Unmasking Autism

Unmasking Autism: Discovering and Reclaiming Your Authentic Self

Executive Summary

Unmasking Autism by Devon Price, PhD, is a comprehensive guide for discovering and reclaiming autistic identity after years of camouflaging and forced conformity. The book traces how narrow diagnostic criteria created a hidden population of masked autistic people—particularly undiagnosed and late-diagnosed autistic adults, women, transgender people, and people of color—who were systematically denied recognition. Price argues that masking contributes to severe mental health consequences including autistic burnout, depression, anxiety, eating disorders, and substance abuse, while offering practical strategies for unmasking, reclaiming autistic traits as strengths, and building neurodivergent-affirming spaces.

Introduction: Understanding Masked Autism

Autism is significantly more common than official statistics suggest. As of 2020, 1 in 54 children is diagnosed as autistic, up from 1 in 68 four years prior and 1 in 2,500 in the 1990s. However, at least half of all autistic people in the U.S. currently fail to get diagnosed—a conservative estimate. Multiple systemic barriers prevent autistic people from receiving diagnosis: economic barriers (assessments cost $1,200-$5,000 without insurance), limited specialists (few assessors qualified for adult autism diagnosis), biased tools (assessment tools based on decades-old criteria for white male children), and diagnostic racism (white children are 19% more likely than Black children and 65% more likely than Hispanic children to be diagnosed with autism).

The Origins of Masked Autism

The root of masked autism lies in the eugenicist origins of autism research. Hans Asperger deliberately excluded girls from his published research and specifically studied wealthy, white boys he deemed “valuable” enough to protect during the Nazi extermination of disabled people. This exclusion wasn’t accidental—it was systematic. Subsequent diagnostic criteria were built entirely on how autism presents in this narrow group, creating a century-long feedback loop where only those matching that prototype received diagnosis and study. This systematic exclusion led to gender bias (girls learn to mask earlier and more intensely due to stricter social expectations), racial bias (Black, brown, and indigenous autistics face compounded erasure due to racism in psychiatry), and LGBTQ+ erasure (transgender and gender-nonconforming autistics often misread because their behavior doesn’t match the “autistic boy” stereotype).

The Neurobiology of Autism

Autism is a developmental disability with genetic heritability, characterized by unique brain connectivity patterns. Key neurological markers include delayed anterior cingulate cortex development (affects attention, decision-making, impulse control, emotional processing), reduced Von Economo neurons (impairs rapid, intuitive processing), unique neuron activation (neurons activate easily and don’t discriminate between nuisance variables and crucial data), variable brain connectivity (some regions hyperconnected, others underconnected), and reduced global-to-local interference (focus on small details even when contradicting big picture).

The most significant difference is how autistic people process information. Unlike neurotypical people who process top-down (intuitively, with mental shortcuts), autistic people process bottom-up (systematically, carefully, intentionally). Bottom-up processing offers benefits: less susceptibility to cognitive biases, more accuracy in mathematical and logical tasks, better pattern recognition, and systematic analysis of complex systems. Challenges in daily life include difficulty with rapid social assessment, energy-intensive processing of sensory information, need for predictable patterns and rules, and exhaustion from constant analysis.

Sensory Processing and Regulation

Stimming is crucial for autistic self-regulation—it soothes anxiety, helps manage stress, and expresses joy. Forms include physical stimming (hand-flapping, jumping, swaying), vocal stimming (echolalia, humming), sensory stimming (sucking candy, smelling candles), and proprioceptive stimming (joint compression, deep pressure). Research shows all humans stim, but autistic people stim more frequently, repetitively, and intensely. The repetitiveness is key to autism diagnosis—many autistic people crave stability repetition provides.

Special interests (sometimes called hyperfocus) are fundamental to autistic wellbeing. Research demonstrates that engaging special interests correlates with improved wellbeing and mental health, better stress management, lower depression rates, and enhanced social, emotional, and fine motor development. Autistic people don’t complete discrete projects—they “build worlds,” expanding infinitely into new subjects while narrowing into precise focus.

The Cost of Masking

Masking involves suppressing natural stimming behaviors, forcing eye contact despite discomfort, scripting conversations, hiding special interests, and performing neurotypical social behaviors. Research shows masking contributes to autistic burnout (state of chronic exhaustion where skills degrade), physical exhaustion from constant performance, psychological burnout and depression, anxiety disorders, and suicide ideation. The exhausting performance of neurotypicality leaves nothing for relationships, hobbies, or self-care.

Destructive Coping Mechanisms

Eating Disorders and Body Dissociation

Autism and eating disorders are highly correlated, especially among women, transgender people, and late-diagnosed maskers. Between 20-37% of anorexia nervosa sufferers are autistic (though actual rates may be much higher). Multiple factors drive this connection: belief that thinness helps blend in, use of eating disorder behaviors as self-stimulation, purging floods body with endorphins creating calming cycles, attraction to rigid structure and clear rules, and need for concrete focal points to manage “vague anxiety.”

