“More than a mask”: A multidimensional model of autistic women’s experience of camouflaging

Autistic individuals may engage in various strategies to better align with non-autistic social stereotypes; most commonly termed camouflaging. Previous research has suggested that autistic women are more likely to camouflage than autistic men. However, there is debate concerning the nature of any gender differences, how best to define and measure camouflaging and its impact on health and well-being. This study explores how nine autistic women conceptualise, experience and engage in camouflaging. A narrative approach is used to analyse the data, in particular, thematic analysis and the narrative tools of broadening, burrowing and restorying. 
Four over-arching themes were generated from looking at the women’s stories. The first theme was “camouflaging as a multifaceted and individualised process”, which captured the breadth and variety of each participant's camouflaging repertoire. The subthemes included methods of camouflaging, awareness of camouflaging, and individualised process. The second theme was “camouflaging and relationships”, with the subthemes of camouflaging inhibiting and enabling relationships, camouflaging within close relationships, and authenticity versus intimacy. The third theme was “societal pressure”, which explored the effect of sociocultural factors on the participants' camouflaging. The subthemes included, pressure to conform to a non-autistic majority, camouflaging as protection, and interaction between gender and camouflaging. The final theme was “diagnosis and camouflaging”, with the subthemes of pre-diagnosis experience of camouflaging, diagnosis revealing and reframing camouflaging, restorying the past, and future camouflaging.
The findings support viewing camouflaging within a multidimensional and intersectional frame, that acknowledges how co-morbidity, gender, ethnicity, age (and other identity factors) affect the type of adaptive repertoire individuals use and their experience of it. The dynamic nature of camouflaging, and the women’s relationship to it, is captured, including the impact of diagnosis. Considering camouflaging in this multidimensional way may help clinicians to better assess and support autistic people. Further research is needed to consider how factors such as co-morbidity and socio-cultural background may influence camouflaging and impact mental health.