www.england.nhs.uk/long-read/report-of-the-independent-adhd-taskforce-part-1/
- “I Was Literally Just Not Myself”: How Chronic Pain Changes Multiple Frames of Identity. https://pubmed.ncbi.nlm.nih.gov/35057679/
- Wounded Body: A Phenomenological Attempt to Define Physical Pain. Adriana Joanna Mickiewicz. A Phenomenological Attempt to Define Physical Pain Biblioteka Naukihttps://bibliotekanauki.pl › articles
- Spotlight on Women’s Health and Neurodivergence issues. Jane Green MBE. https://www.linkedin.com/pulse/spotlight-womens-health-neurodivergence-issues-jane-green-mbe-
- Variant connective tissue (joint hypermobility) and dysautonomia are associated with multimorbidity at the intersection between physical and psychological health. Jessica A. Eccles et al. https://pubmed.ncbi.nlm.nih.gov/34806825/
- The Visible and the Invisible. Maurice Mereau-Ponty
- The Autistic Advocate. https://theautisticadvocate.com/interoception-and-masking/
- The Cass Review. https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://cass.independent-review.uk/home/publications/final-report/&ved=2ahUKEwjOjPOKxMaOAxXpUEEAHcusCFcQFnoECB0QAQ&usg=AOvVaw1v_D9eVzwTL2-6fg7AS4HX
