Receiving an autism diagnosis as an adult can be disorienting and confusing. You’re the same person, but seeing yourself in a different light after years of thinking you were having a hard time fitting in. Where do you begin navigating the world with this new information? Which resources do you need to allow the truest version of yourself to shine through?

Societal acceptance of autism varies considerably across different countries, with lowest levels of acceptance found in Japan and Belgium, new research shows.

A survey of 306 autistic individuals from eight countries revealed that around three quarters of respondents do not feel accepted, or only sometimes feel accepted, as an autistic person. Among these countries, participants in Japan and Belgium reported the lowest levels of acceptance, while those in Canada, the UK, and South Africa reported comparatively higher levels.

The study, published in PLOS ONE, is the first to compare levels of, and explore the relationships between, autism acceptance, camouflaging, and mental health issues in a cross-cultural sample of autistic individuals. Those participating in the research came from Australia, Belgium, Canada, Japan, New Zealand, South Africa, the UK and the USA.

Experiencing a lack of acceptance by society – defined as the general public – was linked to higher levels of depression, while camouflaging one’s autistic traits was linked to higher levels of depression, anxiety and stress.

Lead author, Dr Connor Keating, of University of Birmingham’s School of Psychology, said: “These findings underscore the crucial need to combat the stigma surrounding autism and reduce the pressure on autistic individuals to conceal their identity.”

In terms of camouflaging, Japanese people were most likely to conceal their autistic traits. The researchers suggest this may be connected to Japanese ‘collectivist culture’, in which individuals are more accustomed to adapting other parts of their identity to fit with group norms.

One region where the researchers identified particularly high levels of mental health difficulties for autistic individuals was in South Africa. The team suggest that this could be due to barriers in accessing support. In the USA, 47% of adults with a mental illness accessed mental health services in the past year, compared to just 26% in South Africa.

Dr Keating noted that “By determining the most vulnerable regions, we have identified priority areas for anti-stigma interventions, and highlighted countries where greater support for mental health difficulties is needed.”

The team also identified that non-binary people experienced the lowest levels of acceptance, compared to male and female survey participants, with this group also most likely to camouflage their autistic traits and experience higher levels of stress.