Women and Autism: The Hidden Cost of Masking

For many autistic women, navigating the world often feels like walking a tightrope. The act of “masking” – suppressing natural autistic behaviors to appear neurotypical – becomes a survival mechanism, a way to avoid judgment or rejection. While this might help women fit into societal norms, the cost of masking runs deep, leading to mental health challenges, misdiagnosis, and a loss of identity.

This article explores what autism masking is, why autistic women are often overlooked in diagnoses, the toll masking takes across different life stages, and resources for those seeking support in the Seattle area. By understanding the hidden cost of masking, we can create spaces where autistic women feel empowered to be their authentic selves.

What Is Autism Masking in Women?

Autism masking refers to the deliberate effort to hide or minimize behaviors associated with autism in order to appear neurotypical. This can include things like resisting the urge to stim (self-soothing repetitive behaviors), forcing oneself to maintain eye contact, or rehearsing conversations in advance. These efforts are often an attempt to “blend in” and avoid being perceived as different.

Common masking behaviors include:

• Mimicking the gestures, speech patterns, or expressions of neurotypical peers
• Suppressing stimming behaviors, such as tapping fingers or rocking
• Forcing oneself into social engagements despite sensory overload
• Analyzing social interactions in detail to prepare for and recover from conversations

For many autistic women, masking starts early, often long before they even suspect they may be autistic. While masking can reduce instances of bullying or misunderstanding, it comes at a hidden cost.

Common Signs of Autism Masking in Women

Because masking becomes second nature for many women, it can be hard to recognize. Here are some common signs:

• Feeling exhausted or emotionally depleted after social interactions
• Rehearsing conversations in your head in advance (and replaying them afterward)
• Struggling with identity or not knowing “who you really are”
• Keeping a mental checklist of social “rules” during interactions
• Rarely feeling fully relaxed—even when alone

If these resonate, it might be worth exploring the possibility that you’ve been masking for much of your life.

Mental Health Impact of Autism Masking

The emotional and physical energy required to mask can lead to chronic exhaustion or burnout. Many women describe feeling a constant need to perform, to the point where they lose sight of their genuine selves. Some describe it as feeling like they’ve been “performing a character” for so long, they don’t know how to stop—even when alone.

Mental Health Struggles

Masking can exacerbate feelings of anxiety and depression. Many autistic women receive misdiagnoses, such as anxiety disorders, depression, or borderline personality disorder, because their autistic traits are camouflaged by masking. Without an accurate diagnosis, they often lack the support they need.

Burnout

Chronic exhaustion is a frequent complaint among autistic women who mask. The energy spent on maintaining this facade is unsustainable, leading to periods of extreme physical and emotional depletion.

Loss of Identity

Over time, constant masking may leave women feeling disconnected from their authentic selves. The pressure to conform can blur the lines between one’s natural inclinations and learned behaviors, resulting in a sense of identity loss.

Delayed or Missed Diagnosis

Historically, autism has been studied and diagnosed based on how it presents in boys. This male-centric view has meant that autistic women, who are often adept at masking, can go undetected for years or even decades.

Common Misdiagnoses in Late-Diagnosed Autistic Women

When autism is hidden beneath layers of masking, it’s often mistaken for other conditions. Some of the most common misdiagnoses include:

• Generalized Anxiety Disorder
• Depression
• Borderline Personality Disorder (BPD)
• ADHD (in some cases, ADHD and autism co-occur)
• Social Anxiety Disorder

While these conditions can co-exist with autism, misdiagnosis often delays proper support and understanding. A neurodiversity-affirming evaluation can help untangle these threads.

Why Women Are Overlooked in Autism Diagnoses

The criteria for diagnosing autism were originally developed based on studies conducted largely on boys. Traits such as difficulty with social interactions or a tendency toward repetitive behaviors may look different in autistic girls and women. Girls often form “camouflaged” coping mechanisms like masking, making their struggles harder to identify.

Instead of receiving an autism diagnosis, many women are labeled as “overly anxious,” “highly sensitive,” or even accused of “attention-seeking.” This misdiagnosis cycle can prevent women from accessing therapies, accommodations, or communities that could significantly improve their quality of life.

