Autism is still diagnosed far more often in males than in females, at a rate of about four males for every female. So why camouflaging may hide autism in females is a question this review finds connected to that gap. A 2019 overview puts the idea at the heart of debates about the female phenotype of autism.
In short, the paper argues that some females with autism can show superficial social skills that mask their difficulties. Drawing on eight studies, it says this can delay identification, while people who camouflage may still face high stress and a need for support.
The study, by a researcher at the University of Salford, was published in Psychreg Journal of Psychology. It summarises a 2019 systematic review in Advances in Autism rather than reporting a new experiment of its own.
What the camouflage hypothesis means
The paper describes camouflaging as learned social skills used to hide autism-related difficulties. Girls and women may imitate mannerisms, voice, and personality after watching socially skilled peers. The overview notes that this pattern is often discussed as a key feature of the female phenotype of autism, especially among those with cognitive abilities in the typical range.
Four of the eight studies used interviews. Participants in those samples reported camouflaging to blend in, appear normal enough, or improve connections with others. Strategies described included forced eye contact, intense monitoring of tone and posture, facial expressions that did not match inner feelings, and careful peer imitation. In one study of ten teenage girls, six attended drama classes, and some pretended to read so others would not notice them watching.
What camouflaging can cost
Across those interview studies, exhaustion was a recurring cost. Some participants also reported severe anxiety and stress after camouflaging, and the paper describes a strong need to withdraw and recuperate, sometimes for hours. It argues that effective camouflaging is not a reason to withhold diagnosis or support, because the hidden strain can still be substantial.
A later questionnaire, the Camouflaging Autistic Traits Questionnaire, was given online to 354 autistic and 478 non-autistic adults. Analysis settled on 25 items covering compensation, masking, and assimilation. The overview presents that tool as a way to compare camouflaging across people, with or without a formal autism diagnosis, while calling for more diverse follow-up research.
What the overview cannot tell us
This is a short narrative piece built on a small set of studies, not a new primary trial. Interview findings belong to the participants in those studies and should not be read as proof that all autistic females camouflage in the same way. The author concludes that much more empirical work is needed before the female phenotype of autism is well understood.
Psychreg has also covered research on females flying under the radar of autism diagnosis, why autism in girls is often missed, and whether autism can go undiagnosed into adulthood. Each looks at how masking and delayed recognition can leave people without the help they need.
