* [CHAPTER 2](#chapter-2)

* [Who Are the Masked Autistics?](#who-are-the-masked-autistics)

* [Autistic Women and Gender Minorities](#autistic-women-and-gender-minorities)

* [Traits Commonly Associated with “Female Autism”](#traits-commonly-associated-with-female-autism)

* [Emotional](#emotional)

* [Psychological](#psychological)

* [Behavioral](#behavioral)

* [Social](#social)

* [Black and Brown Autistics](#black-and-brown-autistics)

* [Highly Verbal and Outgoing Autistics](#highly-verbal-and-outgoing-autistics)

* [Autistics with Other Conditions](#autistics-with-other-conditions)

* [“Highly Functioning” Autistics](#highly-functioning-autistics)

* [Meeting Masked Autistics and Finding Your Place in the Community](#meeting-masked-autistics-and-finding-your-place-in-the-community)

---

Bobbi, an Autistic nonbinary person in their mid-thirties, says, “I wasn’t raised or ‘socialized’ as an Autistic girl. I was raised as a weird kid, and a gender failure.”

Bobbi says that as a child, they were interested in sports, local plants and mushrooms, and pro wrestling. They were considered “tomboyish,” and were socially ostracized from their peers because they were awkward and rude, and refused to behave in “ladylike” ways. Even when Bobbi tried to conform to gender norms, they failed spectacularly. They lacked the fine motor control to do makeup or write in pretty cursive letters. When girls subtly bullied them in the lunchroom for their short, self-chopped haircut, Bobbi couldn’t understand what was happening. They assumed that when girls yelled, “Hey Bobbi, nice haircut,” they were being sincere.

No one flagged Bobbi as potentially Autistic, and they certainly didn’t recognize Bobbi as potentially transgender, either.

“I was just in this category of ‘weird annoying kid’ off to the side,” they tell me.

In both respects, it was easy for adults to write off Bobbi’s struggles as a mere annoyance, rather than a sign Bobbi was marginalized both in terms of gender and disability status. Masked Autism and being a closeted gender minority often go hand in hand, and the experiences share a lot of features. The baffled families of transgender people and adult Autistics alike tend to claim there “were no signs” of these identities when the person was young.[^2.1] In actuality, there were often many signs, which the child’s family either did not know to look for, or didn’t wish to see.[^2.2] Signs of nonconformity were likely met with admonishment, “helpful” condescending corrections (“you look so unhappy, please smile!”), or by freezing the child out until they conformed. Bobbi was sarcastically complimented quite often, not just for their hair, but for how they carried themselves, spoke, thought, and for the comfortable, practical ways that they dressed. As they grew older, they began to figure out what was expected of them, and shifted their gender presentation to be more feminine so they could be seen as fully human.

No one in young Bobbi’s life could see them as they truly were. When your belief system teaches that disability and gender variance are embarrassing and disgusting, it’s hard to look at your child and recognize those traits. It certainly didn’t help that in movies and television programs in the 1980s and 1990s, Autistic people were all silent, passive nonentities, and transgender people were perverted serial killers or trashy daytime TV curiosities.

These days, Bobbi surrounds themselves with fellow Autistic and transgender people. They first discovered their disability after their eldest son was assessed in elementary school, and in the couple of years since then they’ve tried to build relationships that help them feel normal and seen for the first time. They described their friend group to me as a land of misfit toys. They’re all people who’d been shut out of mainstream society, most of them in multiple ways. Even the public conversation about Autism ignores their existence much of the time.

“We have to make society over again from the ground up,” they say. “Our own little neuro-queer microsocieties. Because no one else will think to include us.”

---

In this chapter, I’d like to introduce you to the groups of people who most commonly become masked Autistics. These are the people who have been systematically denied access to diagnosis for decades, and are frequently still ignored in public and psychiatric conversations about neurodivergence. They’re Autistic women like Crystal, Autistic trans people like Bobbi, and Black genderqueer people like Anand Prahlad. Some had their neurodivergence erased because they grew up in poverty, or because they had physical ailments that obscured their Autistic traits. Some are assumed to be too “high functioning” to need accommodations, but actually suffer deeply from a lack of accessibility and support. Others are pretty clearly debilitated by disability but were misdiagnosed as Borderline or Narcissistic instead of Autistic. In their stories, you’ll see just how multifaceted the Autistic community is, and how painfully limiting stereotypes about the disability really are to each of us. You may also see yourself reflected in these stories or recognize someone you know. The more Autism is understood and embraced in its full, rich diversity, the less need there will be for these multiply marginalized Autistic people to keep themselves hidden behind a mask of quiet conformity.

Most of the writing and research about gender-based disparities in Autism focuses on the fact that girls are woefully underdiagnosed. Researchers, therapists, and even some Autistic self-advocates talk about “female Autism,”[^2.3] pointing to the fact that among girls, Autistic qualities do seem less severe or obvious on average.

When Autistic girls engage in self-stimulatory behavior, it tends to be less physically damaging: less arm biting, more hair twirling or opening and closing a book quietly many times.[^2.4] When Autistic girls are shy and withdrawn, people are less concerned by it than they would be if a boy exhibited the same reticence. On the flip side, when Autistic girls have meltdowns, it tends to get written off as an emotional outburst. When they do act out or behave aggressively, they’re more likely to be punished severely for not being ladylike, resulting in them learning to censor their aggression at an earlier age than most boys do.[^2.5] Adults speak to young girls using more emotion-related words than they do when speaking to boys,[^2.6] which means Autistic girls often get a leg up in social and relational skills. Much of the play that girls stereotypically engage in (and are encouraged to engage in) involves mimicking adult social interactions, such as playing house or pretending to run a store.[^2.7] As a result many Autistic girls learn how to fake their way through routine conversations at a younger age than boys do.

For these and a variety of other reasons, Autistic girls are assessed and diagnosed at older ages.[^2.8] Many are diagnosed as adults, or are never diagnosed at all. Like Crystal, many Autistic women develop an inoffensive, quiet personality as a crutch to counterbalance their social disadvantages. Unfortunately, adopting a docile persona makes it even harder for their suffering to be seen as a real problem.

Below is a table summarizing some of the most well-known “female Autism” traits. It’s adapted from a list originally published on the now-defunct site Help4Asperger’s, which was maintained by the author of the book Aspergirls, Rudy Simone.[^2.9] This is by no means an exhaustive list, and shouldn’t be taken as a diagnostic tool. As I’ve already mentioned, the idea that all women have “female Autism” is a reductive one. Still, clinicians often fall back on tables like these to determine if an adult woman might potentially be an undiagnosed Autistic, so it’s something to be cognizant of. If someone is aware that a phenomenon such as “female Autism” exists, they’re often taught it looks something like this:

* Strikes others as emotionally immature and sensitive.

* Prone to outbursts or crying jags, sometimes over seemingly small things.

* Has trouble recognizing or naming one’s feelings.

* Ignores or suppresses emotions until they “bubble up” and explode.

* May become disturbed or overwhelmed when others are upset, but uncertain how to respond or support them.

* Goes “blank” and seems to shut down after prolonged socializing or when overstimulated.

* Reports a high degree of anxiety, especially social anxiety.

* Is perceived by others as moody and prone to bouts of depression.

* May have been diagnosed with mood disorders such as Bipolar Disorder, or personality disorders such as Borderline or Narcissistic Personality Disorder, before Autism was discovered.

* Fears rejection intensely and tries to manage how other people feel to avoid it.

* Has an unstable sense of self, perhaps highly dependent on the opinions of others.

* Uses control to manage stress: follows intense self-imposed rules, despite having an otherwise unconventional personality.

* Is usually happiest at home or in a familiar, predictable environment.

* Seems youthful for their age, in looks, dress, behavior, or interests.

* Prone to excessive exercise, calorie restriction, or other eating disordered behaviors.

* Neglects physical health until it becomes impossible to ignore.

* Self-soothes by constantly fidgeting, listening to repetitive music, twirling hair, picking at skin or cuticles, etc.

* Is a social chameleon; adopts the mannerisms and interests of the groups they’re in.

* May be highly self-educated but will have struggled with social aspects of college or their career.

* Can be very shy or mute, yet can become very outspoken when discussing a subject they are passionate about.

* Struggles to know when to speak when in large groups or at parties.

* Does not initiate conversations but can appear outgoing and comfortable when approached.

* Can socialize, but primarily in shallow, superficial ways that may seem like a performance. Struggles to form deeper friendships.

* Has trouble disappointing or disagreeing with someone during a real-time conversation.

In this list of traits, I do recognize elements of myself and many adult-diagnosed Autistics I know of all genders. There’s a particular way the neurotype tends to present among people who only discovered the identity late in life. We tend to be emotionally withdrawn yet friendly and socially adaptive. We’re social chameleons, and masters at making people like us, but we never let much of our real selves show. We erect rigid rules around our lives to manage stress and make an unpredictable social world feel a little less scary: make eye contact for this many seconds, eat this easy-to-prepare meal at this time of day, never talk about yourself for too long. Try as we might to be agreeable, people still comment on how “oversensitive” or “immature” we are, or imply we’re hard to read. When we struggle, people talk down to us, or try to socially “mother” us into more normative behavior.

Lists like these are still pretty popular among therapists[^2.11] and in online spaces for Autistic people and our families.[^2.12] Sometimes therapists who are seeking to educate themselves on “female Autism” will encounter this list online and let it inform their views, or pass it along to their patients. It offers a very broad, very gendered list of traits that reflect a lot of cultural biases and assumptions. What does it mean, for example, to “seem youthful”? Would a large, hairy man who loves collecting Funkopop toys but also enjoys MMA fighting be considered youthful? Or would that label instead apply to a petite woman who wears dresses and speaks in a high-pitched voice about her love of horses? All too often, the difference between who gets perceived as an innocent, shy Autistic and who gets viewed as creepy, awkward, and obviously disabled is more a function of things like race, gender, and body size than it is any innate difference in personality or behavior. There is no objective definition of what makes someone moody or a social chameleon, either. It’s easier to socially camouflage if you’re the kind of person society doesn’t view with much suspicion in the first place.

This cluster of traits is commonly called “female Autism,” but that label ignores the fact that a large percentage of Autistic people are transgender and gender nonconforming.[^2.13] I’m transgender and Autistic, and find that my experiences don’t fully slide into either the “female” or “male” Autism narratives. I’ve always had some male Autistic traits, like a tendency to be didactic and speak in a confident monotone, yet I was also a “sensitive,” “immature” kid who played imaginary games with toys into my teens. Calling any of these qualities signs of “male Autism” versus “female Autism” is as gender reductive as saying there’s an innately “masculine” or “feminine” personality type.

