“If I Want to Live I Have to Camouflage”: Social Camouflaging in Autism Spectrum Conditions (ASC)

Background:  One potential aspect of the female ASC phenotype is the phenomenon of ‘camouflaging’ – using deliberate and/or automatic techniques to mask characteristics of ASC as a way of coping in social situations. Camouflaging at school, home and in clinical settings may account for the large numbers of women and girls with ASC who do not receive a timely diagnosis or are diagnosed later in life. However, there has been little empirical research into camouflaging to produce a standardised construct. In addition, no research has yet explored camouflaging amongst males with ASC.

Objectives:  To assess the camouflaging experiences of adults with ASC. This is the first study to investigate camouflaging in a large sample of adults of all genders with ASC, using a systematic, data-driven, qualitative research approach to produce a conceptual model of camouflaging.

Methods:  As part of a larger online survey, 55 women, 30 men, and 7 other-gendered individuals aged 18-79 with ASC completed a series of open-ended questions about their camouflaging experiences (or lack thereof). Thematic analysis of responses was used to identify key themes relating to respondents’ attitudes to camouflaging and its impact on their lives.

Results:  The vast majority of participants (n = 79) reported camouflaging their ASC in some situations. Respondents viewed camouflaging as a useful tool to help them navigate the social world, but many regretted the need to change themselves in order to fit in. Some viewed camouflaging as deceitful and manipulative, or felt they had little control over their camouflaging behaviours. Physical, emotional and mental exhaustion was the main consequence reported, and this in combination with the more negative attitudes to camouflaging was reported to lead to mental health issues such as anxiety and depression. Some respondents also described camouflaging as a gendered concept, citing the higher social standards set for typically developing women and the common misperception of ASC as a ‘male condition’. These were reasons why some respondents felt that female-presenting individuals were more pressured to camouflage than ASC men. Some female respondents felt camouflaging had hindered their ASC diagnosis or access to support.

Conclusions:  Camouflaging is a real, meaningful experience in the lives of adults with ASC of all genders. The possibility of camouflaging needs to be considered when assessing individuals for ASC, especially women and girls.