mental health sexism
Header image credit: Stocksy

Health and wellness touch each of us differently. This is one person’s story.

Since I was 14 years old, the words “monitor for a personality or mood disorder” were written in bold in my medical charts.

Today is the day, I thought on my 18th birthday. As a legal adult, I’d finally get my official mental health diagnosis after years of being shipped from one mental health treatment program to the next.

In my therapist’s office, she explained, “Kyli, you have a mental health issue that’s called borderline personality disorder.”

Naively optimistic, I felt relieved that I finally had the words to describe the mood swings, self-harm behaviors, bulimia, and intense emotions I experienced constantly.

Yet the judgmental expression on her face led me to believe that my newfound sense of empowerment would be short-lived.

Most searched myth: ‘Borderlines are evil’

The National Alliance of Mental Illness (NAMI) estimates between 1.6 and 5.9 percent of American adults have borderline personality disorder (BPD). They note around 75 percent of people who receive a BPD diagnosis are women. Research suggests biological and sociocultural factors may be the cause of this gap.

To receive a BPD diagnosis, you have to meet five out of nine criteria requirements set forth in the new edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). They are:

  • an unstable sense of self
  • a frantic fear of abandonment
  • issues maintaining interpersonal relationships
  • suicidal or self-harm behaviors
  • mood instability
  • feelings of emptiness
  • dissociation
  • outbursts of anger
  • impulsivity

At 18, I met all the criteria.

As I pored through websites that explained my mental illness, my hope for my future quickly morphed into a sense of shame. Growing up institutionalized with other teenagers living with mental illness, I wasn’t exposed often to mental health stigma.

But I didn’t have to scour the dark corners of the internet to discover what many people thought of women with BPD.

“Borderlines are evil,” read the first autocomplete search on Google.

Self-help books for people with BPD had titles like “Five Types of People Who Can Ruin Your Life.” Was I a bad person?

I learned quickly to conceal my diagnosis, even from close friends and family. BPD felt like a scarlet letter, and I wanted to keep it as distant from my life as I could.

Dating the ‘Manic Pixie Dream Girl’

Yearning for the freedom I sorely lacked throughout my teenage years, I left my treatment center a month after my 18th birthday. I kept my diagnosis a secret, until I met my first serious boyfriend a couple months later.

He thought of himself as a hipster. When I confided in him that I had BPD, his face beamed with excitement. We grew up when movies like “The Virgin Suicides” and “Garden State,” where the main characters became infatuated with one-dimensional versions of mentally ill women, were at the height of their popularity.

Because of this Manic Pixie Dream Girl trope, I believe there was certain allure for him in having a mentally ill girlfriend.

It felt impossible to navigate the unrealistic standards I felt I had to live up to as a young woman — a mentally ill woman, to boot. So, I felt desperate to normalize the way he exploited my BPD.

I wanted my mental illness to be accepted. I wanted to be accepted.

As our relationship progressed, he became enamored with certain aspects of my disorder. I was a girlfriend who was sometimes risky, impulsive, sexual, and empathetic to a fault.

Yet, the moment my symptoms shifted from “quirky” to “crazy” from his perspective — mood swings, uncontrollable crying, cutting — I became disposable.

The reality of mental health struggles left no room for his Manic Pixie Dream Girl fantasy to thrive, so we broke up shortly thereafter.

Photos via Kyli Rodriguez-Cayro

Beyond the movies

As much as I feel our society clings to the myth that women with borderline are unlovable and downright toxic in relationships, women with BPD and other mental illnesses are also objectified.

Dr. Tory Eisenlohr-Moul, an assistant professor of psychiatry at the University of Illinois at Chicago, tells Healthline that many of the behaviors women with borderline display “get rewarded by society in the short term, but in the long term, get really harshly punished.”

Historically, there’s been an intense fascination with mentally ill women. Throughout the 19th century (and long before that), women deemed sick with hysteria were turned into theatrical spectacles for predominantly male doctors to perform public experiments on. (More often than not, these “treatments” were nonconsensual.)

“This [mental health stigma] plays out more harshly for women with borderline, because our society is so ready to dismiss women as ‘crazy.’” — Dr. Eisenlohr-Moul

The lore surrounding severely mentally ill women has evolved over time to dehumanize them in different ways. A notable example is when Donald Trump appeared on “The Howard Stern Show” in 2004, and in a discussion about Lindsay Lohan, said, “How come the deeply troubled women, you know, deeply, deeply troubled, they’re always the best in bed?”

Despite how disturbing Trump’s comments were, the stereotype that “crazy” women are great at sex is commonplace.

Whether adored or hated, seen as a one-night stand, or path to enlightenment, I feel the ever-present weight of stigma attached to my disorder. Three small words — “I am borderline” — and I can watch someone’s eyes shift as they create a backstory for me in their minds.

The real-life consequences of these myths

There are risks for those of us who fall in the crux of both ableism and sexism.

One 2014 study revealed 40 percent of women with severe mental illness had been sexually assaulted as an adult. Beyond that, 69 percent also reported experiencing some form of domestic violence. In fact, women with disabilities of any kind are more likely to be subjected to sexual violence than women without.

This becomes particularly devastating in the context of mental illnesses like BPD.

Though childhood sexual abuse isn’t considered to be an essential factor in developing BPD, research has suggested somewhere between 40 and 70 percent of people with BPD have also experienced childhood sexual trauma.

As a childhood sex abuse survivor, I realized through therapy that my BPD had developed as a result of the abuse I endured. I’ve learned that, albeit unhealthy, my daily suicidal ideation, self-harm, eating disorder, and impulsiveness were all just coping mechanisms. They were my mind’s way of communicating, “You need to survive, by any means necessary.”

Though I’ve learned to respect my boundaries through treatment, I’m still filled with constant anxiety that my vulnerability could lead to more abuse and revictimization.

Beyond the stigma

Bessel van der Kolk, MD, wrote in his book “The Body Keeps The Score,” that “culture shapes the expression of traumatic stress.” While this is true of trauma, I can’t help but believe gender roles have played an essential part in why women with BPD are particularly ostracized or objectified.

“This [stigma] plays out more harshly for women with borderline, because our society is so ready to dismiss women as ‘crazy,’” Dr. Eisenlohr-Moul says. “The punishment for a woman being impulsive is so much greater than a man being impulsive.”

Even as I’ve progressed through my mental health recovery and figured out how to manage my borderline symptoms in healthy ways, I’ve learned that my feelings will never be quiet enough for some people.

Our culture already teaches women to internalize their anger and their sadness: to be seen, but not heard. Women with borderline — who feel boldy and deeply — are the complete antithesis of how we’re taught that women should be.

Having borderline as a woman means being continuously caught in the crossfire between mental health stigma and sexism.

I used to carefully decide who I shared my diagnosis with. But now, I live unapologetically in my truth.

The stigma and myths our society perpetuates for women with BPD aren’t our cross to bear.


Kyli Rodriguez-Cayro is a Cuban-American writer, mental health advocate, and grassroots activist based in Salt Lake City, Utah. She’s an outspoken advocate for ending sexual and domestic violence against women, sex workers’ rights, disability justice, and inclusive feminism. In addition to her writing, Kyli co-founded The Magdalene Collective, a sex work activist community in Salt Lake City. You can visit her on Instagram or her website.