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  • Q&A with Australian Health Practitioners

    Why is it hard for people who have BPD to transition as transgender people?

    Why is it hard for people who have Borderline Personality Disorder to transition as transgender people?
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    Dr Aitken's areas of interest include HIV medicine, sexually transmissible infections, skin conditions affecting the genitals, and gender medicine. He offers discrete, specialist consultations in … View Profile

    Gender transition is a significant process, requiring at times great fortitude, resilience and determination. For people with Borderline Personality Disorder (BPD), there are extra challenges that complicate the process. This is a complex question, and there is much more to the issue than what I can put in this post.

    Gender transition requires significant changes within relationships. The support of family and friends is very important in gender transition, and relationships can be challenged and threatened by the process. People with borderline personality may have difficulty maintaining stable relationships, and consequently lack support for transition. Employers, colleagues and even health professionals usually require the cultivation of warm relationships to offer support to the transitioning person. 

    A strong fear of abandonment is common among people with BPD, and this is often heightened by gender transition. Abandonment is, unfortunately, a common experience among people who are in transition. This combination of increased risk of abandonment in the setting of great fear of abandonment can be very challenging. 

    Mood changes such as anxiety and depression are common in both gender dysphoria and BPD. Sometimes mood problems can be the biggest threat to transition. 

    Finally, the fluctuations in self-awareness and feelings of emptiness or uncertainty about one's own emotional world can make negotiating such a significant transition in identity expression difficult. 

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    Rossanna Williamson

    HealthShare Member

    Thank you, I'm assuming that it also depends on the person and how serious they are about transitioning.

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    Dr Aitken's areas of interest include HIV medicine, sexually transmissible infections, skin conditions affecting the genitals, and gender medicine. He offers discrete, specialist consultations in … View Profile

    Absolutely. People with BPD can transition, and for many the transition makes life more fulfilling. Although there are challenges, there can be great rewards. Gender transition in the setting of BPD is best done with supportive clinicians, preferably within a team that includes a mental health professional. 

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    Rossanna Williamson

    HealthShare Member

    What would you suggest I do?

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