"You have to leave [your autism] at the door”: Understanding high-masking autistic women’s experiences navigating structural and interpersonal stigma

Abstract

Society’s understanding of how autism presents in women is critically misinformed. Autism in girls and women is misunderstood, as the female phenotype presents differently than how it presents in boys. One of the major distinctions in the female phenotype of autism is masking, a form of social camouflage where women “mask” their autistic features to fit in with their peers. When compounded with the already present autism stigma, unawareness of the female phenotype, and structural barriers receiving a diagnosis, autistic women face a unique stigma that is distinct to their group. This study aims to discover how high-masking autistic women navigate the structural and public stigma they face interpersonally. To do so, this study employs structural stigma framework and stigma management communication (SMC) theory to analyze how autistic women navigate this stigma. Thirteen mediated semi-structured interviews were conducted and micro-reflections were collected for data collection. Participants framed masking as necessary but a survival instinct for managing stigma. They also reported silence and activism as common tactics for stigma management. Notably, they often discussed witnessing others face autism stigma and internalizing those events, as opposed to experiencing direct stigma themselves. Practically, the findings underscore the need for educational materials, particularly aimed at medical providers, teachers, and parents.