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Bisexuality and health: The cost of invisibility
On September 23, 2019, the 20th anniversary of , the National Institutes of Health (NIH) held its first-ever bisexual health research workshop. As an invited panelist at this event, sponsored by the NIH鈥檚 , I joined 19 other researchers to discuss key findings, gaps in knowledge, and future directions.
You may be asking yourself: Is there really a need for this workshop? How is bisexual health different from the health of other groups? How many people even identify as bisexual?
What is bisexuality?
, a prominent bisexual activist and writer, defines bisexuality as 鈥渢he potential to be attracted 鈥� romantically and/or sexually 鈥� to people of more than one gender, not necessarily at the same time, not necessarily in the same way, and not necessarily to the same degree.鈥� People don鈥檛 have to identify with the label 鈥渂isexual鈥� to have a bisexual orientation.
Bisexuality can mean having attractions to or sexual behavior with people of more than one sex or gender 鈥� for example, feeling attracted to both women and men. Some people have a range of 鈥渘onmonosexual鈥� identities 鈥� that is, identities that go beyond heterosexual or lesbian/gay 鈥� including . Some people have more than one identity (I identify as both queer and bisexual). The preferred umbrella term for anyone with a nonmonosexual orientation is 鈥渂i+.鈥�
Who is bi+?
People identify as bi+ across genders, races/ethnicities, socioeconomic groups, and ages, but some groups (people of color, adolescents, and ) are more likely to identify as bi+. It may come as a surprise to learn that bi+ people are the largest sexual minority group. Among , more people identify as bisexual than identify as either lesbian or gay. Among adults, bi+ people represent a substantial part of the population. But despite these numbers, there is less research on bi+ health and less available funding for research, compared with research on lesbian and gay people.
How might being bi+ affect health?
If you鈥檙e bi+, a of people of different sexual orientations and racial/ethnic backgrounds found that you may be more likely than people with other sexual orientations to experience certain health problems. For example, gastrointestinal problems, arthritis, and obesity occur more often among bi+ women and men. Additionally, women who are bi+ may have a poor health-related quality of life, while bi+ men may have high cholesterol, high blood pressure, and cardiovascular disease.
If you鈥檙e bi+ and you鈥檙e also a woman or a transgender person, your risk for poor health 鈥� including substance use, depression, and suicide 鈥� climbs even higher compared with other bi+ people (see and ).
Why are bi+ people more likely to experience poor health?
Experts in the field of bisexual health research believe negatively affects health outcomes. Minority stress refers to experiences of prejudice or discrimination based on stigma that lead to poor health. Bi+ people experience , such as negative stereotypes about what it means to be bisexual (bisexuality is a phase, bisexual women are promiscuous, bisexual men are vectors of HIV). Feeling invisible may also create problems. These unique forms of minority stress can be harmful for bi+ people鈥檚 health.
- Bisexual invisibility can affect the quality of medical care. A bisexual woman who is in a relationship with a woman, but also has sex with men, may not be offered birth control or counseling about sexually transmitted infections (STIs) at a doctor鈥檚 appointment, because she is (incorrectly) assumed to be a lesbian and not at risk for pregnancy or STIs.
- Double discrimination can harm mental health. Bi+ people experience discrimination from both heterosexual and sexual minority communities, related to repeatedly needing to 鈥渃ome out鈥� as bi+. This double discrimination can lead to isolation and loneliness, which can be harmful for mental health.
What steps can you take to counter these issues?
If you are bi+, you can improve your health by
- with others who are supportive of your bisexuality, including people who are also bi+ and can understand the unique stresses that bi+ people sometimes face
- being honest with your doctor or mental health provider about your bisexuality, so that you can get the care you need.
Even if you are not bi+ yourself, you can support bi+ people by
- examining your biases and assumptions (for example, not everyone with a different-gender partner identifies as heterosexual) and educating yourself about bi+ people
- educating others about bi+ people to challenge stereotypes and reduce stigma, to increase acceptance of the bi+ community.
About the Author
Sabra L. Katz-Wise, PhD, Contributor
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