Like Bobbi, I was raised and socialized as a bit of an odd freak more than I was a “boy” or a “girl.” Neither girls nor boys related to me as one of their own, and I didn’t identify with them, either. I felt more like a mystical fairy creature dropped into the wrong reality than I felt like a “female,” or even a human being. I played Legend of Zelda: Ocarina of Time and recognized myself for the first time in the game’s wordless, androgynous protagonist Link. He didn’t speak, and didn’t belong in the community of childlike elves he’d been raised in. His difference was what marked him as special and destined to save the world. Link was brave, strong, and softly pretty, all at the same time. He was clueless and ineffectual in most social situations, but that didn’t keep him from doing important things or from being met with gratitude and affection everywhere he went. I loved absolutely everything about Link, and modeled my own style after him for many years. I wore tunic-style dresses and kept my hair long and blond, which read as “feminine” enough to other people that they rewarded me for correctly playing the role of an attractive girl. But in actuality, it was a sneaky way to cosplay as my favorite male video game character every day without consequence. On family camping trips that were uncomfortably bug-ridden, hot, and socially overwhelming, I wandered the woods, pretending I was Link on an adventure across Hyrule. I desperately needed a model of how to be comfortable in my own skin, and Link was there when nothing else was available.

This is actually a really common Autistic experience. Perhaps because so many of us are alienated from mainstream neurotypical life, we come to identify with fantasy creatures,[^2.14] aliens, robots,[^2.15] or animals instead of the people around us.[^2.16] Our hyperliteral, analytic minds recognize that the rules of the gender binary are arbitrary and entirely made up,[^2.17] so making up our own gender identities and rules of presentation seems like fair game. Identifying outside of the binary (and outside of humanity) also helps many of us put a name to how detached we feel from society, and from our bodies. Of course it’s hard for me to carry myself in a “ladylike” way, I’m a robot in a human suit! There’s a term for Autistic trans people who see their neurotype and gender identity as inextricably linked: autigender.[^2.18]

I asked Bobbi if they see their Autism and transness as being associated, and they tell me, “Absolutely, yes, you can’t have one part of me without having the other. My Autism is trans and my transness is Autistic. Bras were uncomfortable for gender reasons and because I can’t deal with tight clothes. I did soccer and flag football to be ‘one of the guys,’ and because when I was running around, nobody could talk to me or ask me questions that were social traps. It’s all wrapped up together.”

I feel the exact same way as Bobbi. I love that my Autism and my transness are linked. On good days, I love being Autistic and see it as a natural, neutral part of my identity, so it never has struck me as a problem that it’s shaped my gender. I’m not a “normal” person, have never been able to be one, so identifying outside of the gender binary as well as mainstream humanity feels like home.

Sadly, many “gender critical” parents and mental health professionals don’t see it that way. Transphobic people often take the strong association between gender variance and Autism as a sign that we aren’t “really” trans, we’re “just” Autistic and confused.[^2.19] They presume Autistic people are un-self-aware and easily manipulated, and therefore shouldn’t be allowed to make decisions about our identities or what we do with our bodies.[^2.20] When Harry Potter author J. K. Rowling published the piece “TERF (trans exclusionary radical feminist) Wars” on her blog in the summer of 2020, she specifically mentioned her fear that many transgender men are actually Autistic girls who weren’t conventionally feminine, and have been influenced by transactivists on the internet into identifying out of womanhood.[^2.21] In presenting herself as defending disabled “girls,” she argued for restricting young trans Autistic people’s ability to self-identify, and access necessary services and health care.

Rowling’s perspective (which she shares with many gender critical folks) is deeply dehumanizing to both the trans and Autistic communities. We’re fully fledged, complex people, who are entitled to the same body autonomy and self-determination as anyone else. And it’s meaningless to question whether a trans Autistic person would have “still” been trans had they not been born neurodiverse, because Autism is such a core part of who we are. Without our disability (or our gender identity) we’d be entirely different people. There is no separating these aspects of ourselves from our personhood or personality. They’re both core parts.

Laura Kate Dale is a transgender woman, video game critic, and author who has written extensively about how her neurotype and gender have run parallel throughout her life. In her memoir, Uncomfortable Labels: My Life as a Gay Autistic Trans Woman, she writes that though she was viewed as a boy when she was growing up, she didn’t have the traditional “cis boy with Autism” experience.[^2.22] She had many recognizably Autistic traits, such as an aversion to bright colors and strong flavors, and a detachment from physical reality that made it impossible to figure out what clothes to wear for any given day’s weather. Yet when she was evaluated for a variety of disabilities as a kid, counselors didn’t consider Autism. Society had deemed her a “boy,” and “boys” with Autism weren’t supposed to be so docile and sweet. She had many of the features of “female Autism,” though the world did not yet recognize her as a female.

Laura writes, “You see, there are stereotypes about children assigned male at birth, and very few of them applied to me growing up. There’s an expectation of brashness, over excitability, loudness and emotional closure…. I was a quiet, reserved child who was sweet and did what they were told and was always in the right place, at the right time, doing what was expected.”[^2.23]

Laura’s interests were often very feminine, rather than boyish. Like Crystal, she didn’t disturb class with meltdowns or hurt anybody’s feelings by being blunt or rude. Since her internal suffering didn’t pose any problems to her classmates or teachers, it flew under the radar, unremarked upon—which is exactly what happens to many cisgender Autistic girls. Even some of her Autistic traits got chalked up to her being a weird or effeminate kid, rather than a disabled one.

Laura’s and Bobbi’s experiences are perfect examples of why the term “female Autism” is misleading; it presents the root of masking as being a person’s assigned sex at birth, or their identity, when really it’s social expectations that lead to a person’s disability getting ignored. Masking is a social experience, not a biological one. “Female Autism” isn’t actually a subtype of the disorder; it’s a way that people cope with their neurodiversity not being taken seriously. Often, it is women who are in that position. But many other marginalized groups go through it, too, and those trends have not been as widely recognized. Black and brown Autistics in particular are underdiagnosed at high rates, just as women are, because racism has similarly distorted how the disorder gets perceived and assessed. They also pay a huge price for being nonconforming and noncompliant, and are thus expected to mask as a means of survival.

Racism has permeated psychology and psychiatry from its genesis. Early clinicians came from white, European backgrounds, and used their culture’s social norms as the basis for what being healthy looked like.[^2.24] It was a very narrow and oppressive definition, which assumed that being genteel, well dressed, well-read, and white were the marks of humanity, and that anyone who deviated from that standard was not a person, but an animal in need of being tamed.[^2.25]

The modern concept of mental illness as a medical condition first formed during the Victorian period in England, a time and place where restraint and dignity was equated with sanity.[^2.26] Even poor English people who couldn’t maintain the polished appearance and icy etiquette of the wealthy were considered to be somewhat savage and sick. Cultures that were more emotionally expressive or less filtered were pathologized as irrational, oversexualized, and aggressive. The mental health needs of white, wealthy people (and the hassle rich mentally ill people presented to their high-status families) were the primary concern of early psychiatrists. Everyone else was, at best, an afterthought, and at worse an undesirable to be purged.

This history shaped how professionals saw and defined Autism from the very start, and its legacy is still with us today. Autistic people of color frequently end up having their Autism ignored due to racism and bigotry.[^2.27] They’re less likely to get referrals to Autism specialists.[^2.28] They have an incredibly hard time finding culturally competent health care.[^2.29] Only about 4 percent of all mental health providers in the United States are Black,[^2.30] though Black people make up 13.4 percent of the country’s overall population. When Black and brown Autistic people see white therapists, normal expressions of emotions like anger may be misperceived as excessive or “threatening,” and misdiagnoses are very common.[^2.31] That’s if they get identified as having a mental health condition at all. Black Autistics are frequently obligated to mask their traits and any negative mental health symptoms because (like girls and gender minorities) society demands they be more obedient and agreeable than white boys are.

Comedian Chris Rock recently came out about being on the Autism spectrum; specifically, he was diagnosed with Nonverbal Learning Disorder. In an interview with The Hollywood Reporter, he describes how clear-cut indicators (such as an inability to pick up on social cues and a tendency to take all statements hyperliterally) were ignored until his mid-fifties. Because he was an outgoing, Black comedian, Autism seemed unthinkable as an explanation for the social and emotional challenges he was facing.[^2.32] Rock says he downplayed his own mental health needs, too, because he’d internalized the idea only white people go to therapy.

This is a systemic and far-reaching problem. White Autistics are 19 percent more likely to be diagnosed than Black Autistics are, and 65 percent more likely to be diagnosed than Latinx Autistics.[^2.33] Black and Latinx Autistic people also get their diagnoses at older ages, reflecting their delayed access to services.[^2.34] Indigenous Autistics are underdiagnosed and delayed in their diagnoses at even more extreme rates.[^2.35]

These long-standing racial and cultural gaps persist for a variety of reasons. The lower a family’s socioeconomic status, the less likely they are to have access to health care of any kind, but particularly Autism testing, which is seldom covered by insurance and can cost thousands of dollars. Additionally, racism influences how teachers and specialists perceive and screen for Autistic traits in Black and brown kids. When a white kid doesn’t listen to instructions and hurls blocks across the room, he might be gently chastised, or soothed. When a Black or brown kid does the exact same thing, he’s “corrected” far more aggressively. He might even be treated as a future criminal in the making.[^2.36]

The writer Catina Burkett is a Black Autistic woman, and she is acutely aware of how people’s perceptions of her disability are mediated by misogynoir, the systemic oppression of Black women.[^2.37]

“Many people with autism can also appear obstinate or are slow to react in new situations,” Catina writes. “When I am inflexible, I am sometimes called unfriendly, insubordinate, lazy, aggressive or uncontrollable.”

I’ve known quite a few white Autistic men who are, as Catina puts it, obstinate at work. If the white guy in question has an advanced degree or a desirable skill set, such as the ability to code, being a bit difficult to deal with doesn’t necessarily get in his way. In fact, for some Autistic men in tech, being a bit arrogant or cold can work to their advantage. Their aloofness signals they must be a tortured genius, a Sherlock in an office of Watsons. Yet when a Black Autistic woman is even slightly flat in her emotional expressions, she has to worry people will call her “angry” or “unprofessional.”

