How support systems interpret and reinforce autistic masking: introducing the concept of ‘visibility logic’

Masking as a survival strategy

Masking refers to the conscious or unconscious strategies autistic individuals use to suppress or hide their autistic traits to appear neurotypical (Hull et al. Citation2017; Livingston et al. Citation2020). These strategies include copying neurotypical body language, rehearsing social scripts, suppressing stimming, or avoiding topics of personal interest. While such adaptations help navigate social and institutional expectations in the short term, the long-term consequences of sustained masking can be severe—contributing to autistic burnout, misdiagnosis or delayed diagnosis, misunderstandings in professional encounters, and lack of access to needed support (Bradley et al. Citation2021; Cassidy et al. Citation2020; Pearson and Rose Citation2021; Raymaker et al. Citation2020). Masking has also been associated with a loss of authentic self, as individuals adapt their behaviour so extensively that their sense of identity becomes fragmented (Seers and Hogg Citation2023). Masking is thus not only a personal coping strategy, but a socially conditioned and often necessary form of self-protection in a world that routinely misinterprets autistic ways of being (Cage and Troxell-Whitman Citation2019).

Structural mismatch in the welfare system

In Norway, access to services and benefits is formally based on universal rights. In practice, however, benefits are often tied to formal diagnosis and visible disability (Ministry of Children, Equality and Social Inclusion Citation2015; Tøssebro Citation2009). This creates a structural mismatch between institutional logic and the lived realities of many autistic people. For those who are perceived as ‘coping well,’ it can create a paradox in which the very strategies used to survive—such as masking—undermine eligibility for support. The challenge of being ‘too “high-functioning” to be supported’ can result in years of unmet needs, emotional exhaustion, and institutional abandonment. The mechanisms described here are likely to apply wherever access to support depends on externally observable traits.

Institutional misrecognition

Although research on masking is growing, few studies have explored how masking affects the recognition of support needs from the perspective of autistic adults themselves (Botha and Frost Citation2020; Gillespie-Lynch et al. Citation2017). Most existing literature focuses either on theoretical models of camouflaging (Lai et al. Citation2017), the development of quantitative self-report scales (Hull et al. Citation2019), or the impact of masking on mental health (Cook et al. Citation2021). Less attention has been given to the institutional consequences of being misperceived as competent due to masking. This gap reflects a broader pattern of epistemic exclusion and testimonial injustice, where autistic individuals’ lived experiences are devalued or misunderstood within institutional systems (Chapman and Botha Citation2023; Fricker Citation2007). In effect, the system listens selectively—trusting only what it sees, not what is said.

The Double Empathy Problem: when neurotypes talk past each other

Traditional models of autism have attributed autistic social differences to deficits in theory of mind (Baron-Cohen, Leslie, and Frith Citation1985) and later extended this to include reduced empathy and social reciprocity (Baron-Cohen Citation2003). However, the Double Empathy Problem, first introduced by Damian Milton (Citation2012), challenges this deficit-based framing by proposing that difficulties in communication between autistic and non-autistic individuals are reciprocal, and arise from mutual misunderstanding due to divergent ways of experiencing, interpreting, and navigating the social world.

Rather than locating the problem within the autistic individual, the Double Empathy Problem emphasizes that both autistic and non-autistic people bring their own cultural assumptions, expectations, and communicative norms to an interaction—and that breakdowns occur because these norms differ, not because one party is inherently impaired (Chown Citation2014; Dinishak Citation2016; Milton Citation2012). For example, while neurotypical individuals prioritize indirectness or eye contact, autistic individuals value direct language or sensory self-regulation, leading to mismatched expectations and misinterpretations. Importantly, autistic-autistic interactions show high levels of attunement, shared understanding, and emotional connection (Crompton et al. Citation2020; Heasman and Gillespie Citation2019), reinforcing the idea that social difficulties are relational, not intrinsic.

This theoretical lens has profound implications for professional encounters, where neurotypical norms dominate. When autistic individuals’ expressions, behaviors, or communication styles deviate from these norms, professionals may misinterpret them as signs of incompetence, resistance, instability, or noncompliance—rather than recognizing them as valid expressions of a different neurotype.

