New Fears of The Old Disability Con

Autistic masking is fake, and disability is cool now? really??

Is it cool to be disabled?

The conservative press sure does want you to think so — a piece from this month by Poppy Coburn in The Telegraph claims that lots of young women are flaunting their canes around town, and might even be faking it for the clout:

I was surprised to find during my research into the #Pots community that many individuals also experienced autism, Tourette’s, Long Covid, chronic Lyme and so on. It would require incredibly bad luck indeed for so many of these women to be afflicted by so many completely different illnesses with totally different medical causes. But luck seems to have nothing to do with it. There is a wealth of medical evidence that disorders with no proven pathology overlap. In many of these cases, if the cause is medical, it is strictly psychosomatic. And if it is not medical, it is likely to be based on identity: the desire to increase one’s status through suffering, or to enjoy a larger community of supporters.

This suspicion of malingering for personal gain is a tale as told as disability — the legal scholar Doron Dorfman calls it ‘fear of the disability con’. But this particular concern, that disability confers unearned status, is the product of an internet built around personal branding and social capital. In this context, talking openly about your disability is equated to flaunting it, which can only be done for some kind of status or money (even though the most lucrative niches online are beauty, fitness, and finance, but I digress).

It’s not really an argument based in the reality of disabled life, because being disabled IRL can be perilous. In April, Frances Ryan interviewed 100 disabled people in the UK who reported being publicly harassed for using handicapped parking placards, with some even being physically assaulted.

“I’ve had people try to take my crutches off me, saying I don’t need them,” one woman said.

Disabled women are more likely to be sexually assaulted at work, to experience intimate partner violence, and to be bullied. It’s no wonder, then, that so many autistic women mask — another aspect of disabled life currently being targeted with skepticism.

This year, famous autism researcher Uta Frith publicly stated that she believes there is ‘no scientific basis’ for the concept of autistic masking. She believes it’s ‘a dangerous development’ and a ‘new villain to be fought’, and considers it ‘unfalsifiable’ because it’s based on self-report.

Which is weird, because most things in the DSM are, in large part, based on self-report, and, as the psychologist and autism researcher Sue Fletcher-Watson responded:

“Without autistic people there is no autism, so saying that their experience is somehow beside the point, or even actively incorrect, is bizarre to me.”

This attempt to discredit autistic masking also plays into the idea that people are claiming disability to be cool — if masking isn’t real, then neither are all these people who claim they weren’t diagnosed until adulthood because they could mask. The most common way to dismiss this is by conflating masking with general impression management.

There is Something That Makes Masking Different

“I expect we could say we are all masking, all the time, trying to adapt to our society’s norms,” Frith told TES Magazine.

In August, she published an editorial called Autism spectrum disorder: has it lost its meaning and is it leading to misdiagnosis?, in which she pondered whether masking was the concept that ‘opened the floodgates’ of autism diagnoses:

“Take the clause that appeared in DSM-V making allowances for symptoms that ‘may not manifest until social demands exceed limited capacities or may be masked by learned strategies’. This clause seems purpose-built for later diagnosed individuals. Yet, if masking can be used to explain the total absence of symptoms, then, in theory, this could lower the diagnostic threshold to zero.”

That speculation is a bit dramatic — clinicians are not basing their diagnoses entirely on self-reports of masking. The NICE guidelines for diagnosing autism in adults recommend consulting family members and school records about developmental history, and using up to five different screening tools. Masking and camouflaging are not mentioned at all.

The clause was included in the DSM so that masking didn’t count against a diagnosis, and it’s in there thanks to the lobbying of the Autistic Self-Advocacy Network, which knew that women and people of color were likely to be overlooked and missed by clinicians due to a combination of societal prejudice and compensatory strategies.

Steven Kapp and Ari Ne’eman documented this process extensively. Specifically, they cited two autistic women:

“Zoe Gross, then an intern with ASAN and later to become the organization’s Director of Operations, drafted critical background material provided to the workgroup on the challenges facing autistic women and autistic people of color in accessing a diagnosis and the resulting disparities these groups faced. She also provided illustrative examples regarding circumstances under which individuals might fall out of the boundaries of early drafts of the criteria, while still needing the support and recognition that an autism diagnosis could provide. Amanda Vivian, an autistic writer and creator of the Autistic Passing Project (http://autisticpassing.tumblr.com/), provided critical feedback on early drafts of ASAN feedback, among others.”