“One white female supervisor complained that I should learn to change my demeanor with different people,” writes Catina. “[^2.She] grew bitter and the work environment became hostile. Eventually, I had to quit.”

Catina’s boss was, in essence, asking her to code switch, and put on different linguistic and social presentations for different situations. Many Black Americans are conversant in code switching, having to shift between African-American English (or AAE)[^2.38] and Standard English as they move between communities, and modulating their appearance, mannerisms, and volume to avoid being negatively stereotyped.[^2.39] Code switching is similar to Autism masking in the sense that it’s an effortful process of signaling you “belong” in a space, and of knowing when to hide the sides of yourself that the majority will be oppressive toward. Code switching is a cognitively demanding activity that can hinder a person’s performance on challenging or demanding tasks,[^2.40] and it is associated with psychological stress and feeling inauthentic and socially isolated.[^2.41] A report in Harvard Business Review found that many Black code switchers described it as a state of hypervigilance, and that they needed to constantly police their actions and speech in order to minimize white discomfort or hostility.[^2.42]

Black Autistic people can have a variety of complicated relationships to masking and code switching. Pretending to be neurotypical by one culture’s rules is wearying enough. Having to do it in a variety of different ways, using different dialects and mannerisms depending on the setting, is an entirely different level of social performance. Autistic researcher and organizer Timotheus Gordon Jr. told me that learning to code switch in his speaking style actually led to him becoming more socially ostracized as an Autistic child, not less.

“Because I’m African American, I have a different English to speak,” he says, “which is African-American English. So I was placed into speech therapy, in my opinion, to sound like a person who speaks the standard American English.”

In speech therapy, Timotheus was trained to communicate more like a white, middle-class person would; in essence, he was being told to mask his culture. But since he went to a majority Black school, this didn’t help him fit in, it marked him as different.

“I went to school with mostly African Americans, or folks of African descent. It backfired because I was mocked for speaking differently, or speaking like I’m from England.”

Over time, Timotheus had to learn to mask his speaking style in order to fit in with his peers, but also to shift back into so-called standard American English when interacting with white people and institutions. Psychological research shows that code switching requires a ton of cognitive resources even for neurotypical people.[^2.43] One masked Autistic woman I spoke to, Mariah, told me that for many years she thought code switching exhausted her. Eventually, though, she discovered that it was the masking as neurotypical that was wearing her out. For some Black Autistics like Catina, it can be prohibitively hard to manage both tasks. Since she couldn’t will herself to transform into a cheery, enthusiastic personality at will, her boss viewed her as hard to work with.

For Autistic people of color, being seen as hostile or difficult can become downright dangerous. When Black and brown Autistics fail to comply with medical instructions or the directions of therapists, they’re frequently institutionalized and stripped of legal autonomy.[^2.44] They also have to worry about incarceration or death at the hands of police. In 2017, Chicago police sergeant Khalil Muhammad shot an unarmed, Black Autistic teenager named Ricardo Hayes. Muhammad claimed he felt threatened by Hayes, but an investigation revealed Hayes had been harmlessly jogging along the side of his street, and didn’t show any aggression toward Muhammad.[^2.45] Five days after the murder of George Floyd, an Israeli police officer in Jerusalem City shot and killed Eyad Hallaq, an Autistic Palestinian man who was profoundly intellectually disabled and unable to speak or comprehend instructions.[^2.46] In April 2021, a Chicago police officer shot and killed thirteen-year-old Adam Toledo, who had his hands in the air. Adam was in special education and neurodivergent.[^2.47] Approximately 50 percent of people who are killed by police have disabilities,[^2.48] and Black and brown Autistics are at an especially elevated risk.[^2.49] Being identified as Autistic can be socially and emotionally perilous for women and gender minorities, regardless of race; for Black and brown Autistics, being visibly disabled can be deadly.

---

In The Secret Life of a Black Aspie, folklorist Anand Prahlad illustrates in lush detail how it felt to mask his Autism and present a neurotypical, nonthreatening façade to the world:

“I learned to grow masks for school. I had to be careful there. Covering up was like an instinct, though. Like a brown walking stick turning green when it sits on a leaf. Watch…Watch hands. Watch lips. Watch eyebrows.”[^2.50]

Anand grew up on a plantation in the 1950s, just two generations from the end of slavery. Living in a rural area with his family (many of whom had Autistic traits), Anand found comfort in nature. Upon entering the school system, though, he had to mask up. In addition to being Black and Autistic, Anand is also genderqueer, so as soon as he was thrust into public school, he had to begin hiding his neurodivergence as well as his soft, feminine side.

Throughout the book, Anand describes how various social settings demanded different versions of him. There was the all-Black elementary school where he was seen as odd, and not sufficiently masculine, but mostly left alone; there was the integrated high school where white people placed a great deal of pressure on him to be a respectable vanguard for racial justice. As an adult, Anand became a professor. In the academy, he was required to hide all emotional vulnerability, censor all casual language and slang, and obscure anything else white colleagues would deem “unprofessional.” Autistic people are usually pretty candid, and Black American culture tends to also value direct “real talk” about interpersonal issues.[^2.51] But in majority-white, abled institutions, openly saying what you mean or complaining about anything scares people. Anand had to adapt to hide the parts of himself that were open, vulnerable, and real.[^2.52]

Throughout his memoir, Anand describes how erecting false selves was necessary, but also made it impossible to genuinely connect with others. It’s an experience I know that many masked Autistics can relate to. We have to keep other people at arm’s length, because letting them see our hyperfixations, meltdowns, obsessions, and outbursts could mean losing their respect. But locking ourselves away means we can’t ever be fully loved.

“I would never have survived following neurotypical rules,” Anand writes. “But my rules weren’t necessarily the best ones to follow in a relationship. For example, my rules said disconnect the minute I’m overwhelmed. Stop listening…Keep my secrets.”

Anand went through several breakups and multiple divorces before finally getting diagnosed as Autistic. Instead of sharing his feelings with his partners, he’d run away, either physically or into the recesses of his mind. When his third wife suggested this might be caused by a disability, Anand finally was put on a path toward self-acceptance.

Masking is a sensible survival strategy when you have no other tools at your disposal. But the more you deviate from what society values, the more elaborate your masking must be. Hiding your Autism, your cultural Blackness, and your queerness or womanhood can be too much. Sometimes the only viable alternative is to shut down and become deeply inhibited. You can’t offend anyone if you simply melt into the wallpaper.

Catina Burkett and Anand Prahlad both describe adopting this strategy, becoming quiet and repressed, keeping their heads down to avoid evoking white people’s fear of confident Black personhood. Other Black Autistics get by in life the way Chris Rock has, working to come across as cheery, funny, and immensely likable. Just as many Autistic women and trans people adapt by becoming nonthreatening and small, Black Autistics frequently have to self-preserve by plastering on a smile.

In 1911, the psychiatrist Eugene Bleuler coined the term autism.[^2.53] It literally means “isolated self.” This is in contrast to the term for non-Autistic, allistic, which means other-self or connected-self.[^2.54] Countless depictions of Autism on TV and in film focus on how alienated and in our own heads we supposedly are. Think of the Autistic boy in the series finale of St. Elsewhere, who is famously revealed to have dreamed up the entire show and all its characters while sitting off by himself, staring into a snow globe.[^2.55] A more contemporary example is the titular character in Sia’s widely panned[^2.56] film Music, a nonverbal Autistic girl who barely seems to notice when her own grandmother dies right in front of her. In the film, Music can’t speak, and can barely use the augmented communication device she’s been given, and only connects with other characters through elaborately choreographed dream sequences.[^2.57] She’s an isolated, antisocial self, locked away in a world of her own making.

Though a majority of diagnosed Autistics report having introverted personality traits,[^2.58] some of us are actually quite extroverted and outgoing.[^2.59] Experimental research suggests that some of the social skills deficits associated with Autism (for example, difficulty recognizing faces) are reduced among Autistics who are extroverted.[^2.60] If you seek out a lot of social contact, you’ll get more practice interacting with people, so it makes sense that extroverted Autistics gradually learn to more easily blend in. Extroverted Autistics also tend to have larger, more expressive emotions than their introverted peers, which can make them easier for neurotypicals to relate to.

Autistics can have intense and bright personalities just as easily as we can seem icy and withdrawn. Many can make strong eye contact, listen actively, and jump in excitedly when someone brings up a topic that interests us. Outgoing Autistics may fumble with social niceties, interrupt too often, seem “too enthusiastic,” or even be accused of histrionics, but a high degree of interest in connecting with others does generally benefit them psychologically and socially.[^2.61]

Unfortunately, because Autism is so singularly portrayed as a disorder that makes you cold and robotic, outgoing Autistics are seldom correctly identified and diagnosed as kids. Teachers and parents think of them as chatty social butterflies, or disruptive class clowns. People may even come to view their large emotional displays and bursts of energy as “manipulative” or “attention seeking.” Over time these labels can become a part of the mask they wear to get by. It can also make it difficult for an Autistic person to have their need for alone time or other social boundaries respected. For example, Timotheus told me that since he can come across as an affable “life of the party” type, it can be hard for his friends and family to understand that he sometimes also needs to recharge alone.

“My grandparents originally came from the deep South, so in that cultural sense it was important nobody gets left out,” he explains. “If you feel sad, then it’s best to be in a group. But in my case, I need to be left alone. But if I say to peers or even family members, I need my alone time, they say no no no, you can’t be alone. I’m damned if I do, damned if I don’t.”

In many different ways, masking as outgoing and sociable can lead to an Autistic person’s struggles being underestimated or erased. My friend Bethy is energetic, wears lots of eye-catching, bright clothing, and is covered in some of the coolest tattoos I’ve ever seen. They’ve been active in Chicago’s theater and circus arts communities for years, and when they’re excited, they jump and down squealing with delight. Bethy also loves modeling, and is very in tune with their body and sensuality. They treat their personal style and physicality as a full extension of their selfhood. For many, these qualities would be a bit surprising to witness in an Autistic person. So many of us have poor coordination and feel at odds with our bodies,[^2.62] and we’re stereotyped as uncool nerds with no sense of style. Bethy is pretty visibly Autistic, but they’re also very charming. If I didn’t know better, I’d assume their sunny, graceful personality meant they had an easier time socializing than more withdrawn, shy Autistic people do.