Substance Use As Masking

Autism and substance use disorders are highly correlated. Alcohol and drugs serve multiple functions: dulling intense sensory pain, loosening social inhibitions, numbing anxiety, and helping regulate emotional dysregulation.

Fawning and Relational Abuse

Many masked autistic people engage in “fawning”—a trauma response that pacifies perceived threats through people-pleasing, helpfulness, and hiding one’s needs. Autistic people are at elevated risk of domestic abuse partly because they’re “gullible or overly trusting, and quick to alter themselves to placate others.”

Intersectionality and Autism

The concept of “female autism” is misleading because it centers gender as the cause of masking when really it’s social expectations and marginalization. Women don’t have “milder” autism—marginalized people have their autism ignored because of peripheral social status. For Black and brown autistics, the pressure to mask is compounded by racism and becomes a survival mechanism. Code-switching—shifting between African-American English and Standard English—is cognitively demanding and associated with psychological stress and hypervigilance. The author identifies as autigender—seeing her autism and transness as inextricably linked. Many autistic people recognize gender binary rules as arbitrary and made-up. Transphobic people weaponize the autism-trans association to argue trans autistics “aren’t really trans, just confused”—a deeply dehumanizing perspective that denies autistic people body autonomy and self-determination.

ABA Therapy: Forced Masking and Trauma

ABA therapy is essentially systematized forced masking and punishment. ABA prioritizes changing outward behavior to be less “disruptive” and more “normal,” regardless of what’s happening internally. ABA practices include using rewards and punishments to train autistic children to camouflage traits, punishing children for stimming, making children force eye contact through reward systems, drilling conversational scripts repeatedly, and using aversive punishments including water sprayed in the face, vinegar on the tongue, and historically, electroshock devices. The founder of ABA, Ole Ivar Lovaas, also invented anti-gay conversion therapy, using the same techniques on both autistic and gay children. Forty-six percent of autistic adults who underwent ABA as children report PTSD.

The Paradox of Masking

Research by Sasson and colleagues demonstrates that neurotypical people subconsciously identify autistic individuals within milliseconds—perceiving them as “weird”—even when autistic people behave appropriately. Paradoxical findings include: when autistic people try to mirror neurotypical behavior too rigidly, it triggers discomfort in observers; when neurotypical people are told they’re interacting with an autistic person, their biases disappear—they like the person more and express interest in learning about autism. This suggests transparency may be more effective than concealment.

Practical Strategies for Unmasking

Values-Based Integration

Heather Morgan developed the Values-Based Integration exercise to help autistic people stop focusing on others’ desires and let life be guided by actual values. The process involves recalling five “key moments” where you felt truly alive, identifying keywords describing why each moment was special, looking for repeated words across stories, grouping related words, and using values-based language to describe those experiences.

Reclaiming Autistic Traits as Strengths

The author presents a reframing exercise, transforming stigmatized autistic traits into strengths:

Perceived “Negative” Trait	Reframed Strength
Arrogant	Confident, principled, independent
Cold & Analytical	Rational, perceptive, thoughtful
Annoying	Enthusiastic, loud, alive, outspoken
Childish	Curious, open-minded, joyful
Awkward	Authentic, doesn’t blend in
Clueless/Pathetic	Reflective, unassuming, sensitive

Neurodivergent-affirming Spaces

Marta Rose’s “divergent design” principle: design spaces for how you actually live, not aspirationally. Rather than shame about clothes piled on floors, use hooks beside the bed; dirty clothes go in hamper or floor for later gathering. Sensory design principles include clean lines and muted colors, avoiding loud patterns/bright lights/ornate details, avoiding sharp furniture corners if stimming involves arm movement, providing soft mats for flopping, and using insulation, rugs, soundproofing panels to dampen noise.

Reconceiving Time: from Industrial to Spiral/Cyclical

Many autistic people don’t thrive in judiciously balanced days; some operate on boom-bust cycles of intense hyperfocus followed by recuperation. Marta Rose suggests thinking of time as “spiral” rather than linear: flowing, cyclical, overlapping periods of dormancy intersecting growth—not factory-model “Industrial Time” of discrete predetermined chunks.

Radical Visibility and Accommodation-Seeking

Radical visibility, a concept developed by disability fashion activist Sky Cubacub, celebrates disability and queerness rather than concealing it. It rejects society’s demand for assimilation, instead presenting assistive tools and disability markers as worthy of pride. Research shows that wearing one’s identity with pride reduces self-stigma and feelings of alienation. Sky Cubacub founded Rebirth Garments, centering queer and disabled bodies with colorful, comfortable items.

Building Community and Relationships

Strawberry People

Samuel Dylan Finch’s concept of “strawberry people”—those who deserve prioritized friendship—addresses insecure attachment patterns common in autistic people. Diagnostic questions identify strawberry people: those allowing disagreement, providing nonjudgmental thinking space, addressing hurt honestly, and respecting boundaries.

