Triple-Masking and Mental Health: A Study of the Burden of Identity Management for Autistic LGBTQ+ Christians in Conservative Church Settings Using a Sequential Explanatory Mixed-Methods Design

The simultaneous management of multiple stigmatized identities—autistic, LGBTQ+, and religious—presents an acute form of psychological strain. This article introduces and empirically validates the construct of Triple-Masking: the concurrent concealment of neurotype, sexual/gender identity, and theological doubt by autistic LGBTQ + individuals within conservative Christian settings. Using a sequential explanatory mixed-methods design (N = 188 for quantitative phase; n = 10 for qualitative phase), this study examines the predictive relationship between Triple-Masking behaviors and mental health outcomes, including anxiety, depression, and generalized minority stress. Results reveal that the Triple-Masking Index (TMI) is a strong predictor of both anxiety (R² = .47) and depression (R² = .43), explaining more variance than individual masking constructs. Thematic analysis of interview data identifies three central experiences: identity fission (living as multiple selves), environmental amplification (the church as a multi-threat space), and subversive faith and digital resilience (adaptive coping through alternative spiritual communities). These findings substantiate the theory that intersectional stress operates multiplicatively, not additively, creating what Meyer (2017) calls “syndemic vulnerability.” Implications for theory, clinical practice, and ecclesial reform are discussed, emphasizing the necessity of neurodiversity- and LGBTQ+-affirming pastoral and therapeutic interventions.