The Double Empathy Problem is particularly relevant to the phenomenon of masking, as explored in this study. Autistic individuals may mask to bridge the communication gap—to avoid misunderstanding, rejection, or punitive treatment in neurotypical contexts. Yet, paradoxically, masking itself widens the gap: it conceals authentic distress, creates false impressions of independence, and leads to a systematic underestimation of need. This dynamic is not a failure of the autistic person to communicate, but a failure of the system to interpret—rooted in cultural asymmetry rather than individual deficit.

By foregrounding autistic participants’ own perspectives, this study takes seriously the idea that understanding must be mutual, not imposed. The findings suggest that the challenges autistic individuals face in accessing support are not due to a lack of insight or self-awareness, but due to pervasive misattunement between how need is experienced and how it is perceived by gatekeepers. Such misattunement aligns precisely with the patterns described in the Double Empathy Problem—and points toward the need for structural, not just interpersonal, change.

When autistic people aren’t believed: epistemic injustice in practice

Many autistic individuals are not only misunderstood—they are systematically disbelieved and misrepresented. This is not merely a social problem, but an epistemic one. Philosopher Miranda Fricker (Citation2007) introduced the concept of epistemic injustice to describe situations in which individuals are wronged specifically in their capacity as knowers—through mechanisms such as testimonial injustice and hermeneutical injustice.

For autistic people, both forms of epistemic injustice are pervasive. When professionals assume that someone who ‘appears fine’ is not struggling, or dismiss reports of burnout or overload because the individual communicates fluently or maintains eye contact, they engage in testimonial injustice. The speaker’s credibility is undermined not by the content of what is said, but by who is saying it—and how their appearance deviates from expectations of what ‘need’ looks like (Chapman and Botha Citation2023; Fricker Citation2007; Yergeau Citation2018).

Epistemic injustice also occurs when autistic individuals are perceived as lacking insight or competence because they express themselves in ways that deviate from neurotypical norms. For example, those who speak with atypical prosody, avoid eye contact, or engage in visible stimming may be dismissed or underestimated—not because of what they say, but because of how they appear. This constitutes testimonial injustice, where credibility is undermined based on prejudice about autistic identity (Fricker Citation2007). In such cases, the system not only fails to listen but actively misjudges competence and need. This dynamic contributes to a double bind in which autistic individuals are either disbelieved because they ‘seem fine,’ or devalued because they do not. Both scenarios reflect structural misrecognition embedded in institutional assessment.

Hermeneutical injustice arises when there are no shared or institutionally recognized concepts to describe one’s experience. Until recently, terms like autistic burnout or masking were not part of clinical or bureaucratic vocabularies, leaving autistic individuals without the language to legitimize their needs (Pearson and Rose Citation2021; Raymaker et al. Citation2020). Even today, autistic people often must translate their lived realities into a framework shaped by non-autistic norms—often unsuccessfully.

This challenge is further compounded by the Double Empathy Problem, in which autistic and non-autistic individuals often operate with divergent communicative norms, priorities, and frameworks of meaning (Heasman and Gillespie Citation2019; Milton Citation2012). When autistic individuals describe their experiences using direct, literal, or internally referenced language, it may be misinterpreted or dismissed by professionals trained to value indirect, emotionally coded, or externally validated expressions. This misattunement amplifies hermeneutical injustice, as autistic people are not only deprived of the shared language needed to legitimize their needs—they are also forced to communicate across a cognitive-cultural divide that undermines recognition. In such settings, even accurate and honest self-report may fail to generate understanding, support, or appropriate institutional response.

The concept of epistemic injustice offers a powerful theoretical tool for understanding how support systems can fail not because they lack resources, but because they misread who is entitled to them. It underscores the urgent need to validate insider knowledge, challenge deficit-based interpretations, and shift toward models of epistemic trust and mutual recognition in both diagnostic and support contexts.

Together, these theoretical lenses—masking, the Double Empathy Problem, and epistemic injustice—highlight the relational and structural barriers that autistic individuals face when seeking recognition and support. They provide a framework for understanding how masking strategies, miscommunication, and power asymmetries intersect in institutional encounters. In this study, these perspectives guided both the formulation of interview questions and the thematic analysis, with a particular emphasis on how autistic individuals interpret and navigate the gap between how they are perceived and what they actually need. Taken together, these perspectives illuminate the systemic conditions under which visibility logic operates, setting the stage for the conceptual contribution proposed in this article.