But because I know Bethy well, I realize none of that is true. While they found it easy to make surface-level friends at the bar where they use to work, they say that bonding with someone in a deeper way proved very difficult. They second-guess themselves, and are constantly running an algorithm in the back of their mind about how their actions and words will be received by others. They think a lot about how they’re perceived and rarely feel at home in any community. Their immaculate style is also an effort to have their personhood and individuality recognized by other people. They’ve always been misunderstood, and every day is a fight to communicate who they really are. Bethy is masking, and putting extensive energy into doing so—just like inhibited, quiet me.

Just as some Autistics desire a lot of social contact, some seek out a high degree of stimulation and sensory input. Contrary to popular belief, Autism doesn’t make a person’s hearing super sensitive or their eyes super responsive to light. What Autism actually does is influence how our brains filter through the information taken in by our senses, and how we combine all that data into a cohesive whole. That can manifest in us being either sensory seekers (sometimes called sensory inattentive types)[^2.63] or sensory avoiders—and most of us are a combination of both, depending on the sense.

For various reasons I outlined in Chapter 1, neurotypical brains tend to dismiss small details that might detract from the “big picture” their brain believes it sees.[^2.64] Metaphorically, when a neurotypical person sees a “forest,” their minds start glossing over the dead, bare trees and clumps of hedges that complicate the view.[^2.65] In contrast, Autistic people perceive all the individual trees, and stumps, and rotting animal carcasses. The thousands of small features don’t effortlessly combine into something larger for us,[^2.66] so we have to process all of it separately. It’s exhausting.

When I walk into my apartment building at night, I’m hit with a wave of discordant sensory information. It’s particularly bothersome if I’ve already had a stressful or emotionally taxing day and my energy is depleted. There’s the frenetic chatter of my neighbors, and the chaotic slamming of doors all along the hall. I can hear the elevator groaning to the ground level, my neighbor’s music thudding below me, and ambulances blaring in the distance. Each piece of sensory information vies for attention, and doesn’t blend into uniform background noise. In fact, the longer I have to endure it, the more annoyed I become. One way I can cope with this is by blocking out the world and dampening all the stimuli that are distracting me. But another, equally effective way to cope with sensory challenges is by seeking out really strong, bold sensations that overpower all that white noise.

When an Autistic person is a sensory seeker, they might crave loud music, spicy food, blazing bright colors, or plenty of activity and motion. They don’t wear headphones in public to drown out the overwhelming noise of other people, but because a thumping synthpop track helps keep them engaged and grounded. The goal is the same in either case—to make sense of a barrage of data that’s hard to process. A sensory seeking, fun-loving persona makes for a very effective Autism mask; no one sees you as an “overly sensitive” disabled person if you’re constantly traveling the world and thrashing to the music at your local bar’s metal night. It might even be an enjoyable mask to wear, though needing to constantly seek out stimulation can prove limiting. In their essay “Autistic People Party, Too,” the writer Jesse Meadows describes how a drinking, drugging party-girl persona helped them fit in with other people and find a modicum of sensory comfort.[^2.67] Eventually, though, that lifestyle proved unsustainable, and they had to learn to seek novelty and stimulation in healthier ways.

Logan Joiner is a teenager who has been sharing his passion for roller coasters with the world since he was eight years old. On his two YouTube channels (KoasterKids and Thrills United), he has a combined viewership of nearly thirty-five thousand subscribers. He shares videos of himself bungee-jumping from bridges, cliff diving into open bodies of water, and racking up amusement park visits. Logan’s Autistic, and he got into roller coasters because they help him regulate how his brain processes sensory information.

“I’m not a big fan of unexpected surprises,” Logan has explained.[^2.68] “But if you think about it, roller coasters aren’t really like that…so they’re not scary because they’re predictable.”

Despite how messy and noisy they can be, amusement parks can actually be quite comforting to Autistic people. Amusement parks offer predictable social interactions and prepackaged experiences that rarely change. The layout is clearly marked, the food is bland yet filling, every attraction is over in a matter of minutes, and the signage is big and clear. Once you get used to a roller coaster, it provides consistent stimulation at expected points in time. For sensory-seeking Autistics, the rushing wind and vibrations of the track can provide relaxing physical input, just like a weighted blanket or fidget cube, only more forceful. There are statistics to memorize, development and launch history to learn about, and a whole community of nerdy online creators to share coaster and attraction lore with. Plus, on a roller coaster you can shout and flail your arms without anyone giving you funny looks. Since many of us have trouble regulating speaking volume and love to arm-flap, roller coasters, concerts, and other noisy, raucous spaces can be unexpected refuges from social judgment.

I have known Autistics who are DJs, salespeople, team managers, nonprofit fund-raisers, and aerialists. The more outgoing and sensory seeking among us love anime conventions, house parties, political campaigning, and competitive sports. It’s often very difficult, though, for these kinds of Autistic people to get their disability taken seriously, because they can be so outspoken and charming. When they do have trouble socializing or they fall behind at work, their loved ones accuse them of “faking” that they’re having a hard time, because they found it effortless to go out and party at a burlesque show the evening before. It’s an all-too-common experience for disabled people, being told that your skills in one area are proof that you’re “not trying hard enough” in another.

Very few people would guess these outspoken, high-energy folks are Autistic, particularly during their rambunctious childhoods. If anything about them seemed unusual, ADHD was probably what people guessed. Incidentally, Autism and ADHD co-occur at very high rates, and are diagnostically quite difficult to untangle.[^2.69] Psychologists often call them “sister conditions” because both of them impact things like distractibility, sensory seeking, and being deeply pained by social rejection. This brings me to the next group of Autistics who often get overlooked: those with comorbid and overlapping conditions.

When it comes to mental illness and disability, diagnostic categories are really flawed things. A disorder is a cluster of symptoms and traits that tend to go together, but don’t always, and the way those clusters get organized tends to change over time. Psychologists have been debating for decades whether anxiety and depression should be considered elements of the same disorder, for example, or looked at as separate conditions that are just correlated.[^2.70] Psychiatrists in the 1940s believed Autism was a form of childhood schizophrenia,[^2.71] but they certainly don’t see it that way now. Our understandings of these labels are constantly in flux, and who gets stuck with a particular label varies across time and cultural context.

Often, a person exists somewhere on a spectrum between multiple disorders, or has a unique combination of traits from multiple conditions. If you have ever had a single manic period in your life, you may get diagnosed with Bipolar Disorder rather than Major Depressive Disorder, for instance, even if the depressive episodes massively outnumber the manic ones. On the flip side, if you don’t meet the low weight requirement for Anorexia, you may never get your disorder recognized no matter how much anguish it presents in your life. This dynamic is particularly challenging for people with Autism Spectrum traits, because our neurotype is so multifaceted and so easily mistaken for other conditions.

People with post-traumatic stress disorder, for example, can look very similar to Autistic people. PTSD sufferers tend to be afraid of large crowds, are easily rattled by loud noises, and become more reserved when placed in hard-to-read situations. PTSD-fueled hypervigilance can look a lot like masking: you’re constantly scanning your environment for threats, and modulating how you present yourself, so you can stay safe. To complicate matters, many Autistic people experience trauma at a young age, and have PTSD symptoms from that. It’s common for us to be mistreated by parents and caregivers, bullied by classmates, or seen as “easy prey” by abusers. The leading treatment for Autism in children, Applied Behavioral Analysis therapy (or ABA for short), has widely been criticized by Autistic people as being traumatic to endure.

For all these reasons, it’s not always possible (or helpful) to try to untangle which of a person’s traits are Autistic and which are caused by the trauma of being neurodiverse in a neurotypical world. Daan is a forty-year-old man living in the Netherlands, and in addition to being Autistic, he was abused by both his parents. He tells me his diagnosis of complex PTSD effectively masked his neurodivergence for many, many years.

“I assume everybody is talking about me and is a hair’s breadth from blowing up and calling me a horrible person,” he says. “And is this Autism and not having a good theory of other people’s thinking? Or is it that my mother would hurl invectives at me if I so much as put the sponge on the wrong side of the sink? There is no answer.”

Daan’s first trauma therapist tried to teach him that his fears were irrational; his mother was long dead, she told him, and could never hurt him again. She believed that she could help him question the “illogical belief” he had that people were unsafe. But Daan was still actively being hurt and rejected almost every day of his life because he was Autistic. His perceptions of the social world as menacing were realistic, not illogical.

“I would make observations that were just, literal facts, like oh hey you got a haircut, and people would think I was making fun of them,” he tells me. “My boss screamed at me for that. Girls would go out with me and then berate me for not acting the way they expected a grown man to act. It was like my mother attacking me all over again. And then I would go to the therapist and she’d say I was reliving my trauma with my mother and seeing her in other people. It was horrible, crazy-making stuff really.”

Clinical studies show Daan’s experiences are far from abnormal. Therapy that is focused on battling “irrational beliefs,” such as cognitive behavioral therapy (CBT), doesn’t work as well on Autistic people as it does on neurotypicals.[^2.72] One reason for that is many of the fears and inhibitions of Autistic people are often entirely reasonable, and rooted in a lifetime of painful experiences. We tend to be pretty rational people, and many of us are already inclined to analyze our thoughts and feelings very closely (sometimes excessively so). Autistics don’t need cognitive behavioral training to help us not be ruled by our emotions. In fact, most of us have been browbeaten into ignoring our feelings too much.

Recently, Daan switched therapists. His new therapist had only taken one continuing education course on Autistic adults in her entire career, but that still made her better informed than most providers. She sent Daan to get assessed, and began to read up on how to alter her therapeutic practice to fit him better.

“My new therapist admits there isn’t much research on helping Autistic people work through trauma,” he explains. “But she at least got me evaluated. And that has unlocked a world of understanding for me, because it’s helped me talk to other Autistics online.”

Autism can also look a lot like an anxiety disorder. Most of us are anxious nearly every moment we’re around other people, after all. Overstimulating, unpredictable surroundings will tend to activate our fight-or-flight response. The rituals and repetitive behaviors we develop to cope with stress can look a lot like Obsessive-Compulsive Disorder. Autistic burnout presents very much like a major depressive episode. All too often, these negative mental health consequences of masking are what a therapist recognizes, rather than the untreated disability that’s caused it.

