Let’s Dispel The Myth:
One of the main things that people tell you if you have BPD is that it is a “woman’s disorder.” This is categorically untrue, and we need to break that stigma! The story continues to present an alternative perspective on gender and what it can conceal about pain and trauma. The mask denies the complexity of psychological suffering and the nuances of the human mind.
On average, women regularly get the diagnosis of BPD more often than men, but this says nothing about the essence of the disorder being gendered. In other words, it indicates the intersection of trauma and social roles imposed on different genders. Gender roles and stereotypes thus often seriously impede the expression, comprehension, and even diagnosis of borderline personality disorder symptoms (Polanco-Roman, 2023; Qian et al., 2022).
BPD symptoms, including self-harm, emotional dysregulation, and abandonment dread, are more common in women, who are also more likely to internalize trauma. Men, on the other hand, may externalize their pain, which can result in substance addiction or aggression.
Most of these behaviors are not strongly associated with BPD in men and may therefore be contributing factors to an underdiagnosis (Qian et al., 2022). Such differences do not relate to biology but rather sociocultural conditioning and exposure to trauma. For example, some types of trauma that would mold people’s attachment styles and emotional regulation, often at the heart of BPD (Bozzatello et al., 2024; Holder, 2025), would more frequently be encountered by women, including types of sexual abuse or intimate partner violence.
Some traumas, conversely, may be less acknowledged for men, an example being that of childhood abuse. Then there is toxic masculinity, which results in different kinds of problems, confusion, and rejection surrounding symptoms that would, in fact, characterize them. Thus, pathologizing such emotions inhibits these women in male-dominated healing worlds and compromises their therapeutic alliance (Holder, 2025). Gender as a masquerade that patients wear to dance with their demons, each garment laced with. This is the best case for using threads of personal trauma and societal expectations as a metaphor, as it is very well put in the term “masquerade ball”. The ball mask of womanhood might hide a woman’s agitation at being taught to internalize pain. In contrast, the masculinity ball mask might hide his vulnerability for a man whose emotional expression is nail-biting. The female side of the mask. May shield from sight the struggles of a woman morally conditioned to absorb sorrow.
On the other hand, the masked vulnerability of a man whose emotional expressions are censored by the dictates of machismo may remain hidden. These masks can cause differential symptom presentation on the mental health understanding system, thus leading to differential diagnosis and treatment sometimes (Polanco-Roman, 2023). From an informed trauma perspective, the question becomes: what is hiding behind this fellow, what kind of mask is he wearing?
In what way have gender identity and the accompanying societal narrative influenced the experiential trail of trauma and coping mechanisms? Looking at BPD through the avenues of trauma and gender pushes beyond common stereotypes into the complex individual behind the mask, full of pain, resilience, and inconsistency.
References
Bozzatello, P., Rocca, P., & Bellino, S. (2024). Gender differences in borderline personality disorder: A narrative review. Frontiers in Psychiatry, 15, Article 1320546. https://doi.org/10.3389/fpsyt.2024.1320546
Holder, A. N. (2025). How gender shapes the diagnosis and treatment of borderline personality disorder [Undergraduate thesis, Angelo State University]. Angelo State University Institutional Repository. https://asu-ir.tdl.org
Qian, X., Zhang, Y., & Li, J. (2022). Sex differences in borderline personality disorder: A scoping review. PLOS ONE, 17(12), e0279015. https://doi.org/10.1371/journal.pone.0279015
The Unquiet Attachment 