Design

The aim of the study is to explore how autistic adults in Norway experience masking in relation to recognition of support needs. The qualitative approach was chosen to elicit rich, in-depth narratives and allow participants to express their perspectives in their own terms. The interviews followed a semi-structured format, guided by an open-ended interview guide developed by the author. This format allowed for flexibility and responsiveness during the interviews, enabling participants to elaborate on topics that felt most meaningful to them. More importantly, a qualitative design was selected because it facilitates the elicitation of insider knowledge—understandings rooted in lived autistic experience that emerge more fully when participants are able to shape the direction and framing of the conversation.

Participants

The study involved nine autistic adults, ranging in age from their late twenties to late forties. Participants included both men and women, including two who did not identify with the gender assigned at birth and one who identified as non-binary. Some had received their autism diagnosis in adulthood—often following years of challenges related to education, work, or mental health—while others had been diagnosed in childhood or adolescence.

The sample reflects a wide range of lived experiences, which enabled a richer exploration of how autistic individuals navigate the interplay between masking, system perceptions, and access to support—and helped identify structural patterns that cut across different life contexts.

Participant characteristics were as follows: P1 was in part-time work, was not receiving disability benefits, lived with a partner, and was enrolled in higher education. P2 was in supported/adjusted employment, was receiving disability benefits, lived with a partner and children, and had attempted higher education twice without completing it. P3 was in regular employment, had previously received disability benefits, lived alone, and had upper secondary education. P4 combined part-time employment with self-employment, was partially receiving disability benefits, lived with a partner and children, and held a master’s degree. P5 was not employed, was receiving disability benefits, lived with parents, and held a bachelor’s degree. P6 was not formally employed but was active in voluntary and organisational work, was receiving disability benefits, lived with a partner and children, and held a bachelor’s degree. P7 was not employed, was receiving disability benefits, lived in supported housing, and had upper secondary education. P8 was not employed, was receiving disability benefits, lived with a partner and children, and had upper secondary education. P9 was in full-time employment alongside self-employment, was not receiving disability benefits, lived alone, and held a master’s degree.

Recruitment

Participants were recruited through purposive sampling. The researcher actively reached out to potential participants via autism networks, social media, and connections. The recruitment materials stated that the study focused on autistic adults and their lived experiences, with a particular interest in how masking may affect access to support. However, prior experience with masking was not a requirement for participation, allowing for varied perspectives.

Data collection

To accommodate participants’ preferences and accessibility needs, interviews were conducted in a variety of settings: some took place digitally via secure video platforms, while others were held in person—either at the participant’s home or the researcher’s—depending on what felt most comfortable for the participant.

All interviews were audio-recorded with informed consent and transcribed verbatim by the author. The duration ranged from ∼40 min to over 3 h, with most lasting around 90 min. The extended length of several interviews reflected participants’ strong desire to be heard and their engagement with the topic, which they described as rarely explored from their own perspective.

Analysis

The researcher conducted a reflexive thematic analysis (Braun and Clarke Citation2006, Citation2019), following an inductive, data-driven approach. No pre-established coding frame was applied; instead, themes were identified and constructed through an iterative interpretive process. The transcripts were read multiple times to ensure deep familiarity with the material before proceeding with systematic coding.

Codes were developed iteratively, with ongoing reflection and revision as patterns and tensions surfaced across interviews. No qualitative software was used; instead, coding and categorization were carried out manually. This approach was chosen to allow for close, embodied engagement with the data and to retain direct familiarity with participants’ words throughout the analytic process. Codes were then organized into higher-order categories, with attention to both semantic and latent content.

The term visibility logic was not predetermined, but emerged through inductive coding and reflexive thematic analysis. Rather than applying an existing theory, the concept was developed post hoc to capture recurring patterns observed across interviews.

The analytic process was informed by critical disability studies and neurodiversity-affirming frameworks, with particular attention to epistemic injustice and interpretive authority. This guided the analysis toward identifying structural mechanisms rather than reproducing explanations that locate the issue in presumed individual ‘deficits’.