Some undiagnosed Autistic people (particularly women) identify as “highly sensitive persons.”[^2.73] Highly sensitive persons are generally described as intuitive, emotionally astute, and easily overwhelmed. Even the creator of the term, Elaine N. Aron, has revealed that some of the highly sensitive family members she has described in writing later found out they were Autistic.[^2.74] The stigma that comes with Autism (and its very male, standoffish associations) may be part of why so many women on the spectrum find labels such as anxious and highly sensitive to be far more resonant.

In some cases, marginalized Autistic people get stuck with mental health diagnoses that are even more reviled and misunderstood than Autism is. It’s quite common for adult Autistic women to be incorrectly labeled with Borderline Personality Disorder, for instance.[^2.75] This is a really disastrous diagnosis. Borderline Personality Disorder is many therapists’ least favorite condition to work with.[^2.76] As a group, they’re commonly viewed as overly dramatic, needy, attention seeking, unreliable, and even abusive.[^2.77] When I’ve taught psychotherapists in training, many of them have shared with me that their supervisors taught them to avoid BPD sufferers like the plague, and to never even befriend a person with BPD traits.

Though it’s called a disorder of “personality,” BPD could perhaps be more correctly described as a disorder of attachment and emotional processing.[^2.78] People with BPD fear rejection very intensely. They have an unstable sense of self that’s highly dependent on the acceptance of others. They’re often described by loved ones and therapists as having extreme emotions that seem inappropriate or manipulative.[^2.79] If these sound eerily similar to the “female Autism traits” from the table earlier in this chapter, that’s not a coincidence. Many women (and other gender minorities) who have been repeatedly rejected and traumatized for being Autistic develop an insecure sense of self, a (reasonable) fear of rejection, and big “overly sensitive” emotions that reflect the distress they almost constantly feel.

Nylah is one such woman who was incorrectly labeled as BPD before finally arriving at an Autism diagnosis. She had all the traits that tend to overlap: insecure self-esteem, fear of being abandoned that would prompt emotional meltdowns, and an unstable sense of who she was.

“I used to pretend to be whoever my boyfriends wanted me to be so they wouldn’t leave me. And that was supposedly so manipulative and evil of me,” she says.

In actuality, Nylah was trying desperately to not be alone. If a partner was into hockey, she filled her wardrobe with hockey jerseys. If a guy liked women who dressed up, she started getting weekly manicures. It didn’t work great, but it was all she knew.

“Living so falsely made me feel suicidal, and what do you know, attempting suicide when you have Borderline means you’re manipulating people for attention,” she says. “I was the one constantly setting myself up to be taken advantage of, but with the Borderline target put on my back, I was a hysterical villain in people’s eyes.”

Nylah only began to question this narrative about herself when a relative received an Autism diagnosis. At age sixty-five, her mother got assessed—after many decades of carrying an equally stigmatizing Narcissistic Personality Disorder diagnosis.

Nylah says, “My mother is very self-involved, but that’s because she literally cannot understand what’s happening in others’ brains and she can get so locked into her own view. Her actions can seem selfish because Autism gets in the way of her empathy. I have really intense empathy, it is painful almost, and she is the flip side. She just doesn’t have it. But is that evil? She literally cannot help it.”

Nylah shares with me that though her mother is inconsiderate and stubborn, she is also a woman who cares deeply about the world. Anything that gets in the way of her activism is a threat to be excised from her life. Recognizing that about her mom, and admiring that passionate, dedicated side of her has helped Nylah feel more at peace about their relationship.

“She cares very much about feminism and saving the environment. Her heart is big and it is wounded. She’s a difficult person doing her very best, which in a Black woman seeking therapy in the 1970s meant you were a narcissist, apparently.”

An article by psychiatrists Meng-Chaun Lai and Simon Baron-Cohen, published in the medical journal The Lancet, has proposed that an entire generation of Autistic people were misdiagnosed as having personality disorders.[^2.80] Unsurprisingly, they propose that most of the misdiagnosed were marginalized women. Usually, I find a lot of problems with Baron-Cohen’s work; he has long been an advocate for the view that Autism is best understood as an “extremely male brain.”[^2.81] Yet in this research, he seems to acknowledge that the reason many women are not diagnosed as Autistic is because they’re labeled as Borderline, Histrionic, or Narcissistic instead. Getting stuck with a personality disorder diagnosis also makes it very difficult for a patient to find affirming, compassionate mental health care, particularly if that stigma interweaves with sexism or misogynoir.[^2.82]

As I briefly mentioned above, Autism and ADHD co-occur and overlap immensely. Both disabilities relate to a person’s “executive functioning,” meaning their ability to plan ahead, divide large goals into smaller steps, sequence tasks in a logical order, and self-motivate to complete them. Yet even the fact that we struggle with these activities is contextual, and cultural: in a world where rugged individualism wasn’t prioritized, it might not be a disability to need help finding your car keys. Both Autistics and ADHDers are easily distracted by stimuli, yet also prone to hyperfixating on activities we find enjoyable, getting engrossed for hours without remembering to pee or eat. Generally speaking, Autistics tend to perceive themselves as having more control over what they hyperfocus on than ADHDers do. ADHDers are more likely to describe boredom and understimulation as painful, where as some Autistics really enjoy stillness and quiet. Both neurotypes are underdiagnosed in women and people of color, and those who aren’t diagnosed at a young age typically wind up masking for decades before figuring their identity out.[^2.83]

Though ADHD is not believed by professionals to affect emotional processing and social skills development directly, one prominent experience among ADHDers is rejection-sensitive dysphoria, feeling intense panic and distress when receiving negative (or even neutral) social feedback from other people. Because ADHDers find rejection so terrifying and painful, their social behavior can be just as restrained and people-pleasing as that of masked Autistics. Autistics may have trouble guessing what other people are feeling or understanding unspoken social norms, but ADHDers may also be accused of being “oblivious” too, talking at length without picking up on others’ boredom, or getting so lost in a video game or favorite hobby that they miss their roommate frustratedly doing all the cleaning. The underlying mechanisms might be different, in other words, but many of the struggles are the same.

While ADHDers don’t appear to process information in as bottom-up a fashion as Autistics do, the high energy and anxiety associated with the neurotype can look incredibly similar to how Autistics react to overwhelming sensory information.[^2.84] And while some masked Autistics may generally be better at staying on task, maintaining a consistent schedule, and keeping organized compared to the average ADHD, many of us are so chronically exhausted and burnt out that we experience the same struggles with daily life that people with ADHD do. Plus there are plenty of non-masked Autistics who require daily assistance, so it’s not fair to say that Autism is a more functional or organized neurotype—however, Autism is often stereotyped to be the “order” to ADHD’s “chaos.”

Though we have many experiences in common, there are some differences between ADHDers and Autistics worth noting. First, an ADHD diagnosis is easier to receive as an adult, though it comes with the very stigmatizing assumptions that patients’ brains are “broken” and require stimulant drug treatment.[^2.85] Second, the accommodations many people with ADHD require can be incompatible with what Autistic people need. As an Autistic person without ADHD, I need a quiet, private, clean space in order to feel calm and focused. I also need silence and darkness in order to sleep. Many people with ADHD, in contrast, require stimulation, novelty, and sensory input. They may need the television blaring while studying, for example, or may be unable to sleep without music on. Clutter and mess overwhelms many Autistic people; for many ADHDers “visual noise” is easy to ignore, so much so that messes can “disappear” from their field of view. ADHDer friends often enlist my help looking for their phones and keys because they can’t scan through their piles of stuff to find it. To them it’s all just a morass of white noise, but I can instantly locate specific objects at a glance.

Many ADHDers that I know describe themselves as “time blind,” or as perceiving time as moving in a spiral or series of waves. I experience time quite linearly, and rigidly, and have never been late to an appointment or missed a deadline in my life. Writers and creatives who have ADHD tend to work in big bursts of late-night passion, and put their work together in an associative, big-picture way. I work on a consistent schedule, analyzing sources and putting them together piece by tiny piece. But I also have an impulsive and chaotic streak, which might have gotten me labeled ADHD (or Borderline, or something else) if I hadn’t been better at hiding it when I was young.

A number of the Autistic people I interviewed for this book are also ADHDers. So are many of the writers, mental health providers, and activists I quote. Within the Autistic self-advocacy community, people with ADHD are usually treated as honorary members by default. And the more we learn about the two neurotypes, the less they seem like distinct categories. They are, in every sense, sibling disabilities, two highly similar groups who belong in community with one another.[^2.86]

In addition to overlapping with many mental disabilities and disorders, Autism also co-occurs frequently with physical disabilities like Ehlers-Danlos syndrome (EDS),[^2.87] gastrointestinal disorders,[^2.88] and epilepsy.[^2.89] Heather Morgan, who has physical disabilities as well as Autism, says we can think of some conditions as sharing Autism’s genetic markers.

“I think there are more of us in that category than we necessarily realize,” she tells me. “[^2.P]eople with disabilities that maybe aren’t typical Autism, but have Autistic characteristics in their genetic sequence.”

When Autism intersects with other disorders or disabilities, traits can take on new forms or be hidden entirely. I’m close friends with the family of Angel, an Autistic teenager with traumatic brain injuries and intellectual disabilities. If Angel hadn’t been diagnosed with Autism prior to the car accident that caused his brain injury, doctors might never have recognized him as Autistic at all. They might have believed, for example, that he couldn’t speak because of neural damage caused by the car accident. If that had been the case, Angel wouldn’t have gotten his augmented communication device, or the iPad he uses to chat with friends on social media. Thankfully, Angel’s family and care team figured out that his lack of verbal communication wasn’t caused by an inability to express himself, but by an Autistic need for nonverbal methods of self-expression.

Angel is a rare example of a masked Autistic person who isn’t viewed by the people around him as “high functioning” or high in intelligence. Of course, the very idea that certain Autistic people function more highly than others, or that functioning status is a binary quality you can catch at a glance, is problematic in its own right. That kind of thinking leads to many of us having our disabilities erased, and the private suffering that makes public “functioning” possible is ignored. It also perpetuates the idea that the only disabled lives worth living are those that can still manage to be productive or impressive in some conventional way.

Neurotypical people are obsessed with functioning levels. If you tell a nondisabled person that you’re Autistic, but you’re able to hold a conversation or maintain a job, they’ll immediately start gushing about how functional you are. Usually, that remark comes with the implication that you don’t really count as disabled because you can fake a nondisabled status (if only for a moment). When I was doing press for my first book, I received a fair share of comments like the following, which was left on a YouTube livestream in which I appeared:[^2.90]

“If Dr. Price is autistic then they are extremely high functioning. Most people with autism spend their whole lives barely able to hold down a job because they’re unable to meaningfully or appropriately interact with others, nor are they able to focus on anything intently for any extended period of time or if they do, it’s something that’s extremely trivial and irrelevant.”

