“I want to fit in… but I don’t want to change myself fundamentally”: A qualitative exploration of the relationship between masking and mental health for autistic teenagers

• Published in: Research in autism spectrum disorders Vol. 99; p. 102069
• Main Authors: Chapman, Louise, Rose, Kieran, Hull, Laura, Mandy, William
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.11.2022
• Subjects: Authenticity; Autism; Masking; Mental health; Young people; Authenticity; Young people; Autism; Masking; Mental health
• ISSN: 1750-9467; 1878-0237
• DOI: 10.1016/j.rasd.2022.102069

Previous research has identified an association between masking and mental health for autistic people. However, the direction of causality and mechanisms involved in this relationship are not well understood. This qualitative study aimed to investigate autistic teenagers’ experiences of masking, mental health and how the two develop and interact. Twenty autistic teenagers took part in a semi-structured interview. The interviews were analysed using Reflexive Thematic Analysis. From the analysis, one theme was identified to conceptualise masking as described by participants. Five more inter-related themes were identified, each involved both in the relationship between masking and mental health and conversely in the relationship between authenticity and mental health. Participants described how masking and mental health both influence each other, and both are influenced by social and environmental factors. The findings are consistent with previous research indicating that masking is associated with mental health difficulties. Our analysis presents a broader conceptualisation of masking than previously defined in the literature, placing social oppression of autistic people at the heart of the relationship between masking and mental health. The findings have implications for diagnostic services, post-diagnostic support and therapeutic interventions, highlighting the need to challenge deficit-based narratives of autism. •Autistic teenagers report both masking, and authenticity around their autistic identities.•Masking and authenticity are impacted by mental health changes, and impact teenagers’ mental health.•Both masking and authenticity are driven by individual and environmental contextual factors.•Acceptance of autistic people is crucial for autistic teenagers’ mental wellbeing.