Speakers - 2026

Title: An institutional ethnography of health care accessibility for women with borderline personality disorder (BPD) diagnoses

Abstract

Objective: This study investigates how systemic stigma and institutional structures shape health care access for women and gender-diverse people (GDP) diagnosed with Borderline Personality Disorder (BPD). BPD is disproportionately diagnosed among females in Canada; the condition is often mischaracterized as “untreatable,” leading to exclusion from services and recurrent emergency department (ED) visits. The research aims to explore how social norms, health care knowledge, and institutional policies influence interactions between health care practitioners (HCPs) and individuals with BPD, and how these factors impact treatment accessibility and outcomes. 

Method: Using institutional ethnography, this qualitative study begins from the standpoint of women and GDP with BPD. Stage 1 involves semi-structured interviews with 20 informants (self-identifying as female or GDP, diagnosed with BPD, aged 16+), recruited via purposive sampling from Ontario Shores, CMHA, and Peterborough Regional Health Centre. Interviews will be transcribed, indexed, and mapped to trace interactions with HCPs and services. Stage 2 includes ethnographic observations and interviews with 10 HCPs (e.g., nurses, psychiatrists, admin staff), alongside textual analysis of institutional documents such as assessment forms, practice guidelines, and health policies. Stage 3 integrates all data to examine how systems of authority and intersecting identities shape service delivery and access.

Results: Findings will identify how lived experiences of BPD are structured by institutional texts and discourses, revealing tensions between patient needs and HCP practices. The study will expose how gendered stigma and systemic inequities are reproduced in health care settings, contributing to ED strain and poor health outcomes.

Conclusion: This research will inform policy reform and improve service delivery by exposing structural barriers and enhancing care for women and GDP with BPD. It aims to empower marginalized populations, reduce stigma, and support equitable health outcomes across Canada.