Researcher positionality

The researcher is an autistic adult with lived experience. These experiences shaped both the motivation for the study and the interpretive lens applied. Rather than striving for detachment, I adopt a standpoint-informed approach in which subjectivity is recognized as a resource rather than a bias. My position informed the questions asked, the interpretations developed, and the theoretical framing of the analysis.

I conducted all parts of the study independently—including interview design, recruitment, data collection, transcription, coding, and thematic analysis. While my lived experience enabled deeper resonance with participants’ narratives, I engaged in continuous reflexive practice to ensure analytical rigor and transparency throughout the research process.

All participants noted that being interviewed by another autistic person made them feel safer, more understood, and more comfortable sharing openly. This shared neurodivergent perspective fostered trust and contributed significantly to the depth and richness of the data—illustrating how researcher positionality can serve not as a source of bias, but as a strength in meaning-making.

Misjudgment and misrecognition in support systems

Autistic adults in this study consistently described being misjudged—either as more competent than they were, or as incapable based on surface impressions. These misreadings had concrete consequences: loss of accommodations, exclusion from education or work, late or denied support, and emotional harm. Two opposing but equally harmful patterns emerged: overestimation of those who masked well, and underestimation of those who didn’t.

Overestimation through masking and denial of support

Masking led professionals to overestimate participants’ functional capacity, interpreting it as evidence of low support needs. Across accounts, participants described a recurring pattern: when they appeared calm and articulate their requests for adaptations were dismissed as unnecessary. This overestimation produced a structural barrier where visible struggle became the only valid route to support.

Because I appear much more functional than I actually am, I fall through the cracks—both in school and at work (P5).

Here, masking functions as a visibility filter: professionals respond to the appearance of competence, leaving the participant illegible within a system that equates calmness with capability.

If professionals had been able to see behind this mask, maybe it would have been possible to find a solution regarding work. But there’s been no understanding at all when it comes to masking (P6).

This highlights the epistemic gap at the core of visibility logic: professionals treat surface-level behavior as complete information, failing to interpret masking as a compensatory strategy rather than an indicator of low need.

I probably should have had lots and lots and lots of accommodations. […] I know people who are really ill who’ve been allowed to complete and were given adjustments. But with me, they just said no. I feel like my autism has ruined my chances of working (P2).

The participant describes a contradiction produced by overestimation: those who appear less distressed are judged as less deserving of support, even when the absence of accommodations directly undermines participation.

In meetings with career counselors, I said I don’t learn very quickly. ‘Yes, you do. You’re sharp. So just put it on your CV,’ they said. And I was like, ‘Okay, but that’s not true’ (P8).

This demonstrates how professional authority overrules self-report: the participant’s explicit articulation of need is dismissed in favor of the counselor’s visual impression, reinforcing the idea that visible cues outweigh autistic communication.

I felt like I needed a community support worker, for example. […] But I was denied support twice at first, and then we kind of had to lie a bit on the application. Because I do need it, but they thought I didn’t (P3).

The denial reflects systemic overreliance on behavioral visibility. Without observable crisis, the participant’s stated needs are judged insufficient, reinforcing the requirement to ‘fail first’ before help becomes accessible.

I’ve always been good at school, so the university didn’t see the need for accommodations during my practicum. Even when I had a doctor’s note saying I needed it (P5).

Academic performance is taken as proof of competence, illustrating how masking plus achievement can erase legitimate support needs—even when documented.

Together, these accounts show how institutional assessments were guided more by surface-level impressions than by articulated needs. Masking rendered struggle illegible within systems that rely on visible distress as evidence, leaving participants overestimated, unsupported, and required to ‘fail first’ before help was considered.

Emotional consequences of being denied help until crisis

A recurring dynamic was that support was only granted once participants had reached a point of visible collapse. Professionals interpreted articulate communication as evidence of coping, meaning that distress had to escalate dramatically before it was recognized as legitimate. This reveals how visibility logic produces a high threshold for intervention—one that requires suffering to become outwardly legible:

They basically assumed that I could handle everything. I’m so good at talking that they thought I was managing just fine. So they put me in situations meant for a typical, ‘normal’ person—and I totally crashed (P6).

