Unmasking Autism: Discovering the New Faces of Neurodiversity

by Devon Price, PhD

This book stands as the most impactful work on the subject of neurodiversity that I have read. I was first made aware of Unmasking Autism when a psychologist provided me with an excerpt from it. That excerpt (which I will come back to) perhaps marks the point where I truly understood the radical paradigm shift offered by affirming and embracing neurodiversity.

But to start at the beginning, the opening paragraphs took my breath away. The introduction contains an unflinching and deeply honest account of the author's graduate school experience. Despite differing in the details (and, unfortunately for me, the outcome), his story precisely mirrored the essence of a similar experience of my own, which I have never been able to effectively articulate or explain even after decades of trying.

So, I was hooked from page 1.

I eagerly but steadily plowed my way through the remainder of the book, marking page after page with sticky notes and annotations, and annoying Mr. Orangutan by continuing to read out particularly salient passages, ostensibly to help understand Oranguette better. Mr. Orangutan would sometimes simply reply "That's you, not her." Fair enough.

It is hard to know what to highlight in this book without simply saying "all of it!" Masking, authenticity, "female" and non-stereotypical autism, schooling, giftedness, comorbidities and misdiagnoses, the LGBTQ+ community, all manner of intersectionality, and the social model of disability are all central themes. It is both heavily research based, and full of personal anecdotes. Below, I will pick out some of the bits that resonated the most for me.

Masked Autism and Giftedness

If I had to select a single theme from the book to highlight, it is the author's insights into the interplay between gifted and masked autism. It is a subject that I haven't yet been able to find much writing on, despite my purely anecdotal observation that giftedness and ASD/PDA frequently co-occur. The author writes:

Many masked Autistics are sent to gifted education as children, instead of being referred to disability services. Our apparent high intelligence puts us in a double bind: we are expected to accomplish great things to justify our oddness, and because we possess an enviable, socially prized quality, it's assumed we need less help than other people, not more.

He continues to recount the story of Dorian, and their descent into self-harm and anorexia due to the "pressure of such high expectations" and the "lack of compassion". What a heartbreakingly familiar tale.

In a separate passage, the author speaks more generally of masking:

Though masking is incredibly taxing and causes us a lot of existential turmoil, it's rewarded and facilitated by neurotypical people. Masking makes Autistic people easier to "deal" with. It renders us compliant and quiet. It also traps us. Once you've proven yourself capable of suffering in silence, neurotypical people tend to expect you'll be able to do it forever, no matter the cost.

This, in my experience, is even more true once a person has demonstrated any sort of giftedness or ability to succeed academically. Autism can go unnoticed in females until later in childhood, when peers move on to a level of neurotypical social sophistication that cannot be matched, and autistic burnout often hits around puberty. Unfortunately, it can be very challenging to be taken seriously and obtain any sort of support, let alone compassion, when these struggles are preceded by a period of early school success.

Masked Autism, Anxiety and Misdiagnosis

There is a complex relationship between autism and mental health diagnoses. Some other diagnoses have a high rate of comorbidity with ASD, and sometimes ASD is misdiagnosed particularly in non-males as mood disorders, say. Sometimes mental health disorders are diagnosed appropriately, but the underlying neurodiversity is missed. This book presents what is the best discussion of this topic I have read to date. Devon Price writes:

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.

He goes on to note the frequency with which autistic women are misdiagnosed with Borderline Personality Disorder, a narrative very similar to the one that Institution 1 incorrectly attempted to impose on my own family, as I mentioned here.

Reframing Neurodiversity and How to Unmask

Above, I alluded to a handout provided to me which served as my introduction to this book. One sheet was a table from the "Creating a Neurodiverse World" chapter listing "Common, Healthy Autistic Behaviors" that tend to be viewed as dysfunctional and pathologized by professionals. The author reframes each of these as normal and healthy. As features, not bugs, if you will.

At first glance, the table is a simple list, perhaps even trivial. However, it was the first time I'd ever seen behaviours like "not noticing sounds or social signals when focusing on an engrossing task" or "needing to know exactly what to expect before entering an unfamiliar situation" cast as appropriate and perfectly normal, rather than awkward and shameful, if not flat out incompetent. Honestly, it's taking a bit of time to get that idea to stick in this orangutan's highly-conditioned-by-neurotypical-norms brain. There is a bit of antagonistic glee mixed in with the shock.

On a practical level, this book also contains many strategies and exercises for the reader to pursue, should they wish to explore unmasking.

The Social Model of Disability

This book also introduced me to the idea of the social model of disability, and was my first exposure to ideas regarding the interplay of constructs like capitalism, the protestant work ethic, and colonialism with disability. Some of these themes are illuminating and exciting, some are challenging, and some I do not know what to think about. I do think they are all worth thinking about, though.

I particularly like the idea that unmasking is not just a strategy for autistic people, but rather a call for authenticity and integration that will benefit us all.