Personality Disorders and Gender Identity

[D0LL]

As a Borderline Personality Disorder (BPD) sufferer, I have problems defining a solid personality for myself. Meaning, because of my disorder, my personality is very fluid; my personality changes depending on the glass I'm poured into. In social situations like a party or gathering, I can become much more social and extrovert, yet when put in a more professional setting, I can be much more quiet and reserved. My interests,morals and goals change depending on my situation as well. Because of the constant change in daily life, I pretty much have different personalities (not the same as Multiple Personalities) depending on where I am and what I'm doing. One day I'll be head-over-heels with my boyfriend, but when I wake up the next day (or sometimes even within that day), I'll suddenly feel no attraction to him whatsoever.

Because of this flip-flopping constantly occurring in my mind, I don't know what I want from life, I don't know what I want to do for a living, I don't know even know what I want to do or eat half the time. I refuse to make decisions because I'm afraid that the person I'll be a few hours from now will regret the decision I made (even something as simple as who I hang out with). I have a closet full of clothes that I hate half the time, and I'm currently in a relationship that I no longer feel the spark in. Even kissing the guy I was ga-ga over just a week ago has me cringing, simply because it no longer feels right to the person I am now. My current personality doesn't like the aspects of his personality that my previous personality enjoyed so much (as confusing as that is).

OBVIOUSLY this causes some confusion in my gender identity as well, and was probably the reason I decided not to transition in the past. Yes, I do feel male, and wish that I'd been born in a male body. I've always felt this way and have never doubted my masculine personality itself. However, my perception of my body and what to do with it lies in a bit of a grey area.

Once I decided to finally begin transition, I stopped taking my female hormones, started letting my body hair grow out, cut my hair off and dressed completely male, all the time. I felt like I'd freed myself, from myself. I fully intended on becoming male, no matter what it took over the next few years to make it happen. I wanted to look as male as possible, as soon as possible, and couldn't stand seeing my too-female body in the mirror. I hated for my boyfriend to touch or see certain parts of my body, as they just didn't feel right on me.

Then the other day, I woke up and stood in front of the mirror, and thought, Wow, what a good female body. Why am I wasting this body I'm stuck with when I could be out enjoying my last years as a female? Why not dress female for the most part, wear my hair out in a longer, androgynous fashion, and get dates with guys while I can? Why should I feel the need to force myself into a male persona immediately, with all I'd be giving up during the transition period?

With this personality change, I still feel the need to be male, but the body dysphoria doesn't bother me as much anymore, as long as I can use this body to my advantage. I don't feel attraction to my boyfriend anymore (I think this was also spurred by the week or so I spent at his house, where I saw different aspects of his own personality that I was able to ignore more easily before, like his laziness and immaturity). I'd rather spend my time with various guys that I actually do like, guys that I wouldn't feel ashamed at myself to be with. I'm suddenly ok with using female parts of my body again (assuming they work) if it means I'll get laid. Everything I had such strong feelings about in the past, I no longer care about. Those feelings no longer belong to me, in the blink of an eye. They're someone else's ideals, not mine, not anymore.

I know a lot of this seems like typical transitional doubt, but there's so much more I can't put into words, and some that I can't write here because many people might find it offensive. It shares a likeness with Multiple Personality Disorder, in which I have this handful of personalities that pop up now and again; however, these are all my personalities rather than completely different people; these are different versions of myself or my perception of myself, and instead of one of them taking over my body for a period of time, I simply become them. I can go from hating sluts to wanting to be one, from loving art to being miserable with it, and from adoring my best friends to hoping bad things happen to them.

I want to know if anyone else suffers from a personality disorder as well, how it affects their transition, and what they do to handle it. Even if I could afford therapy, I don't think I would ever go to something like that; my opinions on that specifically have never changed. So that is not an option for me.

[Lo]

I don't think I suffer from a personality disorder (though some of the things you said about it I feel I can really relate to). I haven't gotten a diagnosis about any of my issues, though I firmly believe that I struggle with anxiety, depression, some dissociation, and that I've got the makings of an addictive personality/body chemistry.

