Camouflaging and identity development among autistic female and gender-diverse youth: A qualitative exploration

Adolescence is a vulnerable developmental period for autistic youth. Autistic adolescents often use camouflaging to combat social challenges, perceived differences, and stigmatization. Although adolescence is an integral period for identity development, integration of these topics remains understudied in current literature. Evidence of elevated camouflaging rates among autistic females and gender-diverse adults underscores the need to examine the developmental trajectory of these topics. The present study qualitatively explored first-person perspectives on camouflaging and identity formation among autistic female and gender-diverse youth. Ten autistic adolescents (female: n = 7; gender diverse: n = 3) and their caregivers were enrolled in the present study. Youths completed a semi-structured interview or focus group discussion. Data were qualitatively analyzed and produced several prominent themes in three domains of investigation: (1) the nuts and bolts of camouflaging, (2) the aftermath of camouflaging, and (3) understanding being autistic. Identified themes and subthemes are discussed. Results demonstrated that autistic youth employ complex camouflaging strategies, motivated and reinforced by their experiences within society, that hold damaging consequences for their self-understanding and well-being. These findings reinforce the harmful implications of camouflaging on youths' positive identity development, mental health, and well-being. Implications and future directions are discussed.Lay AbstractAdolescence is a challenging time for autistic youth. Many autistic adolescents change their behavior in social situations to adapt or cope with social challenges, feeling different, and/or stigma. We conducted in-depth discussions with autistic adolescents who identify as female or gender-diverse to understand how changing their behavior in social situations impacts their identity, or self-understanding. Ten autistic adolescents and their caregivers were included in the study. Discussions were analyzed to understand how and why youths change their social behavior and the impact it has on their self-understanding. Participants described using many complex strategies to change their social behavior that are influenced by negative views our society has about people's differences. The strategies often harmed participants' self-understanding and negatively affected their overall well-being. The results are important for understanding how to support autistic adolescents' self-understanding, mental health, and well-being.