LGBTIQ+ Individuals More Likely To Be Diagnosed With BPD

We know that the effects of parenting, particularly mothering (e.g. Kohut) on the individuals are connected with the later development of borderline personality disorder but these adverse psychological effects can, of course, be exacerbated by other stressors in the individual’s life and one such stressor may be one’s sexual or gender identity.

Silverstein argues that the LGBTIQ+ individual must solve problems relating to both his/her sexual identity and his/her gender identity and that these problems can lead to confusion and that such confusion is further confounded as the variety of lifestyles accepted by society increases. And, because the identities the LGBTIQ+ individual may now adopt are relatively ‘new’ (in the sense that they are not traditional), such individuals are unable to appeal to the past for guidance as to how such identities are expected to be expressed in life; in other words, there are no accepted, well-established, traditional standards to emulate (this is not meant in any pejorative sense, but is, rather, a judgment-free observation). In order to establish a sense of psychological stability, Silverstein contends, LGBTIQ+ individuals now find themselves burdened by the myriad internal problems they must solve to allow mental equilibrium (as opposed to focusing so much on external ones such as prejudice and discrimination that were so predominant in the recent past – though this is by no means to say, of course, that such external problems have disappeared altogether).

Statistics From Studies In Relation To Homosexuals With BPD:

A study carried out by Paris et al., 2011, examined the relationship between homosexuality and psychological factors in men who had received a diagnosis of personality disorder.

The study compared a group of 61 men with BPD and a group of 60 non-borderline men.

The group of BPD men was further divided into those who were homosexual (n=10) and those who were heterosexual (n=51).

After statistical analysis, it was found that there was a SIGNIFICANTLY HIGHER RATE OF HOMOSEXUALITY IN THOSE WITH BPD compared to in those with a non-borderline personality disorder.

It was further found that those men who had both a BPD diagnosis and were also homosexual were:

  • more likely to have experienced childhood sexual abuse
  • more likely to report decreased levels of affection from their mothers
  • more likely to report controlling behavior by both their mothers and their fathers

compared to the heterosexual men who had been diagnosed with BPD.

 

Another study, conducted by Silverstein (1988) in order to investigate sexual practices among patients with BPD found that from a sample of 21 men with BPD, 57% (n=12) were homosexual. This compares to 3.9% of men who identify as LGBT in the general population (Gallup poll, 2017).

This means that, according to this study, men with BPD are nearly 15 times more likely to be homosexual than are men randomly selected from the male, adult U.S. population. 

A third study by Rodriguez-Seijas et al. (2021) found that individuals with minority sexual orientations were 2.43 times more likely to be diagnosed with borderline personality disorder than heterosexuals even after controlling for various, potential contaminating variables such as age and gender. Amongst the minority groups, individuals who identified as bisexual were more likely to be diagnosed with BPD than were those individuals who identified as gay. The researchers concluded that future research into this phenomenon should investigate if such statistical findings are due to clinical bias or reflect real differences.

If the statistics from the studies are anything like an accurate reflection of the state of affairs in the population as a whole it can surely only be concluded that either BPD increases the probability of being gay/bisexual, being gay/bisexual increases the probability of developing BPD (e.g. see Silverstein above), or (because, as we are reminded ad infinitum, correlation does not equate to causation) both BPD and being gay/bisexual are both associated with the third factor (or common denominator). Finally, as Rodriguez-Seijas et al. (2021) suggest, it is also necessary to determine whether there might exist a clinical bias operating causing clinicians to be more likely to diagnose gay/bisexual individuals as having BPD independent of presenting psychopathology. 

I will return to this conundrum in later posts.

REFERENCES:

Silverstein C. The borderline personality disorder and gay people. J Homosex. 1988;15(1-2):185-212. doi: 10.1300/J082v15n01_13. PMID: 3403980.

 

David Hoiser BSc Hons; MSc; PGDE(FAHE).