There is a lot to unpack in this comment. First is the commenter’s assumption that because I seem to function “highly,” my being Autistic is somewhat dubious to him. He says “if” I’m Autistic I must be high functioning, not that I am Autistic and capable or accomplished. He sees the two things as incompatible. Furthermore, he seems to think I don’t really count as Autistic, because I can feign normality so well during an hourlong conversation. Another thing that jumps out is the way he equates holding down a job with having a life of value. In this commenter’s view, I am a high-functioning Autistic because I can hyperfocus on something that makes money. Autistic passions that aren’t moneymaking are, as he says, “trivial” and “irrelevant.” That word irrelevant is also particularly striking—it’s as if the Autistic person’s own feelings and pleasure do not matter at all, only how their life is received by others.

When neurotypical people equate “functioning” with being less disabled, they fail to recognize the immense, hidden labor that goes into appearing normal. It also misses just how oppressive having to seem normal is by itself. It’s reminiscent of when I see a fat person proudly identify themselves as fat, only to be corrected by a thin person with a dismissive, “You’re not fat! You’re just curvy! You’re so pretty!” That kind of response betrays discomfort with fatness and fat pride, and reveals a latent belief that one can’t be fat and beautiful at the same time. But a person can be both fat and beautiful, the two attributes are completely independent of one another. On top of that, it’s insulting that a person’s beauty is part of how their value is defined. Conversely, an Autistic person can function in one (or many) realms of public life, while being significantly disabled in others. Furthermore, some people don’t “function” independently in any area of life at all, and that shouldn’t detract from their value and the respect they receive, either.

The Instagram account @MyAutisticNurse documents the life of one “high functioning” Autistic person, a nurse who goes by the nickname Boo.[^2.91] By all accounts, Boo is a fantastic nurse; her mind is a repository of medical facts that she can call from memory at will. She’s excellent at working with pediatric patients and putting them at ease. She also has days when she is completely unable to speak. After an especially stressful shift at her hospital, she spends hours on the floor, lining up her favorite toys over and over. Like any other Autistic person, she has meltdowns and low-energy days, but because she’s intelligent and capable, her Autism doesn’t fit the “typical” mold.

Until 2013, the Diagnostic and Statistical Manual of Mental Disorders drew a distinction between Autism and Asperger’s Syndrome. Autism was more profoundly debilitating and associated with major communication deficits and intellectual challenges. Asperger’s, on the other hand, occurred in people with high intelligence, and was associated with well-spoken, emotionally frosty math geniuses and computer nerds. The 2013 edition of the DSM folded both labels into one: Autism Spectrum Disorder, or ASD. Today, instead of talking about how Autism differs from Asperger’s, clinicians discuss whether someone is “high or low functioning” or what level their “support needs” are.

The Autistic Self Advocacy Network (or ASAN) and other organizations led by Autistic people reject terms like high functioning and low functioning. Those words oversimplify how a disability affects a person’s life, and equates their productivity with their value as a human being.[^2.92] A person who can speak, socialize, and hold down a job may strike outside observers as very “high functioning”; in private, that same person may need help getting dressed, or may require people to remind them when to eat. Boo’s husband, for example, has created an easy-to-read chart listing all the snacks they have available at home, to help Boo process what to do when she is feeling hungry and run-down. He also helps motivate her to do things like brushing or washing her hair, activities that are both necessary and painful for her.

Conversely, a seemingly “low functioning” Autistic person who cannot speak or dress themselves may be able to excel in school or solve complex math equations, so long as they are provided with accommodations. The writer and activist Ido Kedar spent much of his early life unable to communicate with anyone. He couldn’t speak verbally, and his motor control made it difficult to write. Then he learned to type on an iPad, and his blog “Ido in Autismland” was born. Ido has written two books, given countless interviews, and continues to post regularly about Autism and disability justice to his blog. He also graduated from high school with a 3.9 GPA and is currently working his way through college. Academically and intellectually, Ido functions at a very high level, now that he has the support to make that possible. Yet because he can’t speak and lacked that support for a long time, he occupied a “low functioning” position in society for many years.

Cases like Ido’s and Boo’s really highlight how superficial functioning labels can be. Still, they shape how psychiatrists, teachers, and parents think about Autism, and it does tend to be the people considered “high functioning” who can mask the most readily, and who therefore miss getting diagnosed. Generally speaking, if an Autistic person was verbal from a young age and could fake some social niceties, they were likely to either be considered “high functioning” as kids, or they weren’t identified as Autistic at all. This is a bit ironic, because learning to speak at an early age was an early indicator of Asperger’s Disorder.[^2.93] My mom claims that I said my first word at six months old, and was speaking in sentences by the time I was one. I supposedly shocked a department store clerk as a one-year-old by greeting him and declaring “I believe I smell potpourri.” My whole family has tons of stories like these. Many people who either were labeled as having Asperger’s in the 1990s or are considered “high functioning” now have similar stories of being hyperverbal toddlers. It often led to us being filtered into gifted education programs rather than special education, which came with both advantages and its fair share of poorly boundaried, objectifying experiences.

For me, and for countless “high functioning” Autistics, communication and intelligence become an essential part of our masks. I never could fit in with other kids, but I could impress teachers with my grasp of big words and my sophisticated-sounding opinions. Though my language was highly developed, my social and emotional life was not. I annoyed other kids by talking too much about subjects that didn’t interest them. I clung to adults who found me “impressive” and equated being well-behaved with being mature and worthy of their respect. I also absorbed the idea, common to many “gifted” children, that a person’s intellectual potential belongs to society, not to themselves, and they owe the world greatness to justify their oddness. In my adolescence, English teachers adored my papers, and I excelled on the debate team, but I was brittle and distant to my friends and made all kinds of reckless personal decisions (such as shoplifting and skipping classes that I didn’t like) to the point where I nearly got arrested and expelled. I got so attached to seeing myself as smart and accomplished that I neglected my physical health in the pursuit of success, too. Until I was in my mid twenties and realized I was Autistic, I was basically a perpetual adolescent, performing intelligence for praise but mismanaging my personal life and not connecting with anyone in a deeper way.

Nylah had a similar experience. “I was a fantastic saleswoman when my life was at its most dysfunctional,” she tells me. “I could charm anyone if they didn’t get to know me, really know me, and see how much I was drinking and lying to prop that life up.”

Hiding self-destructiveness behind a mountain of achievements isn’t functioning, not really. The very concept of “functioning status” is predicated on the logic of capitalism and the legacy of the Protestant work ethic, which both have trained us to believe that a person’s productivity determines their worth.[^2.94] No one is more harmed by this worldview than the disabled people who cannot work and produce value at all, and are the most likely to wind up abused, forcibly institutionalized, or homeless as a result. Equating a person’s social value (or even their right to exist) with their productivity is sadly a common outlook, but it’s also a profoundly alienating and ableist one. It harms the Autistic people who are able to “play the game” and mask as productive and respectful; for the Autistics who cannot play along, that game can quickly turn dangerous, even deadly.

Spaces like the Autistic Self Advocacy Network and Autistics Against Curing Autism embrace self-realized Autistics, because the community recognizes not everyone will have the chance to get a fair or affordable assessment. Plus, many people with subclinical Autistic traits may share common struggles and goals with us, and deserve to be included in our ranks. This includes the parents or relatives of diagnosed Autistic children who come to realize they’re on the spectrum as well, and people with “sibling conditions” like ADHD or PTSD.

I want Autistic people to experience less shame about who they are, and to learn to take off the restrictive masks that have trapped us for decades. The first step to unmasking is accepting who you are, and finding others with similar experiences. You don’t need a piece of paper from an assessor to begin to do that.

If you suspect you are Autistic, I encourage you to find a local Autistic Self Advocacy Network (ASAN) chapter, and begin to read writing and watch videos Autistic people have posted online. Learn a bit about just how varied our experiences and identities are. As you learn more, you may find you feel at home among us. Or you might find out some other community (such as the ADHDer community, or the broader Mad Pride movement) is a better fit. Both outcomes are perfectly okay. Even if you conclude you are not Autistic, your self-exploration will mean you’ve learned a whole lot about a group that could use more understanding allies.

When I was first exploring an Autistic identity for myself, I checked out videos by Autistic creators and activists, who showed me just how varied Autistic people can be, both in terms of personality and interests. The more Autistic voices I read and listened to, the less Autism felt like a curse. The shame I felt about my identity began to ebb, and pride in who I was gradually replaced it.

Once I had enough confidence to say I resonated with Autistic experiences, I put effort into meeting fellow Autistic people in the flesh. I met people at a local group, Autistics Against Curing Autism, run by Timotheus Gordon Jr. I also attended a local genderqueer support group and where nearly half the attendees were neurodiverse. I posted on Autism support groups online, like the subreddit r/AutismTranslated, and got to know others like me in those ways. These connections to the Autism self-advocacy world wound up doing far more for me than the psychological establishment did. Establishing official recognition of my disability was challenging, bureaucratic, and ultimately felt very hollow and meaningless—much like getting legal recognition of my gender. I was Autistic long before any professional recognized it, just as I was trans long before the state acknowledged it. However, nothing aided me in accepting myself and unmasking quite like finding my “people” and seeing proof positive that there was nothing wrong with us.

If you suspect you might be Autistic, I hope you can seek out similar spaces and resources for yourself. ASAN has chapters in many major cities, and online Autism groups are filled with supportive people who love to answer questions and share their own stories. On most social media sites, the #ActuallyAutistic and #AdultAutistic tags are filled with useful posts. You might also wish to seek out tools created by Autistic people, for Autistic people. For example, weighted blankets or fidget toys sold by sites like Stimtastic might help soothe your anxiety. Or the social skills toolkits offered on blogs like RealSocialSkills.org may help you develop greater confidence in interacting with people, disabled and neurotypical alike. It is not cultural appropriation or “faking a disability” to try out these tools. If Autism-friendly resources and adaptations prove helpful to you, that’s another key signal you belong in our spaces, or at the very least have a great deal in common with us.

Ultimately, I can’t tell you if you are Autistic, and I don’t necessarily think it’s something we have to discuss in a binary or categorical way. Autism is a spectrum, a rainbow of different shades and hues that thrive when they stand beautifully together. For too long we have hidden what makes us unique, fearing we’re broken or unlovable. Embracing Autism means shedding that mask and finding safe ways to share our vibrant colors with the world.

