As it has been for the last 30 years, male borderline personality are still misdiagnosed and herded into substance treatment, anger management and prison. Gender matters from the failure of clinicians to identify it in men to the failure of researchers to study how it affects men differently and the treatment implications of those dissimilarities.

The authors propose a retrospective study investigating all patients hospitalized with Borderline Personality Disorder diagnosis from 2000 to 2015 in Baixo Vouga Hospitalar Center.

From an average of 500 patients admitted per year, in the considered period, the number of men with this psychiatric diagnosis was irrelevant.

Taking into account the results, it is important recognise some gender differences in borderline personality disorder with respect to specific types of self-harm behavior, such as self-cutting or levels of psychological distress at clinical presentation in order to prevent clinical disgnosis failure.

The authors have not supplied their declaration of competing interest.