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What are the Differences Between Male and Female With Borderline Personality Disorder

Updated: Jul 14, 2023

Men and women have different experiences with Borderline Personality Disorder(BPD), which is visible in their behavior. There is also some biological reasoning on why both genders act out BPD differently. BPD is known to be a “feminine” disorder with a female to male ratio of 3:1. Due to several reasons mentioned in this article, the ratio is most likely inaccurate.

How is BPD different in men and women?

Men and women experience BPD differently from each other. One study found that men with BPD tend to have more explosive behavior than their female counterparts. Additionally, men seek more novelty than women, which may put them at more risk than their female counterparts.

Alcohol and substance abuse is far more common in men than women when it comes to having the disorder. Additionally, men with BPD are more prone to comorbidity. Men will present a more antisocial pattern, while women will lean more towards histrionic behavior. However, women are more likely to have comorbid eating disorders. And in addition to their BPD diagnosis, they will often be diagnosed with mood disorders, anxiety, and PTSD.

When it comes to self-harm, research has found that both genders were equally prone to cutting and other impulsive behaviors.

Treatment is equally utilized by both genders, but while women will find help in psychotherapy and pharmacotherapy, men will more often utilize treatment services for rehabilitation from alcohol and substance abuse.

Biological reasons for BPD gender differences

Aside from the social and psychological reasons, there may also be biological reasons behind the difference in expression of BPD in the two genders. For example, male BPD patients have been shown to have a smaller anterior cingulate cortex than their female counterparts. This part of the brain is responsible for empathy, impulse control, emotion, and decision-making, which could explain why men are more often diagnosed with comorbid antisocial personality behavior (a lack of empathy and remorse) along with BPD, and why they tend to be more aggressive and explosive than women with borderline.

Additionally, men with BPD were shown to have functionally abnormal striatum, which is a brain component responsible for many things, including decision making. This could explain the recklessness, novelty-seeking, and impulsive behavior found more often in borderline men than in their female counterparts.

Women with BPD are less prone to biological alterations than men with BPD. There is a hypothesis that the female BPD amygdala (the brain component responsible for emotional control) might be more dysfunctional than in the male counterpart.

BPD male-female ratio

Borderline personality disorder(BPD) is known to be a “feminine” disorder. According to the most recent edition of the DSM, the BPD female to male ratio is 3:1. However, a more recent study conducted by the National Epidemiologic discovered that the disorder is more equal than 3:1, but because the two genders present the disorder differently, this could lead to different clinical dispositions and sampling bias.

Why are more women diagnosed with BPD than men?

Even though the disorder is experienced differently by the two genders, this does not explain why more women are diagnosed with BPD than men. Listed below are 5 reasons why this is the case:

1. Women tend to seek help easier than men. BPD can cause victims to feel a deep sense of shame, which may be amplified in men who live in a society where male psychological and emotional pain is hardly validated. Because many men are taught that asking for help is a sign of weakness, they prefer to isolate themselves and suffer in silence.

2. Clinicians are shown to be biased when it comes to BPD diagnosis. Because BPD is known to be a female-associated disorder, clinicians will be careful with diagnosing a man with BPD.

3. Men land more often in treatment services for rehabilitation from drug and substance abuse.

These men will not be reported in the percentage of people with BPD, making the proportion unfair. Additionally, since men are more prone to comorbidity with disorders such as paranoid, passive-aggressive, narcissistic, sadistic, and antisocial personality disorders, they will likely have behaviors that will land them in jail. Men with BPD who are in jail will not be counted in the BPD population, contributing to the inaccurate BPD ratio. On the other hand, Women make more use of psychological services and are reported in the percentages of people with BPD.

4. Women are socialized to be more dependent on others. This can make them more sensitive to rejection and could make them more prone to act out their borderline personality disorder.

5. A BPD diagnosis is often related to some form of childhood abuse. Women experience child sexual abuse at a rate of 10 to 20%, while men experience it at less than 5%. The occurrence of incestuous abuse and sexual victimization will damage how people see the world; their relationships with the other gender will be impaired, they will be impulsive in the area of sex, and experience depression as a result of the abuse. All of this can result in a later diagnosis of BPD.


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