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Notes -
I was deliberately vague because my answer has CW implications but I suppose putting it in spoiler tags is a decent compromise:gender dysphoria, specifically of the Mr./Ms. Garrison, Jonathan/Jessica Yaniv flavor.
Tell me what you think about this:
I've long conceptualized trans thought content as a combination of:
When I think about item 4. my model is more women who seems to be trans while having a borderline breakdown or are just chronically severe.
It sounds like you spot more often in men, in comparison to me. I think my blind spot here is that my personal life people I know who are MTF seem to not be borderline - mostly dissatisfied with the world, lonely, looking for ego sources, which writing that out sounds borderline adjacent but I don't get the vibe from knowing them (?compromised objectivity?).
You point out your high profile types though and I go oh yeah shit sounds right.
I think this may just be my pot of MTF based off of my background however.
Really interested in your thoughts because no fucking way in hell can I have a convo about this in an academic hospital.
I think we see this along broadly similar lines, and I would add that the reason I spot more often in men is simply because most of my knowledge comes from them. The only FTM gender dysphoria case I know of is firmly in the first category according to her therapist, and I trust that judgment. More broadly, there's a decent amount of teens that identify as trans and the overall "vibe" that I get from the therapeutic standpoint is that these teens are largely trying out gender (and sexual) identities that are subject to change, as teenagers do in general with their identity.
To dig into MTF a little more specifically, firstly I'm not seeing anything in your description of the MTFs that you know that shouts BPD to me either, and my expectation is that MTF plus BPD is no more than a significant minority. That significant minority is definitely a Thing in my book, though, and what makes them stick out like sore thumbs to me is the DRAMA. Mostly, this seems to present as the individual almost always reporting that relationship failures and poor interpersonal dynamics are because people can't accept the MTF identity of the individual. Said individual never questions the role of their own behavior and treatment of others. There's a particular incident that sticks out in my mind here where a MTF teenaged client's MTF parent hijacked the kid's session and spent it all ranting about their own struggles loudly enough that I could hear it from a room away. The self-centeredness, lack of empathy, and splitting seemed to me to be dripping from just about every sentence. The session was supposed to be about how to help your struggling kid, for crying out loud! Occasionally, the reason for the relationship failures, poor interpersonal dynamics, etc., is seen by the MTF individual as more generally due to envy, jealousy, and other negative emotions that others have, as in, "I'm the hottest of the hot girls and they're just jealous and out to get me!" Either way, it's classic cluster B and to me matches BPD behavior in particular.
If you've got more thoughts, I'm more than happy to continue the conversation too. I think I've mentioned before that my wife is a therapist and some of this is based upon her experience. She is an idealist and is all about the needs of her clients, but even she privately confides in me that she worries about the social contagion aspect herself and cannot speak with this even with her cohort of fellow therapists.
I appreciate you sharing your thoughts.
Good reminder for me that the certain magnitudes and types of pathology are disproportionately noticeable and dangerous and at the same time they are not representative of the "true" range and median of pathology.
Those people have the temperament and social support to be loud, proud and disruptive.
RE: your wife - I can't speak to the therapist end of things but I have noticed that physicians of all specialties are slowly starting to ask more questions and explore more nuance, but the pipleline (med school) is still quite rigid.
I expect us to loosen up in 5-10 years and for adjacent fields to do the same.
Until then....hang in there ugh.
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