BPDFamily.com

My daughter E is almost 20 years old and was diagnosed with BPD when she was 17. She has been very resistant to meds or therapy although we have tried so hard and offered her many different options. She finds fault with psychologists and psychiatrists and takes herself off meds even when they're clearly (to us) helping. Everything started to spiral down when her best friend moved to a different school and made new friends there when my daughter was 14 and she grieved that for over 2 years -- heavy, consistent grief -- and there was just nothing we could do to help. At 17 she developed an eating disorder. We did everything possible to get help for her but she refused to acknowledge that she had an issue and walked out of every office we ever took her to. Eventually she went from 118 to 83 and was hospitalized in heart failure and that finally got her into treatment. Over the following 6 months she was weight restored but she quit the treatment program she was in as soon as she turned 18. When she went into the hospital, she understood that she was very sick and needed help but soon she denied that she had been that sick, was furious that her dad and I put her into treatment, lied to others about the weight loss and now insists that she never had an eating disorder at all. Since her weight is good at around 118 now and has been for almost 2 years, her pediatrician says to just leave it be and let her say whatever she wants and so we do for the most part. I love my daughter so very much but her sisters (my girls are triplets) say that she has run our home for as long as they can remember and I know that's true. She's very intense, gets angry easily, can be quit irritable and controlling, and, as much as this hurts me to admit, she's lies and manipulates to be the victim any time we try to call out unacceptable behavior.
After a year at a local college for all 3 girls (we were so consumed with E's eating disorder and treatment that we weren't able to visit colleges as we should have), our other 2 girls went away to their dream colleges this fall and really thrived in their new environments. E stayed at home as she doesn't know what she wants to do and can't seem to find a direction or anything that interests her. She worked a couple of days a week and planned to look for an internship to try to find a path she might like but that never happened. I think our family was finally starting to feel that we could breathe -- 2 of the girls happily off to school, me working on expanding my business, my husband and I taking a couple of short trips together and trying to reconnect after the very hard last 6 years, hoping that time would help E to branch out and try to find her path. And then on Sunday when he sisters were home for Christmas break, she sat us all down to say that she feels she's a transgender boy. She never had any gender identity issues as a young child (cross dressing, saying she was male, etc... .) but she has always hated conforming to what is expected or socially acceptable which did lead to some struggles with clothes. The arguments were never over wearing a dress; they were over not wearing torn barn jeans and faded t shirts to a restaurant as an example. When we want her to dress up a bit, it's a huge drama but if she wants to go to her work Christmas party or the prom then she chooses girly, lacy dresses that astound me so we've always seen that as a control issue and not a gender conformity issue. We are honestly exhausted and so very overwhelmed. My other daughters feel that this is just another way for E to control the family dynamic. I doubt it's that calculated but I do worry that it's a symptom of her untreated BPD. My other girls are devastated at what they see as the loss of their triplet sister. My husband and I are hurting for our own sense of loss but  also so concerned that she's chasing something else in search of an identity that she won't find. We've told her that if she wants to pursue this transition and have our support, she must establish with a psychiatrist with expertise in BPD and gender issue and that she must continue for at least 1 year complying with recommendations for medications and therapy. My husband and I meet with her previous doctor this week and she said that her sense is that this gender issue is a result of longstanding, untreated BPD but that only time and evaluation will tell. She even said gender identity issues are relatively common in BPD.
I know this has been incredibly long and I'm grateful to anyone who has taken the time to read it but I just need to connect with other parents trying to help a teen through accepting a BPD diagnosis and treatment. Do you think we're wrong to insist that she finally address mental health issue before changing her gender? This is the hardest thing I've ever dealt with. Please don't think I'm anti transgender people or homophobic or any other thing I'm not. I'm just trying to help my child and my family and I'm feeling lost. 

Hi ellabee

Welcome, thank you for giving so much background as it really does help everybody understand your situation. I’m very sorry to hear how tough you’ve got it and triplets to boot. Your girls must be exceedingly close and you all must be reeling and grief stricken. You’ve had it tough and I’m so very sorry.

I’ve no experience of gender issues but there are others in the forum and I’m sure you’ll find each other. I just wanted you to know that you’re not on your own.

My DS27 only got dx at 24 and we had a challenging teenagerhood and early 20s. Diagnosis brought some relief to my DS but it hit him hard. He questioned everything and felt his situation hopeless for a long time. He has a tendency to always look for the quick fixes and now has a drug problem. To be honest, he didn’t start to show any signs of maturity until he was 25 and after I started to change my approach. I threw myself completely into focusing on our core relationship with better skills learnt here on the forum. Unbelievably my DS is now functioning, working and has recently moved out - I’m thankful to this forum and the support I’ve received in this long BPD road. We’d never have achieved what we have without being here inching ourselves forward.