Masking was not a new idea — it had been described since the 90’s in autistic memoirs like Life Behind Glass and Pretending To Be Normal. The first description I could find was actually in a book edited by Frith in 1991!¹ But here, she attempts to discredit the concept by claiming everybody does that:

“Masking… means concealing problems purely to blend in. How does this kind of camouflaging differ from the adaptation and impression management that everyone practices in their social interactions?”

It’s a good question, and something a lot of people seem confused about, because I see this conflation all over social media. Other medical professionals make it, too — the psychiatrist Hannah Spier has conflated masking with basic emotional regulation:

And the ADHD expert Russell Barkley has claimed that masking is good for neurodivergent people to do, and there’s ‘no evidence’ it causes harm:

“Masking is typical of most people when they are in the presence of others. We want to thank you for not belching out loud, or passing gas audibly, or wearing your slovenly work-out clothes that you might have done during the lockdown or on Saturdays when you’re at home. We really appreciate you suppressing that authentic self when you are out in public.”

But the kind of masking we’re talking about goes much further than holding in your farts. According to Amy Pearson and Kieran Rose, the difference is stigma.

In their book on masking, they argue that it’s an inauthentic performance of self that is motivated by avoiding stigma:

“For non-autistic (and other non-stigmatised people) the managing of identity and impression appears to be based around the expression of different aspects of self, in a way that is most relevant to that context, e.g. wanting to make a good impression at work through being your best ‘professional self’. However with stigma-driven IM, inauthenticity seems to be a core issue.. whereby there is a suppression of authentic self, or projection of inauthentic self, rather than a highlighting or softening of contextually less relevant aspects of identity. The latter may allow someone to feel like they are still expressing themselves more authentically as different aspects of self ebb and flow, whereas the former creates disjunction.”

General IM vs Masking, from Pearson and Rose (2023)

Going to the bathroom to cry at work and burping quietly are not inauthentic performances of self that fracture your very identity, and they are not the same as performing a personality that is not really you because society is structurally biased against the way you move, communicate, and relate to others. That kind of masking, done on a daily basis, leads to depression, identity breakdown, and suicidal ideation.²³

The Politics of Dismissal

Interestingly, both Frith and Coburn cite Suzanne O’Sullivan, whose book The Age of Diagnosis argues that a recent rise in disability is largely psychosomatic. Coburn focuses on POTS in particular, which disproportionately affects women and autistic people, and is actually on the rise because of COVID.

Nonetheless, she cites O’Sullivan’s opinion that POTS has ‘no pathology to prove a diagnosis’ and is ‘arbitrary’. What O’Sullivan actually suggests in her book is that POTS is a fear of standing up — a psychological issue, not a physical one, which primes it for dismissal.⁴

It’s no coincidence that these arguments are circulating at a time when the US, UK, and Australian governments are all trying to cut welfare benefits. Coburn, at least, says this part loud and clear:

“All of the major political parties have acknowledged that disability-related welfare costs are unsustainable, with Reform vowing to compel a quarter of a million people back into work, saving taxpayers up to £50bn, if it forms the next government. Overdiagnosis of minor issues that 20 years ago would have resolved on their own can be ruinously costly.”

Coburn denies that they’re outright malingering, instead opting for a more condescending flavor of compassion. She paints them as gullible young girls, desperate for an identity, who have been influenced by the internet and overdiagnosing doctors to believe that they are disabled. They’re not active tricksters, they’re tragedies, victims of a woke, soft culture that is stealing your taxes!

The framing is a little different, but this is a pattern that has played out many times before — welfare states are constantly in ‘crisis’, and it’s always the fault of fraudsters, even though actual welfare fraud is quite rare, and most often committed by private businesses, not individual recipients.⁵

What’s more, certifying eligibility for aid is an expensive process that pads the pockets of major corporations like Deloitte, who purposefully design their administrative systems to be confusing and complicated because it is more profitable for them. To be angry about an imaginary horde of malingerers taking resources when real corporations are actually sucking us dry is absurd, but alas, here we are again!

Back in 1984, while Reagan was busy slashing welfare, Deborah Stone described this cycle in her book, The Disabled State:

“A program grows rapidly, perhaps faster than originally estimated, or perhaps the growth rate suddenly increases. The media begin to publish reports based on data issued by the program agencies themselves, showing that the number of beneficiaries, the size of the benefits, and cost of the program are all increasing dramatically.

Certain phrases become part of the common language used to describe the program: ‘alarming rates,’ ‘threats to financial stability,’ ‘fiscal crisis,’ ‘insolvency.’ Then explanations of the ‘crisis’ are offered, along with the obvious solutions that flow from them. The explanations are always the same: the program encourages abuse because of the structure of its incentives, and the administration of the program is in need of coordination and better management to curb individual abuses.

