Research examining the prevalence, impact, and course of personality disorders in sexual and gender minority populations is sparse; however, the available literature suggests that personality pathology is more prevalent in sexual and gender minorities compared to those who identify as heterosexual and/or cisgender. Although research is limited, several competing hypotheses have attempted to explain this disparity, including environmental, developmental, minority stress, and dual marginalization theories, as well as critical theories that point to possible roles of diagnostic, clinician, and cultural biases. This chapter highlights three critical future directions. First, rigorous longitudinal research needs to be conducted to evaluate competing etiological hypotheses of personality disorders in sexual and gender minorities. Second, future personality research should examine through an intersectional lens how additional aspects of one’s identity (e.g., ethnicity, class) interact with sexual orientation and gender to influence the experiences of these groups. Finally, clinicians and researchers must be sensitive to both the need to accurately document personality pathology, and the need to avoid unnecessarily pathologizing the experiences of sexual and gender minorities. Ultimately, addressing these future directions would enhance clinicians’ and researchers’ understanding of and ability to respond to the mental health needs of sexual and gender minority populations.
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