“He wrote me off as not ‘truly being trans’ because of my Borderline Personality Disorder and Bipolar Disorder.”

I have a myriad of conditions- all diagnosed in adulthood- however I have been experiencing symptoms of most of these things since early childhood, with some popping up in my teen years.

I have Bipolar Disorder (started as a teen/young adult), OCD (started in early childhood), ADHD (born with), autism (born with), Complex PTSD (I’ve had this most my life), Borderline Personality Disorder (started as a teen/young adult), Generalized Anxiety Disorder (my whole life), eating disorders (from elementary school but really more severe in high school and college), and I am sober. I also have learning disabilities and mild tics.

Bipolar is truly episodic, whereas Complex PTSD is my most chronic and disabling condition. My OCD used to be deemed severe but is now mild after treatment. My ADHD and autism are also a constant; they are not necessarily illnesses, but simply the way my mind works. I have sensory processing issues as a part of autism, which affect me more than the social issues these

these days. Generalized Anxiety Disorder is also chronic.

As for my personality disorder, it used to be quite severe but is now a lot milder because of DBT therapy. It was at its most severe at age 23-24, but now at 28 after a lot of therapy, it’s a lot better. I’m still working on my self-harm addiction, but am 21 days clean today.

My Bipolar Disorder is mostly mixed episodes, but I’ve also had pure depression, mania, and hypomania. However I’d say the Complex PTSD is the most disabling of my conditions at present, as it is chronic. EMDR therapy is helping, but doesn’t cure it. I participate in 12 step groups to stay sober and take seven psychiatric medications. It’s a lot. I’m so exhausted and am looking for work but struggle to work, especially as I have physical health conditions now too (migraines, PCOS, osteoporosis, high cholesterol, some pain).

I hope to work full time but I honestly don’t know if I can. I have a master’s degree so a lot of people don’t see me as disabled. But I certainly am. Especially after 12 psych hospitalizations and two residential stays over eight years.

As far as triggers go, my sexual trauma gets triggered very easily. Dissociation and flashbacks are the result. I also have a lot of health-related OCD which is triggered by my health issues. My eating disorder (primarily anorexia) is often triggered by anxiety. Urges to self harm are usually related to my trauma or BPD, feelings of abandonment or emotional dysregulation, or even sensory issues. It’s hard living in this body and this mind. On top of all this, I’m transgender, and navigating medical transition hopefully in the future.

I have found that my BPD diagnosis affects how people treat me, being transgender. I left one provider (I’m pre-medical transition) who I was seeing in hopes to go onto testosterone (T). He wrote me off as not ‘truly being trans’ because of my Borderline Personality Disorder and Bipolar Disorder. It was so awful to be treated as such. I think it was particularly my personality disorder diagnosis that made the doctor feel I ‘wasn’t truly trans’, however he also had concerns over my bipolar diagnosis, and that my having mental illness as a whole was the reason I thought I was trans, but wasn’t actually?

The truth is, I know myself. I am transgender (FTM) and am the happiest I’ve been in my life since coming out. I’ve still had manic depressive episodes that are now managed better by meds, but the way I feel about my inner self is much more at peace than before despite my mental illnesses.

I hope to go on T in the future, but first I am making sure my bipolar is stable since I had an episode this fall and I’m on a lot of medication. One thing I know for certain is that I’m trans. I hate having to ‘prove it’ to a doctor, just because I struggle with mental illness, including a personality disorder.

I am quite open with my friends and have a recovery mental health account that’s also about neurodivergence and being trans. I also write articles for The Mighty (without my last name though). At the same time, I’m no longer open in work place environments due to some poor reactions in the past. Being autistic, I used to not realize that most people don’t go around telling people their diagnoses at work and how that could harm me (stigma/discrimination/ judgement). So I’m not at work at the moment because I’m in a mental health IOP, but in future employment when I ask for accommodations, I will not be disclosing specific diagnoses.

Friends are very understanding of my mental health and neurodivergence. And my partner is autistic and anxious herself so she gets some of it. And what she doesn’t understand, she is very supportive of. My immediate family is very supportive too. Both of my sisters have mental illness (one has BPD, PTSD and addiction, the other has OCD) and one has ADHD so they too understand some of it.

I sometimes worry people will judge that I’ve been hospitalized 12 times and residential twice in just 8 years but my friends never judge. My family worries though. I’d say my residential stays definitely helped. The hospitalizations I’ve had in recent years were more helpful because a) I was at a better hospital and b) I was more willing to get something out of it than when I was in college.

The professionals I’ve had contact with in recent years were very understanding, but I’ve certainly dealt with my fair share of doctors who stigmatized me for having BPD or didn’t see or understand my autistic traits. Bipolar, OCD and PTSD always seemed more understood than BPD or autism.

I think some things are improving- especially among the younger generation- but a lot of doctors are surprisingly biased and stigmatizing. I’m lucky I was diagnosed autistic as an AFAB person with a presentation that doesn’t fit the ‘stereotype’. Many like me don’t get properly diagnosed or misdiagnosed (re autism). I think BPD and even OCD is still highly stigmatized / misunderstood.

Medication and therapy are essential but in the past few months I’ve started meditation, acupuncture, going for walks, and joining 12 step groups … I’ve chosen to stay sober, as well as abstain from self harm and my eating disorder through these groups. It’s been a big help doing 12 step work as well as meditation. Time in nature helps too and stimming/sensory stuff like fidget toys and weighted vests.

Overall, I’d say don’t be afraid to reach out for help. That’s been the biggest part of my journey, advocating for myself and asking for help. I needed help since childhood but didn’t get it until I was 19, when I was old enough to know how to ask for help.

My advice specifically to trans readers would be- you know who you are better than any doctor. Gatekeeping is real when it comes to gender affirming care, and some doctors are great while others stigmatize and discriminate. I recommend always remembering that you know who you are best. And that your mental health diagnoses and trans-ness are equally valid.