Hidden in plain sight: a qualitative exploration of the influence of masking on autistic women’s mental health

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Purpose Masking, the suppression of autistic traits to meet neurotypical expectations, is widely reported among autistic women and linked to adverse mental health outcomes. However, less is known about how masking relates to identity development and internal experience. This study aims to examine the question: what internal “voices,” defined as distinct narrative positions, are present in autistic women’s experiences of masking, unmasking and advocacy? Design/methodology/approach In-depth interviews with eight autistic women were analysed using the Listening Guide to identify patterns of relational and emotional positioning across narratives. Findings Three interrelated categories of voices were identified: voices of masking (shame, exhaustion, disconnection), voices of unmasking (self-acceptance, empowerment, connection) and voices of advocacy (resistance, anger and action). These voices co-occurred and were context-dependent rather than sequential. The findings conceptualize masking as a socially embedded survival strategy shaped by gendered and ableist expectations, with unmasking and advocacy emerging as relational responses to safety, recognition and constraint. Originality/value The study advances a neurodiversity-affirming framework that situates autistic identity as dynamically negotiated within structural contexts and highlights implications for reducing environmental demands that necessitate masking.