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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5739
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Hello. What is the link between GID/Transexualism and BPD?

Resolved Question:

Hello. What is the link between GID/Transexualism and BPD? My husband fits the criteria for BPD (High Functioning) remarkably well though he had improved over our 24 year marriage - that is, until returning from IRAQ in 2008 with PTSD and Major Depression. Prior to learning about BPD he believed he must be a female since he was unhappy as a male. He felt that was the solution to finding "peace" with his unhappiness.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Dr. Z. :

Hello I believe I can help you with your concern

Dr. Z. :

I am so sorry that you husband has been experiencing these symptoms associated with BPD, PTSD, and possibly GID as well, I can imagine how distressing this is for him and for you

Dr. Z. :

I would like to ask a few questions about your husband, so that I can give you the best information possible.

Customer:

Quite distressing. Thank you and yes, what would you like to ask?

Dr. Z. :

You mentioned that the symptoms of Gender Identitiy Disorder (GID) started to occur prior to the BPD diagnosis, was this before or after Iraq?

Dr. Z. :

And also was your husband every sexually abused as a child that you know of?

Customer:

To be clear he has not been diagnosed BPD, but I've been married to him almost 25 years and have seen MANY symptoms in him when he's under stress. He said he's felt uncomfortable in his body for most of his life but only recently told me. This was after returning from Iraq, being diagnosed with PTSD/Major Depression prescribed meds then starting therapy. Many have asked if he was sexually abused. No, he does not believe so.

Dr. Z. :

Well there is not strong link between GID and BPD, but there is a possibility because identity disturbances (e.g. gender identity) is a symptom of BPD as well as dissociation, which can also cause gender identity confusion. The only reason I asked about sexual abuse is because identity issues associated with BPD are strongly correlated childhood sexual abuse. Here is one of the most sited studies on identity issues associated with BPD

Dr. Z. :

Now just because GID and BPD are not associated with each other in the literature, does not mean it does not occur, it just may be a poorly understood link or possibly an unreported link, so there are too few cases to get a good empirical study to examine this.

Customer:

I will read that. His family is really a mess and one sister has been diagnosed with BPD, but he believes there was no sexual abuse. I just began learning about BPD (not know that was the sister's diagnosis), because I believe his conviction that he must transition to have peace was the wrong path. It doesn't add up to me (he's attracted to women, does not want to or feel comfortable in women's clothes, is ok forgoing surgical transition). He has a tremendous amount of shame and has told me many times that he was afraid to admit he was unhappy as a man because he would "have to" transition, which I am not accepting of.

Customer:

I reference a French article that discusses the matter:

Dr. Z. :

You are right the mix of BPD and GID would bring about confusion and he may not have true GID, but his gender identity issues may be tied to his BPD. It would be hard to differentiate between the two and which one is the driving factor in his possible desire to transition. Has he discussed this with a sex therapist at all?

Customer:

He has been seeing MFT type counselors and has just been to see a Psychiatrist who we hear specializes in GID. It just seems to me that transition is being pushed on him without examining the bigger picture of Identity issues.

Dr. Z. :

These are good articles, the only issue I would have with them is that they were written before 1994, and that is when the global psychological community redefined Gender Identity Disorder, so it is possible that these articles may not be valid as I see 1991 and 1982

Dr. Z. :

But they pose interesting results, i will try to find the original articles to read them more thoroughly.

Dr. Z. :

That is true, and I think your concerns are warranted for this as well. I would go to a psychologist and not a psychiatrist, also as psychologists have more assessment skills and can provide empirical tests to give to your husband to help clarify the issue more carefully.

Customer:

I don't want to be deluding myself, if the reality is that he is truly transsexual. There is very little information about GID and this information does seem quite old. I have also read in the book Biological Unhappiness that GID can be a misdiagnosis of BPD.

Customer:

Let me look at this gentleman's business card...

Customer:

He's a psychiatrist. Hmmm...

Dr. Z. :

It is possible, and you are right GID, transexualism, and gender dyphoria disorder are not researched enough, so the data is sparse on this subject matter. The two assessments of the top of my head that I would give your husband would be the Personality Assessment Inventory (PAI) and the Minnesota Multiphasic Personality Inventory Second Edition (MMPI-2).

Dr. Z. :

Those two tests can help confirm identity issues associated with BPD and gender identity issues as well.

Dr. Z. :

I can try to find an assessment psychologist in your area if you like?

Customer:

That would be wonderful! He currently sees the Psychiatrist I mentioned and a doctor (not sure but in Mental Health dept) at the VA Medical Center.

Customer:

We are in Riverside, CA 92508

Dr. Z. :

Okay, the VA can also provide those assessments from a psychologist as well if you want to go that route. Oh wow, I went to undergrad in Redlands, and my doctorate in Los Angeles

Customer:

Neighbors. We had an office in Redlands for many years :)

Customer:

Should I have him ask at the VA?

Customer:

That doctor may be a psychologist, but she's also the one that told him the only way to find out was to take female hormones.

Dr. Z. :

Well if you want the results to be kept confidential you would not want the VA to do it. If you are okay with it being on his record, then go for it.

Customer:

He is now medically retired and off the temporary list, so there's nothing the military can do to our benefits.

Customer:

I think having him ask about those two assessments at the VA is a good route. He seems fairly comfortable with them.

Dr. Z. :

On the MMPI-2 you are paying particular attention to scale 5 - Masculinity/Femininity. And on the PAI there is a scale called BOR for BPD and subscales including Identity problems. These would be the areas to pay attention to for your husband

Dr. Z. :

Then I say have them done at the VA, they have excellent facilities and psychologists for this.

Customer:

You have been so helpful! Thank you. This has been more than I thought I could manage and I finally see a sliver of sense in all of this mess. Thank you, XXXXX XXXXX!

Customer:

Am I able to save a transcript of our conversation?

Dr. Z. :

Anytime, I am always happy to help. I want to wish you and your husband the best of luck with everything. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.


 

Dr. Z. :

A link of this chat should be sent to your email, or you can bookmark this chat using this link

Customer:

All the best to you!

Dr. Z. :

You as well. Have a great rest of your night :)

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5739
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Dr. Z
Dr. Z
Mental Health Professional
5739 Satisfied Customers
Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.