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There is a tendency for most people to look at the diagnosis of Borderline Personality Disorder (BPD) as a women’s issue. But this just isn’t true.

BPD is a set of personality disorders. The hallmark is instability in relationships. There are 9 criteria with which to diagnose Borderline Personality Disorder and 5 must be met to make a definitive diagnosis. These include: frantic efforts to avoid abandonment – real or imagined; pattern of unstable and intense relationships; lack of a sense of self; impulsivity including areas of dangerous behavior (i.e. self-harm or drug use; recurrent suicidal gestures (i.e. threats); emotional instability, chronic feelings of emptiness; inappropriate anger, paranoia or disassociation.

According to the DSM-IV, it is estimated that 2% of the population can be diagnosed with Borderline Personality Disorder. Of that 2%, 10% are found in the outpatient population and 20% in inpatient treatment settings. It is diagnosed 75% of the time in women even though there is clear data showing that BPD is found equally among genders.

The research shows this! The Journal of Personality Disorders reported a multinational clinical trial sample of gender difference in Borderline Personality Disorder and found “an unexpected convergences between genders in our BPD sample.” The paper ended with this sentiment: “Rather than asking how men and women with BPD are different, perhaps it is time to begin to ask, ‘Why aren’t they”?

There are many mental health practitioners who are over-diagnosing this disorder in women likely because of the stereotypical ideas of ‘hysterical women.” Women are often diagnosed more but it could be because they more regularly present for therapy. Since BPD is so deeply a developmental disorder and because we so profoundly raise boys and girls differently, it would make sense that people might label men more narcissistic and sociopathic and women more with Borderline Personality Disorder. Additionally, it is hard to tease out how many men have BPD because they often avoid relationships and don’t end up in therapy.

Borderline Personality Disorder is defined by symptoms rather than a cause such as trauma. While the etiology is unknown, it is thought to be brought on by a combination of genetics and environment and traced back to a stressful childhood. Secondly, it is defined by antiquated and gender-biased ideas about women, their personalities and how they respond to trauma.

Three aspects to the gender question and Borderline Personality Disorder:

• Because of the way children are socialized, they may develop different aspects within BPD.
• Men and women present at different rates for different reasons.
• Clinicians perceive patients differently and over-diagnose women with BPD and under-diagnose men.

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