I was always confused when people said they feel dysphoria, and that it's strong and definite, and that there is no question as to what it is. For me, most days, I can't tell where my unhappiness comes from. I know that I've felt acutely unhappy with my gender situation before, but it's almost impossible for me to tell where it ends and where the anxiety and depression begin. It's for this reason that I don't like talking about dysphoria-- it sounds too wishy-washy when my feelings are put into words, and I have much more pressing body issues that aren't related to gender anyway.

I wish there were more resources on trans* people with mental illness. It doesn't help the anxiety when I hear nothing but trans* people talking about how sure they are and how black and white their feelings are. Almost nothing I feel is anything but grays!

Anyways, tl;dr I guess I can relate in some small way?

[Katie10]

I have been diagnosed with Borderline Personality Disorder since I was a freshman in high school.  I won't lie having it can be pure hell.  I seem to do the best when things are going my way.  When things don't go my way I can become a depressed, suicidal, and a complete bitch.  When I am going through one of those periods it becomes time where I need to be left alone or you become enemy número uno.  Before I started HRT which I am now on I had to have a therapist and be stable on meds.  The funny thing is after bein on HRT for three months I actually feel normal and am at peace with myself and the world.  I haven't decided if I want to have vaginoplasty or not.  When I was younger I was saying that I would kill myself if I didn't have it.  Now I am just taking things one day at a time and go from there.  Part of what has helped me find peace besides HRT is the fact that I am only 5'1" and I pass as a girl without effort.  If it wasn't for those two things who knows where I would be.  I have been living my life for the last several years.  I found that by doing so I was preventing myself from becoming anymore depressed or even killing myself.  My personality is definitely affected by whats going on in my life and who I am around.  If you ever want to talk or compare stories I'm here for you.

[Edge]

I was diagnosed with borderline personality disorder although it is currently in remission. I also have symptoms of PTSD, but have never been officially diagnosed. I also may or may not have another personality disorder, but I don't know for sure since that diagnosis was given to me by a rather sketchy guy with a reputation for screwing things up. I've had medication which disaster doesn't even begin to cover. I've done DBT, anger management, a little bit of CBT, and a self esteem course. I have pretty good idea of who I am, but am still changeable and chaotic. I consider that part of who I am.
For me, it means being extra careful when I start hormones because of what it could do to my moods. I've also questioned how it affects my gender identity and figured it doesn't.

[Jess42]

I don't really know or have ever been diagnosed with any personality disorders but I have two distinct personalities that are polarized with one another. If not I probably couldn't function in the "real" world.

[spacerace]

I don't know what the cause and effect correlation is, but maybe trans people trend towards borderline personality issues because it is hard to hold a steady concept of self when you can't even stabilize yourself around your assigned gender

I don't have any experience with the personality disorder myself, however, so this may be off base completely  - and only you can know if transitioning is right for you, you should take more time to explore it and make sure, etc

[Edge]

I don't know what the cause and effect correlation is, but maybe trans people trend towards borderline personality issues because it is hard to hold a steady concept of self when you can't even stabilize yourself around your assigned gender

That may be a part of it. I've been told one of the causes of borderline personality disorder is growing up in an environment where we lack validation (a huge number of people with BPD come from abusive backgrounds).

[Virginia]

Multiple Personality Disorder/Dissociative Identity Disorder (MPD/DID) is often described as "disorder of secrecy," masking itself as a plethora of other conditions because the victims' lives depended on it. I began counseling in Spring 2009 for sudden acute gender dysphoria. After running a gambit of diagnoses from transsexual to PTSD, the onset of flashbacks and time loss in January 2011 were the first clear indication to my doctors that I had multiple personalities.

It is common for people with MPD/DID to have opposite gender personalities in their systems. Male alters give female trauma victims the strength they do not believe themselves to possess as women. Female alters give men a way to justify in their minds the horror of having been molested and a way to resolve the resulting sexual confusion. I was no exception.

