Queer People More Likely to Be Diagnosed With Borderline Personality Disorder

New research shows some health care professionals may be showing bias when it comes to diagnosing lesbian, gay and bisexual (LGB) patients with borderline personality disorder (BPD).

The results of a study conducted by researchers at the University of Michigan showed that BPD was diagnosed in 20% of LGB people in a survey compared to 11% of heterosexuals in the same sample. In a press release from the university, scientists explained that some behaviors health care professionals used to diagnose BPD in LGB people were likely misread.

“LGB persons might change the way they present differently to other people for safety reasons, such as avoiding discrimination, bullying or even murder,” the researchers shared. “Such behaviors help manage the impressions that other people have and are relatively normative for LGB persons since they grow up and exist in stigmatizing environments.”

This survey included a total of 36,000 participants aged 18 to 90 and showed that when certain factors were adjusted to identify BPD, both groups were diagnosed at similar rates. In particular, researchers said “when the diagnosis was made with specific attention to whether or not the symptoms of BPD cause significant distress or impairment, the prevalence was comparable.”

“LGB persons are more likely to be given the diagnosis particularly when health care professionals are not paying attention to whether or not the behaviors observed among LGB persons cause any significant distress,” said Craig Rodriguez-Seijas, lead author of the study.

Borderline personality disorder (BPD) is a mental illness characterized by periods of emotional intensity, unstable sense of self, chronic feelings of emptiness, “splitting” and impulsive behaviors, among others. BPD is estimated to affect approximately 1.4% of the population. According to the National Institute of Mental Health, known risk factors for the condition include potential biological and genetic factors as well as environmental, cultural and social factors.

This new research suggests that health care workers may not be fully understanding environmental stressors faced by LGB people and the difference between a typical response to hardship and one characteristic of a personality disorder. Because BPD often includes struggling with your identity, it can sometimes serve as another stumbling block to a proper assessment.

“If health care professionals fail to ask the right questions to disentangle this protective way of managing one’s identity from pathological and impairing struggles with identity, they may not accurately diagnose the patients,” Rodriguez-Seijas said.

Rodriguez-Seijas explained that these findings can also help to better serve LGB persons who do have borderline personality disorder by avoiding treatments and therapies that may re-stigmatize them.