The Gender Identity Disorder (GID) is characterized by a strong sense of identity with the opposite gender, by a persistent discomfort with the one's gender and with a feeling of inadequacy to the social role of the biological gender.

The possibility of a higher presence of Borderline Personality Disorder (BPD) in patients with GID has been a subject of research in several studies.

The diagnosis criteria of the BPD includes a global disorder in the individual identity.

Both BPD and GID are associated with a high risk of self-mutilation and suicide.

To analyze and discuss a case report, addressing subjects related to the psychopatology, differential diagnosis and prognosis and therapeutic implications.

Our discussion is focused on a case report, that led us to a non systematic review of the literature.

Our case report is related to a 20 year old man with GID and BPD. This situation is lived in a great social isolation and frequent self-mutilation episodes and suicide attempts.

The clinical outcome is aggravated by a severe instability in the personal relationships, self-image, ambitions and the future projects.

We have discussed the differential diagnosis, psychopatology, prognosis and the identity disorder that the subject presents.

The biologic gender, age and the treatment phase are factors that influence the risk of suicide and self-mutilation in these patients. We did not found a higher probability of BPD in a patient with GID.