When benefit programs are at issue, the culprit is always the program user.”

Stone explains how deception has long been central to the legal category of disability. Societies have two ways of distributing resources — you either work for them, or you get aid based on your need. The boundary between the two has to be policed somehow, so the legal category of disability was constructed to distinguish the genuinely needy from the supposedly lazy cheats.⁶

This created another problem, though — how do you determine that a person is legitimately too disabled to work? In reality, disability is fluid and dynamic, and many disabilities have no objective biomarkers that doctors can use.

Stone writes that the 1948 Social Security Advisory Council wanted the definition of disability to ‘be restricted to those which can be objectively determined by medical examination or tests.’ But doctors at the time told Congress that this wasn’t really possible. Central to their argument were conditions of chronic pain and mental illness, which they called ‘elusive disabilities’:

“physicians asserted that disability determination is inherently subjective, and that honest physicians could legitimately disagree about whether a person is disabled. Many argued that medical science is incapable of determining whether people can or cannot work. Over and over again they told Congress that ‘medicine is not an exact science,’ and that disability is a social and psychological problem not amenable to exact definition by physicians.”

The boundary between work and need is constantly being negotiated, according to Stone, who didn’t have much to say about solutions to these problems. Frith, in particular, is convinced that all we need is to find a biomarker for autism.⁷ But I don’t think there’s any autism criteria good enough to fix the problem of inequitable resource distribution.

By assigning a market value to the productivity of our very bodies, capitalism created a class called ‘disabled’. There is no stagnant definition of disability, or gene we can consult to verify it, because disability is intrinsically tied to economic production. Insisting that we go back to an older, stricter definition of autism, for instance, denies the way that cognitive demands have intensified and are actually disabling more people.

Roddy Slorach argues that changes to the way we produce value will inevitably lead to different types of impairment:

“Workers today are as likely to develop anxiety or depression as they are repetitive strain injuries or back problems caused by operating machinery or manual labour. In every field of industry, employers push workers harder to keep pace with competitors.”

Those doctors in 1948 were right — resource distribution is not a medical problem, it is a political one. ASAN recognized this, and it’s why they lobbied to include a mention of masking in the DSM-5, since these ‘passing’ strategies developed for survival in childhood tended to become a barrier to adult diagnosis, which many people need to be certified for aid. Kapp and Ne’eman wrote that this was:

“the first successful effort of the autistic community—and as far as we are aware, any disability community—to successfully influence the modification of their own diagnostic criteria.”

It’s actually a huge accomplishment, but for every inch of progress, there is a flood of backlash. These kinds of attacks will continue, but we must recognize them for what they are: manufacturing consent for the denial of need.

1. It’s in a chapter by Christopher Gillberg, where he notes in a case study of an autistic girl that ‘symptoms of impairment of social interaction might be less conspicuous than corresponding symptoms in boys.’ A year later, Gillberg and Svenny Kopp published six case studies of girls who were diagnosed later in their childhood. They wrote:

“..the type of social impairment shown by these girls tended more towards ‘clinging’ to other people, imitating their speech and movements without a deeper understanding of the silent laws of ordinary social interaction..”

Kopp and Gillberg hypothesized that girls were not being diagnosed as early or as often as boys because they were not as ‘aggressive’ and could imitate others convincingly.

2. This has been studied — see Miller et al 2021, which found that both autistic and non-autistic groups reported masking behaviors, but sensory suppression and suicidality were specific to the autistic group.

3. Masking your identities can compound, too — a study in 2025 found that queer autistic people report masking more than straight autistics. I didn’t find any studies on the intersection between code-switching and masking for autistics of color, which Mayne Souza Benedetto has called the “dual masking phenomenon,” but there is one currently recruiting.

4. I critiqued this book last year; here’s a video that focuses on what Suzanne gets wrong about POTS in particular.

5. Even the US Treasury admits this! They literally just put this out the other day: “Home health care businesses were identified as the suspected fraudulent provider in 20 percent of all health care fraud-related BSA reports. Other frequently identified providers included hospice care companies, mental and/or behavioral health and addiction treatment providers and companies, medical equipment providers, and adult or child daycares.”

6. For even more history on the construction of disability, read A Very Capitalist Condition by Roddy Slorach

7. she said: “I think of course the reason that [masking is] so strong at the moment is that we just don’t have a biomarker after all these years, and and I think the most desperate thing we need is this biomarker.”