Here, articulate speech is misread as emotional capacity. The participant’s communicative competence overrides their expressed limits, illustrating how visibility logic equates verbal fluency with resilience and uses it as justification for withholding support.

It wasn’t until I quit my job and said I saw no way out other than suicide that they finally took me seriously (P5).

This account makes explicit the structural requirement for extreme visibility: only when distress became life-threatening did the system recognize the need. Support is contingent on crisis rather than on earlier, clearly articulated signals—showing how institutional responses depend on escalation rather than prevention.

They didn’t listen to me, even though I said for years that this was going to go to hell. […] The kitchen burned down a long time ago—they saw the smoke, they saw the flames, but they just completely ignored it (P5).

The metaphor illustrates cumulative neglect: visible signs of deteriorating functioning were present, but reinterpreted as manageable until collapse occurred. This reflects an institutional tendency to ignore early warning signs when the individual does not appear distressed in neurotypical ways.

Why does it have to take so much emotional expression for them to take us seriously? (P9).

This question captures the core mechanism of visibility logic. Participants recognize that systems privilege dramatic, externalized distress, while autistic forms of overwhelm—like shutdown and withdrawal—remain unread. Emotional expression becomes a currency for access.

Even when participants articulated their needs—such as requesting weekly structure at work—the absence of visible distress led professionals to underestimate their struggles. Support was withheld unless suffering became dramatic and overt. A participant who relied on weekly therapy to function was told they didn’t need it ‘because they seemed fine’—despite explicitly stating that the safety net of regular sessions was what enabled them to cope. This created a paradoxical cycle: support was often only granted once participants had already reached a point of collapse—yet when that support helped them regain some stability, it was swiftly withdrawn. As a result, several described oscillating between being denied help when appearing competent and losing functioning when that help disappeared.

Barriers in education, work, and vocational training

A recurring pattern was that participants were denied tailored support in education, vocational training, or employment despite clearly expressed needs. Two participants were unable to complete higher education programmes after their requests for accommodations were repeatedly disregarded—one was unable to complete their degree due to the lack of accommodations during their practicum—a barrier only removed years later under a new program director. Another dropped out of two higher education programs after repeated requests for accommodations were ignored.

Eight of the nine participants described experiences of being placed in unsuitable jobs or vocational training settings, or having their requests for adjustments overlooked. For example, a participant was assigned to work in a grocery store but stopped showing up because he was expected to handle customer interactions—even though his social anxiety was well known. Another described being passed around in the social services system for 17 years without anyone suggesting an autism assessment—until she finally requested it herself. Reflecting on the experience, she emphasized that the failures were not due to bad intentions, but to a persistent lack of understanding of autistic presentation. Her experience illustrates how systemic misrecognition can delay both identification and access to appropriate support for years.

Underestimation of those who do not mask

Where masking led to overestimation, lack of masking produced the opposite distortion: participants were judged as incapable, unmotivated, or impaired based solely on visible autistic traits. In these cases, visibility triggered restrictive assumptions that limited access to education, employment, and autonomy:

I find it upsetting that throughout my life, things have been taken away from me just because someone thought I was too weird, or that something about me wasn’t quite right. And at the same time, they stand there preaching about how we all need to be inclusive (P2).

This account illustrates how deviation from neurotypical norms becomes pathologized. The participant is not responding to a lack of skill, but to a misreading of autistic embodiment as deficit—an interpretive move central to visibility logic.

They had already decided that I wasn’t going to be able to do anything (P3).

Here, underestimation is not the result of assessment, but presumption: visibility substitutes for evaluation, closing off opportunities before capability can be demonstrated.

They placed me in a store, and I don’t like working in stores, so I did a poor job. And then they decided to classify me as disabled. […] I just felt like a burden on society, really (P3).

This quote highlights a circular dynamic: a mismatch between environment and need is reinterpreted as personal failure. Rather than adjusting the context, the system attributes poor fit to individual incapacity, reinforcing the idea that visible difference signals permanent limitation.

Together, these accounts demonstrate how visibility can trigger downward categorization: those who do not mask are underestimated and redirected into segregated settings. Within visibility logic, not masking becomes misread as incompetence, resulting in diminished opportunities and reduced autonomy.

