Are there underlying differences between sexually diverse and non-sexually diverse people diagnosed with Borderline Personality Disorder?

Previous studies have demonstrated that people with Borderline Personality Disorder (BPD) are more likely to report a sexually diverse orientation (e.g gay, lesbian) than people with other or no psychiatric condition(s). Past literature has attempted to link the BPD symptoms of impulsivity (causing an increase in varied sexual behaviour) and identity disturbance (causing changes in sexual identity) to this overrepresentation. This however can be stigmatising and possibly suggest sexual diversity orientation as a pathology. To address this, the current study aimed to explore this overrepresentation in a more sensitive manner, and examine whether sexually diverse and non-sexually diverse people with BPD differ significantly in demographics, overall BPD symptomatology, identity disturbance, and impulsivity. An online survey was completed by 162 participants (152 cisgender female, 5 cisgender male, and 5 non-binary/third gender; mean age 33.01 years [SD = 9.44]); who self-reported receiving a diagnosis of BPD. Survey data included questions concerning demographics, respondents' mental health (such as diagnoses, treatment status) and aspects of their sexuality (identity, attraction, relationship history), in addition to the measurement of BPD symptomatology (MSIBPD), identity disturbance (SLIM), and impulsivity (UPPS-P). Survey data analysis suggested that sexually diverse individuals with BPD were younger than their non-sexually diverse (heterosexual) peers and were more likely to have changed their self-labelled sexual identity during the previous year. There were no significant differences in other demographic factors, BPD symptomatology, identity disturbance or impulsivity. The study clearly highlighted the challenges of using a single criterion to define sexual diversity, as the groups differed markedly according to whether classification was based on current and past relationship history, sexual attraction, or self-labelled sexual identity. The findings also suggest that BPD symptoms of identity disturbance and impulsivity may not explain the overrepresentation of sexual diversity in people diagnosed with BPD, and that further investigation is warranted.