For what it’s worth I think you’ve made the right decision as I’d be as concerned as you are. You’re all in crisis and it’s going to take time to process and work out your own personal priorities, emotional support for all the girls and find a way forwards. BPD is devastating and exhausting and serious amounts of patience is required.  

My DS refused treatment but accepted his diagnosis but it took time. My son is a quiet BPD and doesn’t rage and so it was very difficult to understand what was going on emotionally with him. Irritability, mood swings and depression were part of the territory. Thankfully our situation is a lot better as I no longer walk on eggshells or dance around him. I interact with him in a way that he generally stays calm and he now listens.

Have you read up on BPD? If not, I encourage you to do so as your first priority. Knowledge is power and I found I reacted less to his behaviours. I was also able to explain our situation better to other family members. That was my first step - get calm through learning. My husband and younger son learnt by my example.

What did you say to your daughter when she told you? How do you think she’s feeling and is she aware of how you all feel about the situation?

Hugs

LP

Hi Ellabee,

My heart goes out to you!

When I read your post I had a thought about the transgender issue ... .of course I don't know all the details, so disregard this if it does not feel right, but you might consider letting her identify as and dress as male without putting up any resistance or conditions -- but letting all the "work" of this fall to her. So, for example, if she wants to research possible future treatments or go to transgender support groups and so on, don't jump in and do any of this for her (driving, footing bills, etc). This might take a lot of the "charge" out of it. If this recent development is (maybe subconsciously) a way to generate conflict in the family, it will be easier to tease this out if you and your spouse and the other triplets offer no resistance. If E says her new name is Evan, call her Evan. If she wants a new pronoun, cheerfully use it. If a few weeks later she says she is back to her original name, switch back without making any sort of an issue out of it. (Because this male identity did not crop up in her childhood, I suspect it may well not be a permanent thing.)

Where I would draw the line with this easy-going approach is with non-reversable things like surgery, or expensive treatments. If she really is a transgender male and feels she cannot be whole until she has taken non-reversible steps, I would step out of the way and let her figure out how to bring these things about independently (for example, getting a job with medical insurance). Putting the ball in her court might be a way of slowing things down in a healthy and natural way so she does not jump into an identity (in BPD style) which is not her true identity and will just lead to more suffering. You would not be saying you disapprove or are shocked -- you'd just be saying you know she is an adult now and you respect her adult decisions (leaving her with all the work). Any time I have made treatment a condition of giving something to my son that he desperately wants, this has led to escalating conflict, not his getting treatment. (Or he goes once or twice, furious and resentful, rages, and refuses to go back.) Your daughter may be more reasonable, in which case making treatment a condition of medically transitioning might work.

As far as things like clothing or haircuts ... .if you can bring yourself to do so, I would just roll with it. If the other triplets are getting girl cuts and E wants a boy cut, I would let it happen and say it looks great. If she wants to wear scruffy jeans and a baseball cap to a restaurant, I would not say a word if you can! (This seems like it will cause the least wear and tear on the family and have the greatest chance of her thinking: oh maybe I will get a bit more dressed up after all.) I try to separate in my mind, when dealing with my son, which things will cause lasting damage and which things (like his dressing like a gangster for a while) will leave no permanent marks on him or anyone else. 

I wish your family as peaceful a holiday as possible.

Hi Ellabee,

There is so much I relate to in my own BPD daughter who, to my amazement has made it to age 39.  It's been so stressful and exausting for many years - I can't imagine having triplets.  One thing you have on your side is that your husband is still with you.  The divorce rate in these situations is 80%.  I wish I had more knowledge when she was younger.  I spent too many years trying to be a "good" mother which I now see has done nothing for her while running myself into the ground attempting to fix and control the situations.  At 12 she became anorexic and nearly died when her weight went below 70 lbs.  She continued her eating disorder through her teens and added drugs and alcohol.  I was told by a dr. she was not likely to make it to 18. Her father abandoned her at age 2 so it all fell on me.

In her early 20's she came out as gay and started dressing like a man which has continued.  She was very femminine as a girl so I was taken by surprise and as a Christian had difficulty accepting this news.  She recently was interviewed  and told the audience that when she came out I threw her out of the house and called her the work of the devil.  The truth was she had her own apt at the time and I was not disparaging her.

I would like to encourage you to set clear boundaries and take care of yourself andthe rest of your family and not let her run the show.  I got to the point that I have been treated for depression, anxiety and PTSD from stress and exaustion.

It is good that you found this site and I wish you the best.

With blessings,

KCat