Misplacement in special needs streams and denied opportunities

In some cases, participants described being underestimated to such a degree that they were never given a real chance. Two participants said they were placed directly into special needs units when starting upper secondary school. One of them explained that although he struggled with theoretical subjects, he was skilled in practical tasks. Yet he was assigned to the most adapted department, reserved for students with the highest needs. He never received grades or got to try regular academic classes—and felt denied the chance to prove what he was actually capable of.

In one case, a participant was placed directly on disability benefits without any meaningful opportunity to undergo work capability evaluation. To gain access to employment-related support rather than being routed straight into permanent benefits, he felt pressured to downplay his difficulties and present himself as more work-ready than he actually was. He explained that this was not masking to appear ‘fine’, but masking to be given a chance. One woman reflected on how masking might hide support needs, yet said she was afraid of being seen as intellectually disabled if she stopped masking altogether. This reflects how internalized stigma—rooted in ableist social norms—can shape the way autistic people manage their visibility.

Masking, stigma, and managing visibility

If being visibly autistic leads to exclusion, then masking becomes a strategy for survival. All participants described how their tendency to mask was not something they naturally chose—but shaped, reinforced, or even demanded by the systems they interacted with. Over time, they learned that authenticity came at a cost, while performance was required for acceptance.

I’ve had to adapt to society, even though society has never once adapted to me. They brag about inclusion and say all the right things—but the moment you don’t meet their expectations, it’s like: What, you can’t handle that? Seriously? Are you stupid, or what? (P2).

Here, masking is framed as a coerced adjustment to neurotypical norms. Inclusion rhetoric is contradicted by punitive responses to autistic embodiment, illustrating how visibility logic operates at the level of cultural expectation: the autistic person must adapt, while the system remains unchanged.

When people have looked at me the way they have—like, ‘No, you can’t work with anything’—then you quickly choose to mask. Because you don’t want to be seen that way, to be underestimated. So instead, you’d rather be overestimated, and that’s why you end up masking (P2).

Masking becomes a response to stigma. The participant articulates a double bind: visible traits trigger downward categorization, while masking produces overestimation. In both cases, support becomes inaccessible.

So I politely asked if I could be allowed to avoid eye contact. And they were like, ‘Well, what are we supposed to do then? Just talk over you?’ And then they actually did that. I just thought: And you work with this? You work with this! […] Whatever, I’ll just make eye contact anyway. Even though what I really needed was just to sit completely still (P2).

This account shows how systems can actively suppress autistic communication needs. A basic adaptation (avoiding eye contact) is rejected not because it is unworkable, but because it conflicts with neurotypical expectations of reciprocity. Masking becomes the only viable option for being seen as competent.

I think the thing is, we’re really afraid of losing our humanity. That they’ll think we’re less human, or less competent, if we don’t mask (P2).

Here, masking is described not only as a behavioral adaptation but as protection against dehumanization. The participant identifies a fear of being misread as less worthy, underscoring how stigma shapes self-presentation.

It was partly driven by how I wanted the world to see me, but also by being in the patient role for so long, and in the welfare system for so long. I had to adjust to new jobs, new placements, new courses—being like a chameleon for 17 years (P8).

Masking is depicted as institutionalized over time—a learned response cultivated through repeated encounters.

In the beginning, I was honest about things and tried to explain. But I felt like they weren’t listening to me. So I thought, okay—why should I even show them who I really am? (P3).

Here, masking emerges as resignation: when self-advocacy fails, self-concealment becomes protective. This directly reflects visibility logic’s central mechanism—systems treat autistic communication as less credible unless accompanied by neurotypical markers of distress.

Masking as protection in healthcare and perinatal care

Across the participants, masking was frequently described as a protective strategy—particularly in contexts where professionals hold evaluative power. This dynamic became especially visible in a case where the participant reflected that masking felt like ‘a wisdom born of injury’—a response to years of being misjudged and sidelined. She described how, when interacting with health professionals—especially as a new mother—she deliberately suppressed signs of autism out of fear of being seen as unfit or incompetent. At the maternity ward, she worked hard to appear capable, hiding her needs. But once she came home, the exhaustion hit, and she crashed. For her, masking was not about deceiving others—it was about staying safe in a system where showing vulnerability might lead to judgment or loss.

