Last week we established that masking neurodivergent traits is exhausting — a second job that no one pays you to do. The price is not the same for everyone. For some people the masking tax is manageable. For others it can be overwhelming. The difference often has less to do with the trait itself than with who you are, where you came from, and how long you’ve been doing it.

This post goes into some sensitive topics. Gender, culture, generation, and class all factor into who masks the most. The goal is simply to follow the research honestly, because understanding who carries the heaviest burden is the first step toward doing something about it.

A Simple Example First

In 1900, only 3% of people worldwide identified as left-handed. By 1960 it was 12%. The trait didn’t change. What changed is that society, specifically schools, stopped punishing it.

The regional data tells the same story. In South Korea, a 2019 survey found that the reported rate of left-handedness among people under 30 was roughly three times higher than among those over 60. Same country. Same gene pool. Three times the rate — in a single generation. The difference isn’t biology. It’s permission.

The same dynamic applies to neurodivergent traits. The underlying rate is similar across populations. What gets expressed, identified, and supported varies enormously depending on where you were born, how you were socialized and what your environment tolerates.

Women

The gender gap has the most research, and the results are striking. Girls get socialized earlier and more intensively to read social cues, manage emotions, and maintain harmony. Those are exactly the skills masking requires. The result is that ADHD, autism, and dyslexia are less visible in women, and the current diagnostic system consistently misses them.

The pattern is well documented. Women with ADHD get labeled daydreamers. Autistic women get labeled anxious or overly sensitive. Research using the Camouflaging Autistic Traits Questionnaire  found that autistic females score significantly higher on masking than autistic males. The condition may be the same, but women do more work to hide it.

Diagnosis often arrives decades late. When that happens, it’s often triggered by a child’s diagnosis. Mothers suddenly see themselves in the description.  The diagnosis criteria were developed by studying males. It’s no wonder so many women slip through the cracks until they recognize the traits and proactively seek a diagnosis.

Generation and Age

Older generations masked for decades before the vocabulary even existed. Gen X and Boomers were frequently mislabeled as lazy, difficult, or just quirky. Many won’t receive a first diagnosis until they are in their 40s, 50s, or 60s. They built coping mechanisms so robust that they often don’t recognize them as coping at all, so many still go undiagnosed.

Culture

In many communities across East Asia, South Asia, Latin America, and Africa, cultural values place the needs and harmony of the group above the expression of the individual. Standing out, expressing struggle, or seeking mental health support can bring shame not just to the person but to the entire family. That’s a very different kind of pressure than most Western cultures create.

For someone who is neurodivergent in that environment, the math gets complicated quickly. The neurological drive to mask is already there. Layer on top of it a cultural framework where difference is a family liability and disclosure is not an option — and the masking becomes deeper, longer, and far less likely to ever get named. The South Korea example of left-handedness reflects what happens with neurodivergent traits.

Race

Diagnostic bias operates differently from cultural pressure. It has to do with the clinician’s perceptions. Research consistently shows that Black, Hispanic, and other minority children in the US are significantly underdiagnosed with ADHD and autism compared to white children displaying identical symptoms. Black and Hispanic children are diagnosed at roughly two thirds the rate of white children. Instead of a neurodivergent diagnosis, children of color are disproportionately labeled as having behavioral problems. The traits are the same. The bar for being seen accurately is not.

That means more masking, for longer, with less support. Less chance that anyone ever explains why it’s so exhausting.

Socioeconomic Status

The road to receiving a diagnosis can be challenging. It requires time, money, and multiple people to advocate for you. Lower income populations are less likely to have those resources, so are less likely to be diagnosed.

Without that diagnosis, schools won’t provide the additional resources required. Being undiagnosed makes them more likely to be labeled as behavioral problems, further reducing the support available to them.

The masking continues, unnamed and unaddressed, and the tax keeps accumulating — often across an entire lifetime.

What This Means If You Lead People

Think about your team. Do you have high performers from any of the groups we talked about in this article? They may be among your most capable, most reliable people. They may also be exhausted and struggling in ways you have never considered.

Team members who perform well, never complain, and seem completely fine may be running two jobs simultaneously. They are not trying to be deceitful, but they are hiding their challenges from you because that is what they have always had to do. If something doesn’t change, you will only learn about it when they burn out or leave. By then, it’s too late.

The Bottom Line

The strategies should be the same, regardless of who is on your team. Build environments where differences don’t have to be hidden. Explicitly share what your expectations are — don’t imply them and assume everyone knows what you mean. Offer multiple ways for people to receive and share information. Provide a safe environment where someone can confidently say “this format doesn’t work for me.”

Just because people are high performers doesn’t mean they aren’t struggling with that second job. Pay special attention to the above-mentioned groups, and anyone else who is showing signs of exhaustion. Learn more about what is or isn’t working for them in the workplace and adjust accordingly.  Don’t do it just because it’s the right thing to do. Do it so you will get the most out of your people and retain them for longer.

How many neurodivergent people are you aware of on your team?  When you think about the groups we covered in this article – are you sure you haven’t missed any?  There’s a good chance you have more than you realize.

If you’d like to have someone talk to your team and provide strategies for the neurotypical, the neurodivergent, and the undiagnosed on how to work together,  Reach out . Schedule a quick conversation here to learn more.