Get access

Gender Identity and Sexual Orientation in Women with Borderline Personality Disorder

Authors

  • Devita Singh MA,

    1. Gender Identity Service, Child, Youth, and Family Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
    Search for more papers by this author
  • Shelley McMain PhD,

    1. Borderline Personality Disorder Clinic, Centre for Addiction and Mental Health, Toronto, ON, Canada
    Search for more papers by this author
  • Kenneth J. Zucker PhD

    Corresponding author
    1. Gender Identity Service, Child, Youth, and Family Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
      Kenneth J. Zucker, PhD, Gender Identity Service, Child, Youth, and Family Program, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario, Canada M5T 1R8. Tel: 416-535-8501/4040; Fax: 416-979-4668; E-mail: Ken_Zucker@camh.net
    Search for more papers by this author

  • Supported by a grant from the North American Task Force on Intersexuality.

Kenneth J. Zucker, PhD, Gender Identity Service, Child, Youth, and Family Program, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario, Canada M5T 1R8. Tel: 416-535-8501/4040; Fax: 416-979-4668; E-mail: Ken_Zucker@camh.net

ABSTRACT

Introduction.  In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text revision (DSM-IV-TR) (and earlier editions), a disturbance in “identity” is one of the defining features of borderline personality disorder (BPD). Gender identity, a person's sense of self as a male or a female, constitutes an important aspect of identity formation, but this construct has rarely been examined in patients with BPD.

Aims.  In the present study, the presence of gender identity disorder or confusion was examined in women diagnosed with BPD.

Main Outcome Measures.  We used a validated dimensional measure of gender dysphoria. Recalled gender identity and gender role behavior from childhood was also assessed with a validated dimensional measure, and current sexual orientation was assessed by two self-report measures.

Methods.  A consecutive series of 100 clinic-referred women (mean age, 34 years) with BPD participated in the study. The women were diagnosed with BPD using the International Personality Disorder Exam-BPD Section.

Results.  None of the women with BPD met the criterion for caseness on the dimensional measure of gender dysphoria. Women who self-reported either a bisexual or a homosexual sexual orientation had a significantly higher score on the dimensional measure of gender dysphoria than the women who self-reported a heterosexual sexual orientation, and they also recalled significantly more cross-gender behavior during childhood. Results were compared with a previous study on a diagnostically heterogeneous group of women with other clinical problems.

Conclusion.  The importance of psychosexual assessment in the clinical evaluation of patients with BPD is discussed. Singh D, McMain S, and Zucker KJ. Gender identity and sexual orientation in women with borderline personality disorder. J Sex Med 2011;8:447–454.

Get access to the full text of this article

Ancillary