28% of MPD/DID patients are diagnosed in their 40's or later. Whether they are aware of their system or not, they established an inner homeostasis that allowed them to present the image of having a healthy life until an external life crisis triggered decomposition. I had a successful career and 20+ years of marriage before my System became unstable.

It is common for newly self-aware alters to battle for control or to attempt to kill other personalities. In my case that struggle between my male and female selfs (2 of 5 alters discovered so far in therapy) presented itself as "gender dysphoria." A transition level HRT regimen quelled the dysphoria but it was the calm before the storm until the nightmares, flashbacks and time loss characteristic of MPD/DID began.

My System is typical of others with MPD/DID who used dissociation as a coping mechanism to survive their childhood trauma. An Inner Self Helper (ISH) and two fragment personalities (Protector who contains rage and a 7 year old, the result of the trauma leading to the first personality split who contains fear) are genderless and have little narcissistic investment. The ISH comes to conscious as needed in its supervisory capacity in the system. The frags operate quietly in the background unless triggered. The two primary alters are male and female. As is often the case with alters, they are both extremely stereotypical to function in their required rolls in the System. The female alter (Virginia) is a strong alter, hosted the System throughout Junior High. She is a bulimic 13 year old who before 2009 had not been self-aware since 1975. The product of the trauma leading to the second personality split, she contains psychological pain. The host, the personality the system chose to represent itself to the external world for the majority of its life (VA), is male, a retired married technical professional, largely devoid of emotion and contains physical pain. Both are capable of fronting for extended periods, have grown quite coconscious over the course of therapy and pass well for each other when necessary.

It took a lot of give and take to settle on a grooming ritual that was acceptable to the primary alters. Fortunately the physical effects of HRT were minimal and the body they share has many intersexed characteristics, the likely result of prenatal DES exposure. Hair, what is removed and what remains, is extremely important. The hair on the head is worn in a shoulder length grunge. Laser/electrolysis treatment returned the eyebrows to their androgynous childhood shape and removed the beard excepting a Van Dyke.  The body itself is not shaved. The light vellum hair that remains post HRT does not prevent the female alter from wearing dresses or going to the beach in a bikini and is extremely important to the male alter's sense of self. The small breasts pass for well-developed pecs allowing the male alter to go without a shirt in public and are extremely important to the female alter's sense of self. The fingernails are kept an active length with clear hardener and the toes have a French pedicure. It is about balance; the solitary Self does not win if one gains at another's expense.

Both alters are extremely confident of who they are and are rarely misgendered. Although they enjoy expressing their maleness/femaleness with clothing, this androgynous grooming enables each to receive societal acceptance of their gender by simply coming to the front. The male alter can literally walk into the mens room in his jeans and a tee shirt, comb his hair differently and let the female alter front, and people will see him as female when he walks out.

The alters live completely separate lives ala Victor/Victoria, Tootsie or Mrs Doubtfire, each having their own wardrobes, friends and interests. They are not "out" as such because it is vital to each to be perceived by the people in their respective worlds as the man/woman they are. Accepting the Self as transgender or any crossover in their worlds would destroy the doublethink used to maintain the delusion of being separate people. It would be a catastrophe of epic proportion to the Self for the boundaries that contain the feelings and memories held by each personality of the System to break down.

The male alter is the more robust of the two. As agreed to by the system and the male alter's wife, he controls the body 4-5 days a week and the female the remainder. Triggered personality shifts remain beyond the system's control and the Self is generally unaware of which alter is fronting. The female alter does respect the male alter's wife's wishes that she not use her voice or wear her clothes in her presence and passes as the male alter when she needs his wife's companionship. This balance has been reasonably stable since 2010-

It took 2 ½ years of cognitive therapy for the male and female alters to come to peace with each other before they were able to begin to explore the pain of their childhood. Another year and a half of twice weekly psychodynamic trauma therapy and the conscious mind has slowly begun to allow itself to experience the feelings the alters have held in silence for 45+ years. Yoga has become an instrumental part of the path to acceptance. Piecing together the events of my childhood with my adult mind I am beginning to understand how my childhood innocence, my freedom to think and feel and be were stolen from me, and that I cannot be the person I am as an effeminate man, a crossdresser or any transgender expression of solitary self.

