Camouflaging in autism spectrum disorder: Examining the roles of sex, gender identity and diagnostic timing
Camouflaging in autism spectrum disorder (ASD) could be a factor in later diagnosis of individuals without co-occurring intellectual disability, particularly among those assigned female sex at birth. Little research to date has examined how gender identity impacts camouflaging, however. Further, no study has compared groups that differ in diagnostic-timing to directly investigate if later-diagnosed individuals demonstrate elevated camouflaging relative to those receiving an earlier diagnosis. Using the Camouflaging Autistic Traits Questionnaire (CAT-Q) subscales (Assimilation, Compensation, and Masking), we investigated the roles of sex, gender identity (gender diverse vs. cisgender), and diagnostic timing (childhood/adolescent-diagnosed vs. adult-diagnosed), and the interactions of these factors, in ASD adults (N=502; ages 18-49 years). Main effects of sex, gender identity, and diagnostic-timing were revealed. ASD females reported more camouflaging across CAT-Q subscales compared to males. Gender diverse adults reported elevated camouflaging on the Compensation subscale compared to cisgender adults. Adulthood-diagnosed individuals reported elevated Assimilation and Compensation compared to childhood/adolescence-diagnosed individuals. We discuss how the ‘performative’ aspects of camouflaging probed in the Assimilation and Compensation subscales may have particular implications for the intersection of neurodiversity and gender diversity, and for later diagnostic timing.