How Autism Masking Evolves Across the Lifespan

Adolescence

Many autistic girls start masking in middle or high school, when social pressures peak. Fear of rejection or bullying can prompt them to suppress natural behaviors, such as avoiding eye contact or speaking honestly. They may study their peers closely, mimicking social cues to fit in.

While this might help some girls avoid overt criticism, it plants the seed of long-term struggles. Constantly pretending to be someone else can have significant emotional costs, even if it avoids immediate social pitfalls.

Early Adulthood

The transition into adulthood amplifies the need to mask. Careers, romantic relationships, and societal expectations often demand high levels of social interaction. Autistic women may feel an even greater pressure to “perform,” pushing through social fatigue and sensory overload to maintain jobs, relationships, or family roles.

This stage often marks the height of exhaustion and the beginning of long-term mental health struggles, as women stretch beyond their limits just to keep up appearances.

Adulthood

Without a proper diagnosis, autistic women may feel like they’re perpetually “on stage,” never able to relax into their true selves. Many report symptoms of burnout, emotional disconnection, or identity crises. For some, a late autism diagnosis provides clarity and a sense of relief. However, the years (or decades) of masking can leave lasting scars.

How Autistic Women Can Begin Unmasking

After years or decades of masking, the idea of “unmasking” can feel both liberating and terrifying. Unmasking is not about abandoning self-awareness or disregarding others—it’s about dropping the performance and allowing your authentic self to take the lead.

Here are a few ways unmasking might look:

• Setting Boundaries – Declining social events that drain your energy without guilt
• Stimming Freely – Tapping your fingers, rocking, or using fidget tools to self-regulate
• Speaking Honestly – Using direct communication, even if it doesn’t follow neurotypical social scripts
• Wearing Comfort Over Conformity – Dressing for sensory comfort instead of fashion norms
• Connecting with Other Autistic People – Finding community where masking isn’t necessary

Unmasking is a process, not a destination. Many women describe it as peeling away layers of expectation and discovering, sometimes for the first time, what it feels like to be at ease in their own minds and bodies.

Autism Support and Diagnostic Resources in Seattle

If you or someone you care about suspects they may be autistic, there’s hope and help available. Here are some Seattle-area resources tailored to support neurodivergent women:

Neurodiversity-Affirming Assessments

• Love Neurodiversity Consulting offers comprehensive autism evaluations, particularly for women and teens who mask. This service specializes in understanding the unique ways autism presents in women.

Advocacy and Community

• Washington Autism Alliance assists individuals and families in navigating services and evaluations. They advocate for accessible care and education tailored to autistic individuals.

Social Groups

• Square Pegs Social Club provides meetups for autistic adults. They even offer a Ladies Group on the fourth Friday of each month.
• Seattle Autism Spectrum Support Group meets monthly. It’s a welcoming space for adults exploring autism, whether recently diagnosed or just beginning the journey.

Recommended Reading

For deeper insights, Divergent Mind by Jenara Nerenberg is an excellent book that highlights the experiences of neurodivergent women. It’s available locally at Third Place Books.

You might also explore:

• Unmasking Autism by Devon Price
• Women and Girls with Autism Spectrum Disorder by Sarah Hendrickx

The Path Forward

Masking may be a learned survival strategy, but it isn’t the only way to exist in the world. With growing awareness and community support, more autistic women are embracing the path of unmasking—reconnecting with their true selves and redefining what success and well-being look like.

By acknowledging the ways autism uniquely manifests in women, we can reduce misdiagnosis and build supportive environments where women feel empowered to be their unmasked selves.

Frequently Asked Questions

What are signs that I might be masking?
Common signs include social exhaustion, replaying conversations, identity confusion, and a constant sense of being “on stage.”

Is masking always bad?
Masking can be a useful short-term tool to navigate social situations, but chronic masking without support often leads to burnout, anxiety, and identity loss.

Can I stop masking completely?
Unmasking is a gradual and personal process. It involves self-discovery, setting boundaries, and finding safe environments where you feel accepted.

How is autism different in women?
Autistic women often develop strong social camouflaging strategies. Their traits may show up as intense interests, high empathy, or perfectionism—often missed by traditional diagnostic criteria.

Where can I get evaluated for autism in Seattle?
Services like Love Neurodiversity Consulting provide neurodiversity-affirming evaluations tailored to women and teens.