Autistic Community Spaces

Research confirms autistic people feel far more socially at ease around other autistic people. Autistic community spaces, often created and led by autistic people, feature structures supporting neurodivergent needs: clear rules, specific discussion topics, acceptance of stimming and comfort items, flexible seating, and minimal eye contact expectations.

Systemic Barriers and Necessary Changes

While unemployment and underemployment are serious problems for autistic people, employment itself is precarious. In at-will employment contexts, autistic workers can be fired for a single awkward moment or for appearing “too disabled” after disclosure. For autistic people unable to work, disability benefits create poverty traps: $2,000 maximum in savings, marriage penalties, and frequent re-evaluation requirements requiring repeated “proof” of permanent disability. For black and brown autistic people, visible disability can be criminalized and turn deadly. Approximately 50% of people killed by police have disabilities; black and brown autistics face especially elevated risk.

Neurodiversity Framework and Language

The term “neurodiversity” was coined in 1999 by sociologist Judy Singer in her honors thesis about her daughter’s disabilities. The concept includes people with ADHD, Down Syndrome, OCD, Borderline Personality Disorder, brain injuries, strokes, and those pathologized as “crazy” without formal diagnosis. The vast majority of autism self-advocates prefer identity-first language (“autistic person”) over person-first language (“person with autism”) because autism is integral to identity and can’t be separated. They discourage functioning labels (“high/low functioning”) and prefer “high/low support needs.”

Key Takeaways

1. Masked Autism Results from Systemic Exclusion: The narrow diagnostic prototype created a century-long feedback loop where entire populations were excluded from recognition and study.

2. Masking Has Severe Documented Costs: Lifetime masking contributes to burnout, depression, anxiety, eating disorders, substance abuse, and suicide ideation.

3. Forced Normalization Through ABA Causes Trauma: ABA systematically teaches autistic children that their authentic way of being is shameful and wrong.

4. Body Dissociation Leaves People Vulnerable: Many masked autistic people mentally retreat from their bodies as masking coping, struggling to connect external cues to internal needs.

5. Autistic People’s Vulnerability to High-Control Groups: Yearning for acceptance, combined with struggles with boundaries and fawning responses, makes them prey for cults and abusive relationships.

6. Reclaiming Autistic Traits as Strengths: The supposedly “inconvenient” traits—arrogance, stubbornness, intense focus, principled stands—are actually superpowers enabling moral clarity and complex systems thinking.

7. Special Interests and Values-Based Living: Engaging special interests correlates with stress management and low depression. Values-Based Integration helps autistic people build lives aligned with actual priorities.

8. Neurodivergent-Affirming Spaces Demonstrate What’s Possible: When autistic people design and lead spaces, they naturally create structures supporting neurodivergent needs.

9. Systemic Change is Necessary: Individual unmasking cannot overcome economic injustice, racism, transphobia, or social exclusion.

10. The Social Model Reframes Disability: Disability is often created/worsened by social exclusion—society’s failure to adapt creates the sense of brokenness, not the neurodiversity itself.

Critical Warnings and Important Notes

Eugenicist Legacy of Autism Research

Hans Asperger’s research was explicitly conducted within Nazi extermination programs. He knowingly sent visibly disabled autistics to death camps while protecting “high-functioning” boys he deemed “valuable.” This history directly shaped all subsequent autism research and diagnostic criteria.

Therapy and Mental Health Systems

The history of psychiatry includes forced sterilization, forced institutionalization, psychiatric racism, and forced medical procedures. Therapists and mental health professionals are not inherently allies to autistic people.

This Book’s Limitations

The author acknowledges privilege: her ability to mask, to articulate experience, to access education and professional opportunity. The book centers on masked autistic experience and does not cover nonspeaking autism, intellectual disability, or severe support needs.

Resources and Support

Organizations and Advocacy Groups

• Autistic Self Advocacy Network (ASAN): Autistic-led organization centered on acceptance and self-advocacy
• Real Social Skills: Disability-affirming resource created by autistic people
• Neurowonderful: Video series by autistic self-advocates
• Rebirth Garments: Disability and queer-centered adaptive fashion

Books and Authors

• Divergent Mind by Jenara Nerenberg
• Aspergirls by Rudy Simone
• NeuroTribes by Steve Silberman
• Uncomfortable Labels: My Life as a Gay Autistic Trans Woman by Laura Kate Dale
• The Secret Life of a Black Aspie by Anand Prahlad

Conclusion: The Path Forward

Unmasking is both personal and political. It involves recognizing how masking has harmed you, reclaiming disowned parts of yourself, building supportive community, and working toward systemic change that makes the world more accessible to all autistic people. The journey toward authenticity requires rejecting capitalist logic that disability is only acceptable if the disabled person can still be productive. True liberation requires systemic change, but individual unmasking—celebrating stimming, visible accommodation use, authentic self-expression, and reclaiming special interests—both reduces personal shame and makes inaccessibility undeniable to neurotypical people, forcing systemic attention.