Narcissism is one of those disorders that the public has taken to their hearts and calling someone a narcissist is a common insult to attack someone perceived as vain, egocentric or self-absorbed, however this does not reflect the full spectrum of the diagnosis. As with most things the public presses to their heart as the pejorative du jour, they failed to understand the full complexity of the disorder and the diagnostic criteria. Being a vain, self-centered bastard is part of the diagnosis, but is not the only thing required to be a narcissist, if it was most of us would qualify at one point or another.
Narcissism in the western culture is a growth industry  thus, the socio-cultural aspects of the diagnosis, is influenced. This follows from the BPS response to the DSM-V, where they write
The putative diagnoses presented in DSM-V are clearly based largely on social norms, with ‘symptoms’ that all rely on subjective judgements, with little confirmatory physical ‘signs’ or evidence of biological causation. The criteria are not value-free, but rather reflect current normative social expectations. Many researchers have pointed out that psychiatric diagnoses are plagued by problems ofreliability, validity, prognostic value, and co-morbidity. 
DSM-V Diagnostic Criteria
The most recent update to the diagnostic and statistical manual of mental disorders breaks down a diagnosis of a personality disorder into three levels. Impairments in personality functioning, impairments in interpersonal functioning and pathological personality traits. Furthermore, in order for a diagnosis of a personality disorder to be made, the impairments and trait expression must be relatively stable across time and consistent across situations. They must not be better understood as normal considering the individual’s development stage or socio-cultural environment. Finally, they must not be purely due to the effects of a substance.
Thus, it follows that in a socio-cultural environment where the norm is to be excessively referential to others for self-definition for instance, one could not diagnose a case of narcissism.
Impairments in Personality Functioning
The first trait of a narcissist is are significant impairments in personality functioning manifest by multiple traits. In regards to identity, they are excessively referential to others for self-definition, and the regulation of their self-esteem. Their self-appraisal is often exaggerated and may be deflated or inflated, and vacillate between the two in extremes. 
When viewing female behavior, and considering the point made by the BPA, one must ask whether women within our social context may frequently vacillate between exaggerated self-appraisal and extremely low self-appraisal. The fact that the woman alone or with a girlfriend mourning the pointless of her life after a breakup over icecream has become a stereotype, would indicate so in one regard. Furthermore, the “yo go girl” slogan with associated behaviors appear to encourage such behavior. One can frequently view a woman go from being extremely self-confident about her physical appearance, based on the expressed opinions of other women or other men.
A second impairment common to narcissists, is in their ability to self-direct. Their self-direction tends to be colored by both setting goals based on the reactions of others, while holding themselves to unreasonably high standards of performance in order to see themselves as exceptional. Alternatively, holding themselves to low- or no standards at all, based on their feelings of entitlement.
Without belaboring this point, most people who have interacted with a group of females for long, will have noticed the tendency for behavior within such a group to be highly affected by the reactions of other members of the group. One does not outshine the Bride on her wedding day, one does not upset the queen bee. Insults between females are given as backhanded compliments, and so on. To the second aspect of this criteria, some women do have excessively high standards, requiring themselves to have a full-time career (ideally in an exiting field on a management track), while being full time moms, keeping themselves in shape, have a perfect house and so on. However, one can also observe the opposite in female participation in the labour force, a tendency to hold part time jobs and my personal favorite maternity leave without pregnancy  One could also add the incessant demands that society cater to the whims of women, for instance the recent demands to “listen and believe” or pro-female legislation.
Perhaps the greatest example touching on both impairments, come in the form of the insistence that in order to get more women in STEM, one must create programs that encourage women to be interested in and earn STEM degrees  or maintaining them in STEM fields once they graduate. The utilization of narratives and social influence mechanics to do so, indicate that one must communicate to women that “It is OK to be interested in STEM“, and that unless women can see visible role-models they have a higher chance of dropping out, which points to both external self-definition and impairments in self-direction.
Impairments in Interpersonal Functioning
Interpersonal functioning in a narcissist is manifested in two ways, through a lack of empathy, and intimacy. To deal with the lack of empathy first, this is demonstrated through an impaired ability to recognize or identify with the feelings and needs of others. The narcissist is very attuned to the needs and reactions of others but only if it is important- or pertaining to the narcissist.
In western culture there is a social program that identify women as the emphatic sex, however, if one notices the modern feminism movement, one can immediately point to the the “male tears” mugs, that come out when men attempt to mention biased court systems or the male suicide rate. Furthermore, one who is familiar with the manosphere, will immediately point to the mechanics of a branch swing or war brides dynamic that leads to a woman seemingly shutting off all emotions for a man upon ending the relationship without concern for his well-being.