In the next chapter, I’ll explain how the ableism, sexism, and white supremacy lurking behind early Autism research created the pressure for so many of us to “mask.” I’ll outline what the gradual development of the mask looks like over the course of an Autistic person’s early life, and discuss the science on what masking really is and what psychological processes undergird it. I’ll provide some tools and exercises for investigating your own mask, and where it might have come from. We’ll also reflect on the psychological and emotional costs of masking. In the chapters that follow, I’ll introduce you to Autistic people who are slowly unlearning Autism stigma and taking their masks off, and provide some tricks and tips developed by Autistic coaches, counselors, and activists. We’ll also discuss some public policy changes that would help Autistic people and other neurodiverse groups attain justice. As the next portion of the book will outline, masking is just as pervasive as Autism is. It’s much more than faking a smile—it impacts how we identify, how we dress, the careers we choose, our relationships, and even how we lay out our homes. When we unmask, we get to reexamine every choice that we’ve made to “fit in,” and begin to construct more authentic and affirming lives. A world that is more tolerant of difference is a safer and more nourishing place for everyone. And we can begin to build that world today, simply by questioning the ways we’ve been forced to live, and choosing instead to exist proudly as ourselves.

[^2.1]: Ashley, F. (2020). A critical commentary on “rapid-onset gender dysphoria.” Sociological Review, 68(4), 779–799. https://doi.org/​10.1177/​0038026120934693.

[^2.2]: https://www.washingtonpost.com/​lifestyle/​2020/​03/​03/​you-dont-look-autistic-reality-high-functioning-autism/.

[^2.3]: Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotype. Journal of Autism and Developmental Disorders, 46(10), 3281–3294.

[^2.4]: Mandy, W., Chilvers, R., Chowdhury, U., Salter, G., Seigal, A., & Skuse, D. (2012). Sex differences in autism spectrum disorder: Evidence from a large sample of children and adolescents. Journal of Autism and Development Disorders, 42: 1304–13. doi:10.1007/​s10803-011-1356-0.

[^2.5]: Meier, M. H., Slutske, W. S., Heath, A. C., & Martin, N. G. (2009). The role of harsh discipline in explaining sex differences in conduct disorder: A study of opposite-sex twin pairs. Journal of Abnormal Child Psychology, 37(5), 653–664. https://doi.org/​10.1007/​s10802-009-9309-1.

[^2.6]: Aznar, A., & Tenenbaum, H. R. (2015). Gender and age differences in parent–child emotion talk. British Journal of Developmental Psychology, 33(1), 148–155.

[^2.7]: Fung, W. K., & Cheng, R. W. Y. (2017). Effect of school pretend play on preschoolers’ social competence in peer interactions: Gender as a potential moderator. Early Childhood Education Journal, 45(1), 35–42.

[^2.8]: Goin-Kochel, R. P., Mackintosh, V. H., & Myers, B. J. (2006). How many doctors does it take to make an autism spectrum diagnosis? Autism,10: 439–51. doi:10.1177/​1362361306066601.

[^2.9]: http://www.myspectrumsuite.com/​meet-rudy-simone-autistic-bestselling-author-advocate-director-worldwide-aspergirl-society/.

[^2.10]: Full checklist archived at https://mostlyanything19.tumblr.com/​post/​163630697943/​atypical-autism-traits; original site Help4Aspergers.com is now down.

[^2.11]: https://www.psychologytoday.com/​us/​blog/​women-autism-spectrum-disorder/​202104/​10-signs-autism-in-women.

[^2.12]: https://www.aane.org/​women-asperger-profiles/.

[^2.13]: https://slate.com/​human-interest/​2018/​03/​why-are-a-disproportionate-number-of-autistic-youth-transgender.html.

[^2.14]: https://www.wesa.fm/​post/​some-autism-furry-culture-offers-comfort-and-acceptance#stream/​0.

[^2.15]: Huijnen, C., Lexis, M., Jansens, R., & de Witte, L. P. (2016). Mapping Robots to Therapy and Educational Objectives for Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 46(6), 2100–2114. https://doi.org/​10.1007/​s10803-016-2740-6.

[^2.16]: https://www.psychologytoday.com/​us/​blog/​the-imprinted-brain/​201512/​the-aliens-have-landed.

[^2.17]: Warrier, V., Greenberg, D. M., Weir, E., Buckingham, C., Smith, P., Lai, M. C.,…& Baron-Cohen, S. (2020). Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature Communications, 11(1), 1–12.

[^2.18]: https://www.queerundefined.com/​search/​autigender.

[^2.19]: van der Miesen, A. I. R., Cohen-Kettenis, P. T., & de Vries, A. L. C. (2018). Is there a link between gender dysphoria and autism spectrum disorder? Journal of the American Academy of Child & Adolescent Psychiatry, 57(11), 884–885. https://doi.org/​10.1016/​j.jaac.2018.04.022.

[^2.20]: Neely Jr., B. H. (2016). To disclose or not to disclose: Investigating the stigma and stereotypes of autism in the workplace. Master’s thesis in psychology, submitted for partial fulfilment of degree requirements at Pennsylvania State University.

[^2.21]: https://www.jkrowling.com/​opinions/​j-k-rowling-writes-about-her-reasons-for-speaking-out-on-sex-and-gender-issues/.

[^2.22]: Dale, L. K. (2019). Uncomfortable Labels: My Life as a Gay Autistic Trans Woman. London: Jessica Kingsley.

[^2.23]: Dale, L. K. (2019). Uncomfortable Labels: My Life as a Gay Autistic Trans Woman. London: Jessica Kingsley, 26.

[^2.24]: https://www.nature.com/​articles/​d41586-020-01126-w.

[^2.25]: Fernando, S. (2017). Institutional Racism in Psychiatry and Clinical Psychology. London: Palgrave Macmillan.

[^2.26]: For a great review of how mental illness and disability’s definitions have shifted over time, see Scull, A. (2015). Madness in Civilization: A Cultural History of Insanity from the Bible to Freud, from the Madhouse to Modern Medicine. Princeton Univ. Press.

[^2.27]: Dababnah, S., Shaia, W. E., Campion, K., & Nichols, H. M. (2018). “We Had to Keep Pushing”: Caregivers’ Perspectives on Autism Screening and Referral Practices of Black Children in Primary Care. Intellectual and Developmental Disabilities, 56(5), 321–336.

[^2.28]: Begeer, S., El Bouk, S., Boussaid, W., Terwogt, M. M., & Koot, H. M. (2009). Underdiagnosis and referral bias of autism in ethnic minorities. Journal of Autism and Developmental Disorders, 39(1), 142.

[^2.29]: Bhui, K., Warfa, N., Edonya, P., McKenzie, K., & Bhugra, D. (2007). Cultural competence in mental health care: A review of model evaluations. BMC Health Services Research, 7(1), 1–10.

[^2.30]: https://www.apa.org/​monitor/​2018/​02/​datapoint#:~:text=In%202015%2C%2086%20percent%20of,from%20other%20racial%2Fethnic%20groups.

[^2.31]: https://www.npr.org/​sections/​health-shots/​2020/​06/​25/​877549715/​bear-our-pain-the-plea-for-more-black-mental-health-workers.

[^2.32]: https://www.hollywoodreporter.com/​features/​this-is-the-best-part-ive-ever-had-how-chris-rocks-extensive-therapy-helped-prepare-him-for-fargo.

[^2.33]: https://www.spectrumnews.org/​news/​race-class-contribute-disparities-autism-diagnoses/.

[^2.34]: Mandell, D. S., Listerud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among Medicaid-eligible children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 41(12), 1447–1453.

[^2.35]: Dyches, T. T., Wilder, L. K., Sudweeks, R. R., Obiakor, F. E., & Algozzine, B. (2004). Multicultural issues in autism. Journal of Autism and Developmental Disorders, 34(2), 211–222.

[^2.36]: Mandell, D. S., Ittenbach, R. F., Levy, S. E., & Pinto-Martin, J. A. (2007). Disparities in diagnoses received prior to a diagnosis of autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(9), 1795–1802. https://doi.org/​10.1007/​s10803-006-0314-8.

[^2.37]: https://www.spectrumnews.org/​opinion/​viewpoint/​autistic-while-black-how-autism-amplifies-stereotypes/.

[^2.38]: Sometimes referred to as African American Vernacular English or AAVE, though this is technically incorrect. AAE refers to a whole spectrum of communication styles and contexts, not just a vernacular. See Di Paolo, M., & Spears, A. K. Languages and Dialects in the U.S.: Focus on Diversity and Linguistics. New York: Routledge, 102.

[^2.39]: DeBose, C. E. (1992). Codeswitching: Black English and standard English in the African-American linguistic repertoire. Journal of Multilingual & Multicultural Development, 13(1-2), 157–167.

[^2.40]: Walton, G. M., Murphy, M. C., & Ryan, A. M. (2015). Stereotype threat in organizations: Implications for equity and performance. Annual Review of Organizational Psychology and Organizational Behavior, 2, 523–550. https://doi.org/​10.1146/​annurev-orgpsych-032414-111322.

[^2.41]: Molinsky, A. (2007). Cross-cultural code-switching: The psychological challenges of adapting behavior in foreign cultural interactions. Academy of Management Review, 32(2), 622–640.

[^2.42]: https://hbr.org/​2019/​11/​the-costs-of-codeswitching.

[^2.43]: Molinsky, A. (2007). Cross-cultural code-switching: The psychological challenges of adapting behavior in foreign cultural interactions. Academy of Management Review, 32(2), 622–640.

[^2.44]: https://www.spectrumnews.org/​features/​deep-dive/​the-missing-generation/.

[^2.45]: https://apnews.com/​b76e462b44964af7b431a735fb0a2c75.

[^2.46]: https://www.forbes.com/​sites/​gusalexiou/​2020/​06/​14/​police-killing-and-criminal-exploitation-dual-threats-to-the-disabled/​#39d86f6e4f0f.

[^2.47]: https://www.chicagotribune.com/​opinion/​commentary/​ct-opinion-adam-toledo-little-village-20210415-yfuxq4fz7jgtnl54bwn5w4ztw4-story.html.

[^2.48]: https://namiillinois.org/​half-people-killed-police-disability-report/.

