Why We Mask: A Neurodivergent, Clinical, and Cultural Perspective

Written By: Dr. LaKeisha Thomas, PhD, LCSW, LMSW, Doula

There is a version of you the world rewards—and a version of you that feels the most real.

For many neurodivergent individuals, those two versions are not the same.

In clinical spaces, we call this masking or camouflaging: the process of consciously or unconsciously suppressing natural behaviors, emotions, or cognitive patterns in order to align with socially accepted norms. While the concept has gained visibility in recent years—particularly in conversations around autism and ADHD—masking is not new. It is deeply rooted in survival, shaped by systems, and reinforced by culture.

And for many people, especially those from marginalized communities, masking is not optional. It is necessary.

Understanding Masking Through a Clinical Lens

Masking is most commonly studied within neurodevelopmental conditions such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Research suggests that individuals engage in masking to reduce stigma, improve social acceptance, and navigate environments that are not designed for neurodivergent ways of thinking or being (Hull et al., 2017; Livingston et al., 2019).

Clinically, masking can include:

·        Forcing eye contact despite sensory discomfort

·        Rehearsing conversations to appear socially “appropriate”

·        Mimicking facial expressions, tone, or body language

·        Suppressing stimming behaviors or emotional responses

·        Overcompensating through perfectionism or hyper-functioning

On the surface, these adaptations are often interpreted as strengths. Individuals who mask effectively are frequently described as “high functioning,” “articulate,” or “put together.”

But that interpretation is incomplete.

Because what is often labeled as functioning is, in many cases, strategic self-suppression.

Masking as a Trauma Response

From a trauma-informed perspective, masking aligns closely with what is known as the fawn response—a survival strategy in which individuals prioritize pleasing others, minimizing conflict, and adapting behavior to maintain safety (Walker, 2013).

For clients with histories of emotional neglect, chronic invalidation, or unsafe environments, masking becomes a learned response:

·        “If I am too much, I will be rejected.”

·        “If I express myself honestly, I will be punished.”

·        “If I adapt, I will be safe.”

Over time, this response becomes automatic.

What begins as protection evolves into identity.

The Urban and Cultural Context of Masking

To understand masking fully, we must move beyond diagnosis and into context.

For Black and Brown individuals, masking does not occur in isolation from race, culture, or systemic inequities. It intersects with code-switching, respectability politics, and the constant awareness of how one is perceived in predominantly white or clinical spaces.

In these contexts, masking can look like:

·        Adjusting speech, tone, or expression to avoid being labeled “aggressive”

·        Over-performing competence to counter stereotypes

·        Suppressing emotional vulnerability to maintain perceived strength

·        Navigating professional spaces where authenticity may be penalized

For neurodivergent individuals within these communities, this creates a dual layer of masking:

1.     Masking neurodivergence to appear neurotypical

2.     Masking cultural identity to meet dominant societal expectations

This is not simply adaptation. It is psychological labor.

And it is exhausting.

The Hidden Costs of Masking

Masking is often effective in the short term. It can increase access, reduce conflict, and create opportunities.

But clinically, the long-term impact tells a different story.

Research has linked chronic masking to:

·        Increased anxiety and depressive symptoms

·        Emotional burnout and fatigue

·        Identity confusion and diminished self-concept

·        Delayed or missed diagnoses, particularly among women and people of color (Hull et al., 2020)

In therapeutic settings, this often presents as:

·        A disconnect between internal experience and external presentation

·        Difficulty identifying authentic needs, preferences, or emotions

·        Chronic exhaustion despite appearing “functional”

·        Statements such as, “I don’t know who I am when I’m not performing.”

Masking does not eliminate distress. It redistributes it—internally.

Reframing Masking: From Pathology to Adaptation

It is critical to approach masking with nuance.

Masking is not inherently maladaptive. It is, in many cases, an intelligent and necessary response to environments that lack psychological safety, cultural awareness, and neurodiversity-informed practices.

The goal is not to eliminate masking entirely.

The goal is to restore choice.

Healing involves:

·        Increasing awareness of when masking is occurring

·        Understanding the purpose it serves in specific environments

·        Identifying spaces where masking is not required

·        Gradually reconnecting with authentic expression in safe, supported contexts

This is particularly important for marginalized individuals, for whom unmasking indiscriminately may carry real social or professional risks.

A Holistic and Culturally Competent Approach

At Holistic Therapy & Wellness, masking is explored through an integrated framework that includes:

·        Trauma-informed care

·        Neurodiversity-affirming practices

·        Cognitive and behavioral interventions

·        Somatic and mindfulness-based approaches

·        Culturally responsive and identity-affirming therapy

This means we do not rush clients toward vulnerability without first establishing safety. We do not pathologize adaptation. And we do not ignore the systemic realities that shape behavior.

Instead, we ask:

·        Where do you feel safe enough to be seen?

·        What parts of yourself have been silenced?

·        What would authenticity look like—on your terms?

Because authenticity is not about removing all masks.

It is about no longer being trapped behind them.

Closing Reflection

Masking did not begin as a flaw.

It began as a response.

A response to environments that misunderstood difference.

A response to systems that rewarded conformity.

A response to the human need for safety, belonging, and connection.

The work now is not to shame the mask—but to understand it.

And, when possible, to gently create spaces where it is no longer required.

References

Hull, L., Petrides, K. V., & Mandy, W. (2017). The Female Autism Phenotype and Camouflaging: A Narrative Review.

Livingston, L. A., & Happé, F. (2019). Conceptualising Compensation in Neurodevelopmental Disorders.

Hull, L. et al. (2020). Gender Differences in Self-Reported Camouflaging in Autistic and Non-Autistic Adults.

Walker, P. (2013). Complex PTSD: From Surviving to Thriving.