Somatic misinterpretation and neurotypical projection

The stakes can be even higher in medical and psychiatric contexts. In some cases, autistic traits were misread in ways that led not just to misunderstanding, but to harm. Five of the participants described being dismissed or misdiagnosed when experiencing somatic symptoms—because they did not express pain or distress in expected ways. These encounters were not necessarily due to intentional masking, but rather to what one participant called ‘neurotypical projection’: professionals interpreted autistic expressions through a neurotypical lens, leading to serious misunderstandings and delays in care. For instance, one participant experienced significant gastrointestinal symptoms, including unexplained bleeding and extreme weight loss, yet was told to simply ‘relax’ and was dismissed as psychosomatic—dropping to a BMI of 16 before receiving proper attention. Another, due to an atypical pain response and opioid immunity, was denied adequate pain relief, their condition misread as drug-seeking behavior.

Psychiatric misreadings and coercive interventions

Some of the most severe consequences of misreading autistic distress appeared in psychiatric contexts. Eight of the nine participants described how fear, overload, or shutdowns were interpreted as resistance, aggression, or pathology, and how this led to misdiagnosis or inappropriate treatment. Rather than receiving support or trauma-informed care, they were subjected to coercion and containment.

I was deeply depressed, and the environment around me wasn’t adapted—there was no structure, no daily plan. And then they start talking about ECT, saying I needed electroshock treatment again. […] ‘This isn’t up to you, I’m the psychiatrist and I’m in charge.’ But that’s honestly bullshit, because the environment was absolutely what mattered here. It was the environment that made me completely unable to function (P7).

Here, the participant identifies an institutional misattribution: functional collapse is interpreted as psychiatric illness rather than a response to environmental misfit. The professional’s authority overrides contextual understanding, illustrating visibility logic at its most consequential—distress becomes legible only as pathology, not as an interactional effect of unmet needs.

I’ve sort of gone through my history with psychosis—how things ended up the way they did. […] How differences in communication—because I take things literally—ended up being interpreted as illness (P7).

This account shows how autistic communication styles can be reinterpreted as symptoms of psychosis. Literal interpretation, slowed processing, or atypical affect are reframed as diagnostic criteria, revealing an epistemic vulnerability: when clinicians rely on neurotypical markers of coherence, autistic expression becomes pathologized by default.

I was clearly scared, and I was seriously ill, and they used a lot—a lot—of coercion. I was strapped down over 250 times in a single year, and I took a couple hundred Valium tablets in one month (P7).

Here, the consequences of misrecognition are extreme. Fear and overload are met with restraint and sedation rather than accommodation. This is visibility logic functioning as coercive practice: because autistic distress does not present in expected ways, the system escalates control rather than support, producing cycles of trauma and further dysregulation.

Together, these findings show how psychiatric settings may amplify the harms of misinterpretation. When autistic distress is readable only through a neurotypical lens, shutdowns, fear, or overwhelm are reframed as defiance or illness. This not only obscures underlying needs but legitimizes coercive interventions that deepen vulnerability.

Structural visibility logic across contexts

These examples illustrate a systemic pattern in which the burden of visibility falls on the autistic individual. Professionals fail to recognize support needs unless they manifest through neurotypical distress cues. This reveals not only a lack of awareness about masking but also a deeper structural issue: an epistemic gap in how distress is read and validated. When autistic expression is misinterpreted in ways that carry serious consequences, it becomes understandable—perhaps even inevitable—that some will resort to masking as a form of self-protection.

These stories exemplify what I refer to as visibility logic: the idea that institutional decisions are guided more by what appears externally than by what is actually experienced. When support is contingent on visible cues, both ‘high-functioning’ appearance and apparent dysfunction can result in misrecognition. One informant summarized it with painful clarity:

There are good professionals, but most of them just look—and then they go by what they see. And no matter how direct an autistic person is, saying ‘I need this and that,’ they still rely on their eyes and their neurotypical system to judge what they think is best, instead of actually listening to what we’re saying (P7).

Figure 1. Visibility logic in institutional responses to autistic traits. Figure created by the author.

What does the concept of visibility logic make possible to understand?