[^2.49]: https://www.forbes.com/​sites/​gusalexiou/​2020/​06/​14/​police-killing-and-criminal-exploitation-dual-threats-to-the-disabled/​#c4b478c4f0fa.

[^2.50]: Prahlad, A. (2017). The Secret Life of a Black Aspie: A Memoir. Fairbanks: University of Alaska Press, 69.

[^2.51]: This Twitter thread by Marco Rogers is a great, approachable primer on racial and cultural differences in approaches to “real talk.” https://twitter.com/​polotek/​status/​1353902811868618758?lang=en.

[^2.52]: Deep, S., Salleh, B. M., & Othman, H. (2017). Exploring the role of culture in communication conflicts: A qualitative study. Qualitative Report, 22(4), 1186.

[^2.53]: https://www.webmd.com/​brain/​autism/​what-does-autism-mean.

[^2.54]: From the Greek “allo,” or other.

[^2.55]: https://www.vulture.com/​2018/​05/​the-st-elsewhere-finale-at-30.html#:~:text=Today%20is%20the%2030th%20anniversary,gazes%20at%20all%20day%20long.

[^2.56]: The movie has been widely criticized by Autistics, and by critics in general. See, for example: https://www.indiewire.com/​2021/​02/​music-review-sia-autism-movie-maddie-ziegler-1234615917/​; https://www.rollingstone.com/​movies s/​movie-features/​sia-music-movie-review-controversy-1125125/; https://www.nytimes.com/​2021/​02/​11/​movies/​sia-music-autism-backlash.html.

[^2.57]: For a quick rundown of some of the issues with Music, including how it misrepresents augmentic communication, see: https://www.bitchmedia.org/​article/​sia-film-music-ableism-autistic-representation-film.

[^2.58]: Wakabayashi, A., Baron-Cohen, S., & Wheelwright, S. (2006). Are autistic traits an independent personality dimension? A study of the Autism-Spectrum Quotient (AQ) and the NEO-PI-R. Personality and Individual Differences, 41(5), 873–883.

[^2.59]: Nader-Grosbois, N., & Mazzone, S. (2014). Emotion regulation, personality and social adjustment in children with autism spectrum disorders. Psychology, 5(15), 1750.

[^2.60]: Morgan, M., & Hills, P. J. (2019). Correlations between holistic processing, Autism quotient, extraversion, and experience and the own-gender bias in face recognition. PloS One, 14(7), e0209530.

[^2.61]: Extraverted people high in Autism spectrum traits are less likely to camouflage themselves in as intense a way as introverted Autistics do; see Robinson, E., Hull, L., & Petrides, K. V. (2020). Big Five model and trait emotional intelligence in camouflaging behaviours in autism. Personality and Individual Differences, 152, 109565.

[^2.62]: Fournier, K. A., Hass, C. J., Naik, S. K., Lodha, N., & Cauraugh, J. H. (2010). Motor coordination in autism spectrum disorders: A synthesis and meta-analysis. Journal of Autism and Developmental Disorders, 40(10), 1227–1240.

[^2.63]: Lane, A. E., Dennis, S. J., & Geraghty, M. E. (2011). Brief report: Further evidence of sensory subtypes in autism. Journal of Autism and Developmental Disorders, 41(6), 826–831.

[^2.64]: Liu, Y., Cherkassky, V. L., Minshew, N. J., & Just, M. A. (2011). Autonomy of lower-level perception from global processing in autism: Evidence from brain activation and functional connectivity. Neuropsychologia, 49(7), 2105–2111. https://doi.org/​10.1016/​j.neuropsychologia.2011.04.005.

[^2.65]: See thread by the Autisticats that summarizes this research well: https://twitter.com/​autisticats/​status/​1343996974337564674. It is also archived permanently here: https://threadreaderapp.com/​thread/​1343993141146378241.html l.

[^2.66]: Mottron, L., Dawson, M., Soulieres, I., Hubert, B., & Burack, J. (2006). Enhanced perceptual functioning in autism: An update, and eight principles of autistic perception. Journal of Autism and Developmental Disorders, 36(1), 27–43.

[^2.67]: https://www.queervengeance.com/​post/​autistic-people-party-too.

[^2.68]: https://www.wcpo.com/​news/​insider/​logan-joiner-addresses-his-fears-and-those-of-others-on-the-autism-spectrum-by-riding-and-reviewing-roller-coasters#:~:text=Facebook-,Roller%20coaster%20conqueror%20Logan%20Joiner%2C%20on%20t the%20autism%20spectrum,helps%20others%20overcome%20their%20fears&text=Since%20then%2C%20he’s%20gone%20from,reviewer%20with%20a%20YouTube%20following.

[^2.69]: Gargaro, B. A., Rinehart, N. J., Bradshaw, J. L., Tonge, B. J., & Sheppard, D. M. (2011). Autism and ADHD: How far have we come in the comorbidity debate? Neuroscience & Biobehavioral Reviews, 35(5), 1081–1088.

[^2.70]: Möller, H. J., Bandelow, B., Volz, H. P., Barnikol, U. B., Seifritz, E., & Kasper, S. (2016). The relevance of “mixed anxiety and depression” as a diagnostic category in clinical practice. European Archives of Psychiatry and Clinical Neuroscience, 266(8), 725–736. https://doi.org/​10.1007/​s00406-016-0684-7.

[^2.71]: https://www.sciencemag.org/​news/​2018/​05/​cold-parenting-childhood-schizophrenia-how-diagnosis-autism-has-evolved-over-time.

[^2.72]: Moree, B. N., & Davis III, T. E. (2010). Cognitive-behavioral therapy for anxiety in children diagnosed with autism spectrum disorders: Modification trends. Research in Autism Spectrum Disorders, 4(3), 346–354.

[^2.73]: https://medium.com/​@KristenHovet/​opinion-highly-sensitive-person-hsp-and-high-functioning-autism-are-the-same-in-some-cases-842821a4eb73.

[^2.74]: https://kristenhovet.medium.com/​opinion-highly-sensitive-person-hsp-and-high-functioning-autism-are-the-same-in-some-cases-842821a4eb73.

[^2.75]: https://www.autismresearchtrust.org/​news/​borderline-personality-disorder-or-autism.

[^2.76]: Knaak, S., Szeto, A. C., Fitch, K., Modgill, G., & Patten, S. (2015). Stigma towards borderline personality disorder: Effectiveness and generalizability of an anti-stigma program for healthcare providers using a pre-post randomized design. Borderline Personality Disorder and Emotion Dysregulation, 2(1), 1–8.

[^2.77]: King, G. (2014). Staff attitudes towards people with borderline personality disorder. Mental Health Practice, 17(5).

[^2.78]: Agrawal, H. R., Gunderson, J., Holmes, B. M., & Lyons-Ruth, K. (2004). Attachment studies with borderline patients: A review. Harvard Review of Psychiatry, 12(2), 94–104. https://doi.org/​10.1080/​10673220490447218.

[^2.79]: Scott, L. N., Kim, Y., Nolf, K. A., Hallquist, M. N., Wright, A. G., Stepp, S. D., Morse, J. Q., & Pilkonis, P. A. (2013). Preoccupied attachment and emotional dysregulation: Specific aspects of borderline personality disorder or general dimensions of personality pathology? Journal of Personality Disorders, 27(4), 473–495. https://doi.org/​10.1521/​pedi_2013_27_099.

[^2.80]: Lai, M. C., & Baron-Cohen, S. (2015). Identifying the lost generation of adults with autism spectrum conditions. Lancet Psychiatry, 2(11):1013–27. doi:10.1016/​S2215-0366(15)00277-1. PMID:26544750.

[^2.81]: Baron-Cohen S. The extreme male brain theory of autism. Trends Cogn Sci. 2002 Jun 1;6(6):248–254. doi: 10.1016/​s1364-6613(02)01904-6. PMID: 12039606.

[^2.82]: Sheehan, L., Nieweglowski, K., & Corrigan, P. (2016). The stigma of personality disorders. Current Psychiatry Reports, 18(1), 11.

[^2.83]: https://www.nytimes.com/​2021/​05/​24/​style/​adhd-online-creators-diagnosis.html.

[^2.84]: Lau-Zhu, A., Fritz, A., & McLoughlin, G. (2019). Overlaps and distinctions between attention deficit/hyperactivity disorder and autism spectrum disorder in young adulthood: Systematic review and guiding framework for EEG-imaging research. Neuroscience and Biobehavioral Reviews, 96, 93–115. https://doi.org/​10.1016/​j.neubiorev.2018.10.009.

[^2.85]: Many ADHDers do benefit from using stimulant medications. For a nuanced view of this topic, Jesse Meadow’s essay on Critical ADHD Studies offers an excellent primer: https://jessemeadows.medium.com/​we-need-critical-adhd-studiess-now-52d4267edd54.

[^2.86]: Again, Jesse Meadows has a fabulous essay on the link between Autism and ADHD: https://www.queervengeance.com/​post/​what-s-the-difference-between-adhd-and-autism

[^2.87]: Velasco, C. B., Hamonet, C., Baghdadli, A., & Brissot, R. (2016). Autism Spectrum Disorders and Ehlers-Danlos Syndrome hypermobility-type: Similarities in clinical presentation. Cuadernos de medicina psicosomática y psiquiatria de enlace, (118), 49–58.

[^2.88]: Black, C., Kaye, J. A., & Jick, H. (2002). Relation of childhood gastrointestinal disorders to autism: Nested case-control study using data from the UK General Practice Research Database. BMJ, 325(7361), 419–421.

[^2.89]: Bolton, P. F., Carcani-Rathwell, I., Hutton, J., Goode, S., Howlin, P., & Rutter, M. (2011). Epilepsy in autism: Features and correlates. British Journal of Psychiatry, 198(4), 289–294.

[^2.90]: https://www.youtube.com/​watch?v=GCGlhS5CF08.

[^2.91]: https://www.instagram.com/​myautisticpartner/.

[^2.92]: https://autisticadvocacy.org/​2012/​10/​october-2012-newsletter/.

[^2.93]: https://www.iidc.indiana.edu/​irca/​articles/​social-communication-and-language-characteristics.html. See also: Foley-Nicpon, M., Assouline, S. G., & Stinson, R. D. (2012). Cognitive and academic distinctions between gifted stud dents with autism and Asperger syndrome. Gifted Child Quarterly, 56(2), 77–89.

[^2.94]: For more on this, see Price, D. (2021). Laziness Does Not Exist. New York: Atria Books.