Masking is a trauma response; it's not always conscious. It's not that we are completely different than our true selves when masking, unless something else may be happening simultaneously. However, I can see how masking for a long period of time can lead to identity crisis, etc. I know masking caused stress on my body, so I try to limit how much I go out or only seek out people and places where I feel psychologically safe.
YOU bring up good points, especially the harm masking causes to the extent autistics or neurodivergents mask.