Therapy has taught the personalities the benefits of an integrated existence but given the length of time the system has existed only continued therapy will show the extent to which personality fusion is possible. In God's infinite wisdom, the Self found a way to survive the childhood trauma and gender variance that would have led to suicide. The psychological pain has been excruciating but the consolation of truth is peace.

[Virginia]

A few things I have learned about MPD/DID:

Time/memory loss is a primary characteristic of dissociation, and trauma based dissociative identities/personalities are a psychological disorder. Post Traumatic Stress Disorder (PTSD) and MPD/DID have received a tremendous amount of attention because of the widespread problems experienced by veterans coming back from the Middle East and the horrible devastating effect these conditions have on a victim's life.

The relationship between trauma and MPD/DID is so well established, patients are assumed to have experienced childhood trauma unless the therapist determines otherwise. The narcissistic personalities the Self uses to express itself to the world do not have access to the memories of trauma held by the personalities that contain them. Patients with MPD/DID are in deep denial of their condition, often going to jail or turning to alcohol/drugs rather than facing the reality of their disorder or reliving the horror of the childhood trauma that caused it. I stonewalled my therapist's hints that that my childhood was less than perfect and that I had been molested for nearly two years with the self delusion that I was transgender.

The personalities of the system perceive themselves to have existed since birth because in a sense they have. Their psychological age depends on when the actual dissociation that created them occurred. Think of the original personality as a chocolate bar and the alters as the individual pieces. Each piece will always have its memory of being part of the whole bar. But its coconsciousness of the whole ends when it is broken off. All five of the alters in my System perceived themselves to have existed since birth, each insisting they were the "original" personality. It took over a year of twice weekly psychodynamic therapy for me to begin to put together the memories each of them had so I could understand this was not the case.

An alter's psychological age is approximately the same as the host personality's age at the time of the dissociation that caused the split. Children are oblivious to my adult body and play with the 7 year old in my System like any other kid at the park. My female alter is preoccupied with her looks and friends like any adolescent. She has the classic bulimia associated with young girls who were subjected to early childhood trauma. Experiencing consciousness only as the Self calls on them to cope with trauma alters live a piecewise existence. It was a horrible shock and adjustment to the female alter when she became self aware in 2009 and realized it wasn't 1975; the world she knew did not exist anymore.

People with MPD/DID must come to their own peace with the reality that their recovered memories are true and not false memories created in therapy. Our adult brains have a difficult time accepting/understanding the way our undeveloped child's brain remembered the knowledge of trauma. Unlike an adult mind's concrete images and facts, a child's mind stores information as feelings, sense/body memories, shadows and imagery.

The recovered memories that surfaced as emotional flashbacks, nightmares, snippets and feelings for me all pointed to what I knew without knowing and did not want to be true. Despite my therapist's objective perspectives, I persisted with the doublethink that had protected me for a lifetime. Despite the pictures in the family album, the consistency of the facts from my childhood my adult mind did remember with my recovered memories, I continued to delude myself that it was all just coincidence. The recovered memory became real when my Mother confirmed I had been molested.

A therapist's objective perspective is vital to the process of setting the historical record straight so the MPD/DID patient can begin to understand the things that happened to them as child with their adult mind. Accepting the thoughts and feelings they protected themself from with dissociation they can begin to rediscover the Self and begin make their own choices for the first time in their life.

A common end result of therapy, the current methodology is not to merge personalities (fusion) but to help them work together so the patient can live a peaceful happy life. The degree to which personalities integrate the way they interact or fuse into fewer personalities is determined by what the System perceives to be in its own best interest with its new understanding of Self. It has always been and always will be that way for the dissociative person.

Excellent references:
Childhood Antecedents of Multiple Personality Disorders, Kluft et al
Soul Murder: The Effects of Childhood Abuse and Deprivation, Shengold