The Camouflage You Cannot Self-Report

What the research found

“Camouflaging” is the word researchers use for hiding autistic traits: rehearsing conversations, suppressing the urge to fidget, copying other people’s facial expressions, forcing eye contact that feels unnatural. It is effortful, and many autistic adults describe it as exhausting. A common belief is that autistic women and girls camouflage more than men, and that this is one reason they are diagnosed later, or missed entirely. This study set out to test that belief carefully, using two very different ways of measuring the same thing.

The researchers studied 174 young adults, aged 21 to 24, drawn from a long-running British twin study (the Twins Early Development Study). Half had a formal autism diagnosis (86 people; 40 women, 46 men). The other half had high levels of autistic traits but no diagnosis (88 people; 43 women, 45 men). This second group is the interesting one. They resemble diagnosed autistic people on trait questionnaires, yet somehow never entered the diagnostic system.

The first measure was a self-report questionnaire, the Camouflaging Autistic Traits Questionnaire, on which people rate how much they consciously mask. The second was cleverer. It is a “discrepancy” measure: it compares how autistic a person looks during a structured observation against how autistic they are underneath, judged by their self-reported traits and by tests of social cognition. If someone appears far less autistic on the outside than their inner profile predicts, they are, in effect, hiding it well. Higher discrepancy means more effective camouflaging.

The two measures did not agree. Self-reported camouflaging correlated only weakly with one discrepancy score (a correlation of 0.36) and not at all with the other (0.04). In plain terms: how much you say you mask has little to do with how well you actually pull it off. These are not two thermometers reading the same fever. They are measuring different things.

On the self-report questionnaire, there were no differences at all: not between the diagnosed and undiagnosed groups, not between women and men. But on the discrepancy measures, two patterns emerged. First, among diagnosed autistic people, women scored higher than men across all camouflaging measures, consistent with the familiar story. Second, and more surprising, the undiagnosed high-trait group camouflaged more effectively than the diagnosed group, and here there was no sex difference at all. Undiagnosed men, in particular, showed markedly higher effective camouflaging than diagnosed men. The authors’ interpretation is cautious but striking: effective camouflaging may itself reduce the likelihood of receiving a diagnosis, for men as much as for women.

What this means for you and your child

The headline for parents is not “girls mask more.” It is subtler and more useful: what a person says about their masking and what they actually achieve are two different things, and the gap matters. Your child may not report camouflaging at all, or may not have the words for it, and still be doing it constantly and well. A confident, articulate teenager who “seems fine” in a clinic may be fine precisely because they are working hard to appear so.

That has a direct bearing on assessment. This study found that undiagnosed young people with high autistic traits were the most effective camouflagers, especially in a structured observational setting, the very setting a diagnostic assessment relies on. A child who holds it together for an hour with a clinician, then falls apart at home, is not contradicting themselves. The clinic may be seeing the mask. If your instinct as a parent conflicts with a brief professional snapshot, that instinct is worth taking seriously and stating plainly.

It also reframes the sex-differences debate. The popular narrative that camouflaging is a female phenomenon was only half-supported here. Yes, diagnosed women masked more than diagnosed men. But among the undiagnosed high-trait group, men masked just as effectively as women. Effective camouflaging that keeps a boy out of the diagnostic system is easy to miss because we are not looking for it in boys. If you have a son who is stretched thin by the effort of seeming ordinary, do not let the “girls mask, boys don’t” shorthand talk you out of asking questions.

Be honest, too, about what this study cannot tell you. It is a single study of 174 people, and once split into four groups, some of those groups were small; the authors say plainly the analysis may have been underpowered. The participants were mostly white and all in their early twenties, so the findings may not transfer to younger children, to other ethnic backgrounds, or to non-binary young people, all limitations the authors name themselves. Crucially, the discrepancy measure leans on a social-cognition test as a stand-in for “true” autism, and the authors themselves question whether their observational tool captures autism well, particularly in women. This is a thoughtful piece of measurement research, not a diagnostic verdict.

The practical takeaway is modest and durable. Do not treat a self-report of “I don’t really mask” as proof that a child isn’t struggling, and do not treat a composed hour in a clinic as proof that all is well. Effortful camouflaging is real, it is not always conscious or reportable, and it can hide genuine difficulty from the very people whose job is to spot it. If your child is coping brilliantly in public and exhausted in private, that pattern is itself information. Bring it to the professionals, and describe what you see at home in detail.