I was reading in the news this week about Lukas Gage, known for his roles in film and TV shows such as Euphoria, Smile, and White Lotus. In Gage’s newly released memoir, I Wrote This For Attention, he discussed his own experience learning about and eventually getting therapy for borderline personality disorder. Given both the increased interest in the subject, I thought I would provide some insights into the relationship between the queer community and BPD.

What Is Borderline Personality Disorder?

Borderline personality disorder (BPD) is a disorder often characterized by difficulties such as severe mood instability, feelings of emptiness, interpersonal problems, all-or-nothing thinking, frequent suicidal thoughts or behavior, and lack of a stable sense of identity. People with BPD can show combinations of different traits, and thus the disorder can look very different from one person to the next. Living with BPD and other personality disorders can lead to immense distress and feelings of alienation from loved ones for much of a person’s life.

Uniqueness of the Queer Experience

There is an emerging body of research demonstrating that LGBTQ+ individuals have increased rates of BPD and other personality disorders compared to the heterosexual and cisgender population. In some ways, this may not be that surprising. Due to the adversity, discrimination and stress that often comes with being part of a marginalized group, LGBTQ+ individuals are already at higher risk of suffering from mental health conditions such as depression, PTSD, and anxiety. Given the commonality of trauma and adverse childhood experiences in people with BPD, there is likely some good reason that more queer-identified people might show signs of this condition. People with borderline personality disorder report high rates of childhood traumatic experiences in childhood such as abuse, neglect, or sexual assault. Those who identify as LGBTQ+ also report significantly high rates of similar traumas, as well as experiences specific to this community, such as traumatic invalidation, community violence, discrimination, and bullying.

On the flip side, many therapists and other mental health professionals lack the knowledge and understanding of what it’s like to live as part of the queer community, at times leading to overdiagnosis. I have heard confused and misguided statements from some of even the most well-meaning professionals about trans, gender diverse, and nonbinary people coming for therapy. For example, since one of the common symptoms of BPD is disturbance of identity, clinicians might believe that a person who is trans is actually confused about their gender identity. Despite most trans and gender diverse (TGD) people becoming aware of their gender in childhood and remaining constant throughout life, there is still a significant gap between understanding and appreciation for the nuances of TGD life. Therapists in this position may find themselves out of their depth, leading to either a misdiagnosis or fear of leaning into the client’s shared problems. 

Given the lack of knowledge from even well-meaning professionals, many LGBTQ+ people leave the therapy setting feeling like they haven’t truly been heard, or like they keep getting passed along from one provider after the next who has “given up” on them. Clients going through these experiences may find themselves navigating the healthcare system for years before receiving an accurate diagnosis and beginning the proper treatment. This is also why an effective therapist who provides treatment for either BPD, or a related condition with similar symptoms such as complex post-traumatic stress disorder (cPTSD), should take their time during the intake process rather than rushing to a quick diagnosis after the first session.

The Takeaway

• People living with BPD experience significant feelings of distress and disconnection from loved ones.
• LGBTQ+ people often have higher rates of personality disorder, in part because of their shared commonalities of trauma and adverse experiences with BPD.
• Even professionals who are allied with the queer community may lack the knowledge, skills, and experience to properly support LGBTQ+ people with severe mood dysregulation, interpersonal problems, and other symptoms of BPD.
• Queer people with BPD often find themselves feeling lost or abandoned after being passed on from therapist to therapist for years.
• A therapist with good training and support will spend time getting to know their client and getting to know their experience as a queer individual before diagnosing with a personality disorder.

Get Help Today

If you are looking for therapy for BPD or other personality disorders, there is hope for you. I provide therapy in person to people living in Los Alamitos, Cerritos, Long Beach, and other surrounding areas. For more questions, or to start your therapy journey, Contact Me today and schedule a free 15-minute consultation.