This piece first appeared as a letter in the Guardian on 6 November 2026, co-signed with my colleague Dr Emma Bede, clinical psychologist, London.
In a recent Guardian article on autistic masking, John Harris quoted the psychologist Uta Frith calling masking "completely unfalsifiable", then moved on as if no one had tried to falsify it.
People have. Will Mandy's group at University College London built the standard masking questionnaire, the CAT-Q,1 and has spent years publishing its weaknesses, which is what good science looks like. Meng-Chuan Lai and colleagues measured masking by comparing how autistic adults present in a clinical interview with how they perform on social-cognition tests,2 a gap no one can produce simply by saying they mask.
At Birkbeck, University of London, Jagdeep Wadhwa-Brown is now recording neural activity in autistic adults during social tasks, alongside their own accounts of masking. The study is at an early stage, but it is exactly the kind of test Frith says cannot be done. The neuroscientist Francesca Happé has described watching the mask slip in a tired house guest. That is an observation, not a feeling.
Why this matters in the consulting room
Between us, every week we assess people who present with what is sometimes called "internalised" autism: people who make eye contact, hold down demanding jobs and have spent decades being told, like Abigail Stow (who featured in Harris's article), that they "can't possibly be autistic".
The measures need work, and the researchers say so. But "the measure needs work" and "the phenomenon does not exist" are different claims, and only one was put to readers.
If you recognise yourself in this and are wondering about an assessment, my guide to adult autism assessment in London explains what to expect.
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