The second aspect of this criteria manifest through superficial relationships, where they serve to regulate self-esteem rather than sharing in the experiences and showing an interest in the lives of others. Furthermore, they show a high tendency to be formed for personal gain. Referring back to the earlier comment about the “you go girl” type of relationships, that appear to be formed around what can be argued as a cheerleader squad for each individual female. This function of female friendships being formed around the function of building self-esteem in each individual female, appear to fit very will with the first part of this criteria. Secondly, female friendships are generally centered around the sharing and confirmation of choices and actions made by each individual female, and the affirmation of her.
Pathological Personality Traits
Antagonism: Characterized by Feelings of entitlement, either overt or covert; self-centeredness; firmly holding to the belief that one is better than others; condescending toward others.
How does one adequately identify feelings of entitlement among those who have been raised to think they are entitled to everything? Narcissism is growing more and more within the United States, and everyone one turns there is a movement to have more self-esteem, to get rid of your shame and worship yourself.
Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking.
This may take many forms, one could easily argue that seeking admiration on instagram or various other social media sites, or the attention lavished on women on online dating sites are symptoms of attention seeking. However, relative to our culture it appears to be the norm. I find myself wondering, in the age of unbridled attention seeking, could one ever qualify for this diagnostic personality trait?
Approaching a diagnosis
This was in many ways the most difficult part of the post to write, unlike anti-social personality disorder and borderline personality disorder that to some extent still present traits that cannot be viewed within the context of normalcy. While there are tendencies towards the normalization of the interpersonal sensitivity of borderline personality disorder, and the sociopaths exploitative lifestyle, the extreme variants of those personalities are still recognized as deviations from the norm.
Many of the core traits of narcissism have been embraced within our culture. Children are raised to have self-esteem without accomplishment, women may gain attention and validation from hundreds or thousands of other people online on social media. How could one not think that one is beautiful or special if this is being validated by thousands online? What defines a superficial relationship in a world where someone has thousands of friends they have never met on Facebook? Most of the aspects of the diagnostic traits and problems in functioning has been normalized to the point where what used to be abnormal has largely become normal.
It is no longer a question of “Is this person a narcissist” it is a question of “How narcissistic is this person?“. The more interesting question becomes, are we slowly becoming a culture of pure narcissists or a culture of neurotics and narcissists. One must consider that many boys are raised in a very unfriendly climate, where they are medicated from a young age, told their gender is cause of all evil in the world, are denied mental help and help in education, as outline in “The FOG of Modern Society“. Thus, one must wonder if half our culture is being built up, and thus are becoming more narcissistic, and therefore, more entitled. While the other half is being torn down, and thus are becoming neurotic, perhaps the male suicide rate may give an indication .
As the BPS response outlines,  one must wonder about the effect of culture on these phenomena, as certain behaviors become normalized and in fact embraced as within the bounds of normal personality functioning.
Summary and Conclusions
While the existence of narcissistic women is hardly a point of contention, one must wonder how the last 50 years of feminism and cheering for girls have affected their levels of narcissism. This is true for men as well, however one must keep in mind that many initiatives have been focused solely on women and girls. While there are arguments to be made that raising females up, does not push men down, it does alter dynamics and opportunity. For instance, if 100 people can study electrical engineering at a given school, and 30 of those places are reserved for women, while the other 70 are for either gender, that does mean women may compete for 100 slots, while men only for 70. Which does mathematically reduce opportunity for men to study electrical engineering.
I’m not sure what has caused the rise of narcissism within Western Culture, but I suspect that it is a mixture of the self-esteem movement, and social media are largely to blame. Telling everyone that they are special, should be valued merely by virtue of existing, and can become anything they want, can hardly be said to prepare someone for the harsh realities of life. Furthermore, a social media culture of self-worship, combined with a string of people who give validation for a poorly lit selfie is perhaps a compounding variable. This tendency has been much more pronounced towards women and girls. Where the tendency is that boys are medicated for what was considered “normal” behavior for boys 30 – 40 years ago, such as being very active while young, and struggling boys within the school system get little aid. The behavior of women outside the boundaries of normal, has been celebrated and encouraged.
How does one tell the difference between a narcissistic female and a woman who has been told that she is entitled to everything, and a special snowflake since the day of her birth by all of society?
I recently launched a Patreon page where I will be posting additional content every month for those who support me and I will do a Google Hangout for the highest tier Patrons (limited to 10 people).
I’ve also had some requests for consults, which I’ve declined up until now, but due to demand I’ve chosen to open up for doing some consults on request. For details please check out my Consulting and Patreon Page
Dangerous personalities by Joe Navarro
It’s All About Her: Surviving the Female Narcissist by Lisa E. Scott
 BPS Response