Do All Transsexuals Have BPD?

QUESTION:

Dear Dr. Heller!

While searching the web for some information about BPD and transsexualism I found "BiologicalUnhappiness.com".  First of all I want to pay a compliment: great site with lot of information!

Getting down to business, here's my question:

I am 26 and was diagnosed with BPD five years ago.  It's not that I have doubts about that.  Lots of difficulties I had in every-day-life resulting from BPD I am able to deal different with today, but after six years of permanent therapies in hospitals as well as in ambulant treatments I still feel very uncomfortable with my sex and gender.  I never wanted to be a girl or be treated as one.

Once I told a psychiatrist about my problem he said something like, "No, no, you are a borderliner and not a transsexual.  You must have been abused and that's the reason for your problem, which isn't really a problem After that I never said a word to anybody else...

Do you think that BPD and transsexualism can occur in parallel? Neither my parents nor I can remember of any sexual abuse during my childhood.  Let us assume something has happened, could it in fact be the reason for my feelings?  And if so, what should I do now?

It would give me great pleasure if you answered me!

And sorry about my bad English, I am German :o

Kind regards

ANSWER:

I've treated a few transsexuals who didn't have the BPD, but most do have the BPD that I've encountered.  There is no reason one can't have both diagnoses.

Most transsexuals remember feeling trapped in the wrong sex body all their lives - which can be very traumatic and that trauma can trigger the BPD.

Studies have shown that Tegretol can stop the desire for a transsexual existence.  I suspect these individuals just have the BPD with chronic dysphoria (anxiety, rage, depression and despair) and identity problems, and have found changing sexual identity improves their dysphoria.