Why Do Some Trans Autistic People Feel They Must Hide Who They Are?

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Many autistic people feel pressure to hide aspects of themselves to fit into society, while transgender people can face similar pressure to conceal their gender identity. A new study from Spain has examined what happens when someone experiences both, revealing how years of hiding can leave people feeling exhausted, isolated and disconnected from who they really are.

Published on 5 November 2026 in Frontiers in Psychiatry, the research explored the experiences of 20 autistic transgender and gender-diverse people aged between 15 and 48. Researchers found that participants frequently concealed both their autistic traits and gender identities to avoid discrimination, often experiencing considerable emotional distress as a result.

The study, led by María Clemente-Sánchez and Irene Garcia-Molina of Universitat Jaume I in Spain, describes this experience as a complex form of hiding that can become deeply embedded in everyday life. Its title, Like a Never-Ending Performance of Myself, reflects how some participants felt they were constantly acting rather than being able to express their authentic identities.

Why do autistic trans people feel pressure to hide?

Autistic camouflaging, sometimes called masking, involves concealing autistic traits or changing behaviour to meet social expectations. For transgender people, remaining closeted can involve hiding their gender identity because of fears about rejection, discrimination or personal safety.

Researchers found that these two experiences frequently overlapped, creating additional pressure for participants who felt they had to conceal different aspects of themselves simultaneously.

All 20 participants reported camouflaging their autistic traits at some point, while 19 described unfair or unpleasant experiences associated with being autistic and transgender. Fifteen feared physical attacks linked to their identities, and seven reported experiencing physical harm.

One participant, identified as Marcia, described difficulties accessing gender-affirming healthcare because clinicians questioned whether her transgender identity was genuine. She explained that her autism diagnosis had led medical professionals to regard her gender identity as a possible fixation rather than recognising her account of her own experiences.

The researchers argue that such experiences can encourage people to monitor their behaviour constantly, particularly when they fear that expressing themselves openly could lead to rejection.

What happens when people spend years masking their identities?

Participants described how concealing their identities gradually affected their sense of self, with some struggling to distinguish their genuine preferences from behaviours they had adopted to satisfy other people.

One participant explained that masking their autism throughout childhood had made it difficult to recognise and explore their gender identity separately. Another described feeling as though they were portraying a caricature of themselves rather than living authentically.

The emotional consequences were particularly concerning, with eight participants describing feelings of dissociation or a fragmented sense of identity. Five reported diagnoses associated with traumatic experiences, while others discussed hopelessness, isolation and recurring suicidal thoughts.

The authors suggest that masking and remaining closeted can initially provide protection in environments perceived as unsafe, but prolonged suppression may come at a substantial psychological cost. Several participants felt they had little choice but to continue hiding, even when doing so affected their wellbeing.

What does the research mean for mental health support?

The findings highlight the importance of understanding autism and gender identity together rather than treating them as entirely separate experiences. Researchers argue that autistic transgender people may face overlapping forms of discrimination that are not always recognised by healthcare professionals, families or support services.

They recommend greater access to mental health support that respects both neurodiversity and gender diversity, particularly for people who have experienced rejection or pressure to conceal their identities.

However, the study involved only 20 participants recruited through autism organisations and personal networks, meaning its findings cannot represent every autistic transgender person. The participants were also all white, with only one transgender woman included, limiting the range of experiences examined.

Despite these limitations, the research provides important insight into a group whose experiences have received relatively little academic attention. Its central message is that people should not have to conceal fundamental aspects of themselves to feel accepted, and that recognising overlapping experiences of discrimination could help improve the support available.

About the research: The study by María Clemente-Sánchez and colleagues was published in Frontiers in Psychiatry on 5 November 2026. Read the original research paper.