The concept of visibility logic offers an integrated framework for understanding how autistic people are misread and misjudged within support systems. Rather than treating masking, support denial, or diagnostic errors as isolated phenomena, visibility logic shows how these outcomes are systematically interconnected.

The concept captures four distinct but overlapping dynamics:

1. the overestimation of those who mask successfully,

2. the underestimation of those who appear visibly autistic,

3. the withdrawal of support once someone appears to function better, and

4. the way systems themselves induce masking through incentives, punishments, or epistemic disregard.

The findings underscore a critical need to decouple perceived competence from actual need. Autistic people should not have to perform distress or suppress their traits to be believed. Assessments must move beyond surface impressions and engage with the person’s stated experience—even when it doesn’t align with neurotypical expectations.

Second, the data shows that masking often emerges in response to systemic pressure. If services want to support authenticity, they must first build trust and psychological safety. Masking cannot simply be ‘removed’—it must be unlearned in environments where the cost of being oneself is no longer too high. Finally, the current reactivity of many support systems—waiting until a person breaks down—must shift toward early, proactive, and individualized support. If visibility logic governs who gets help, those who need it most may be the last to receive it.

What does this reveal about knowledge and power?

The findings highlight a fundamental asymmetry in how knowledge is produced and legitimized in professional encounters. Despite autistic individuals clearly articulating their needs, their accounts are often overruled by what professionals see. This reflects a deeper epistemic injustice—where neurotypical norms of expression are treated as the standard for what counts as credible or ‘real.’ Autistic knowledge is not just overlooked; it is systematically devalued. Visibility logic reveals how this imbalance of power is maintained: it is not enough to say what you need—you must appear to need it in the ‘right’ way to be heard.

These patterns are strikingly consistent across participants—yet they have remained largely unexamined in the academic literature. That such a pervasive dynamic has gone unnoticed points to a deeper issue: the persistent absence of autistic voices in research about autism. Visibility logic as a concept emerged not from existing theory, but from the lived accounts of autistic people—seen through the lens of an autistic researcher. This underscores why epistemic inclusion is not optional. Without autistic perspectives at the centre of both inquiry and interpretation, entire structures of harm can remain invisible—even in plain sight.

Limitations

The dataset is rich and heterogeneous, including participants with a wide range of life experiences and support needs. However, all participants had sufficient verbal ability, meaning the study does not capture the perspectives of autistic individuals who rely on alternative or augmentative communication. Future research should aim to include these voices to explore whether similar systemic patterns apply. While the sample is small and not intended to be representative, the findings provide a solid qualitative foundation for further investigation.

Conclusion

This article has introduced the concept of visibility logic to describe a systemic paradox in how autistic individuals are assessed, supported, and misunderstood. Based on rich qualitative data, the findings show that visibility—displaying autistic traits—often leads to exclusion, while invisibility—masking—leads to neglect. Either way, the autistic person loses. Support is granted only in crisis, withdrawn as soon as functioning improves, and contingent on displaying distress in neurotypical ways.

These patterns reveal an epistemic gap in how need is recognized and validated. Masking is not simply an internal coping mechanism, but a system-induced response to misrecognition. The burden of being legible to professionals—of making one’s needs visible in the ‘right’ way—falls on the autistic person, reinforcing cycles of masking, burnout, and systemic harm.

The findings support and deepen existing research showing that autistic communication are often misread within institutional settings (Botha and Frost Citation2020; Milton Citation2012). By introducing visibility logic, this study offers a framework that explains why these misinterpretations persist even when policies emphasise inclusion. Positioning these insights within the broader literature underscores the need for systemic, not only interpersonal, change in how support systems evaluate and respond to autistic needs.

Professionals must learn to recognize needs that are not outwardly dramatic, and to question how their own expectations of expression shape what they see. Support must be proactive, not crisis-based, and grounded in trust rather than proof. Further research is needed to examine how systems can be redesigned to reduce the need for masking in the first place. This article offers only a glimpse of the deeper systemic patterns at play. Future research will trace how visibility logic is embedded in the assumptions, documents, and routines of Norwegian welfare institutions. Professionals may not see it yet—but this logic is already shaping lives. A final reflection from the author: