Bisexual Health Disparities

Why do they often present with a greater number of psychological concerns?

Posted Apr 26, 2016

The U.S. Department of Health and Human Services defines a health disparity as, “a particular type of health difference that is closely linked with social or economic disadvantage.”[1] Studies repeatedly find bisexual men and women experience health disparities when compared to heterosexuals, gay men, and lesbian women:[2]

  • Bisexual people experience a greater likelihood of suffering from depression and other mood or anxiety disorders.
  • Bisexual individuals report higher rates of hypertension, poor or fair physical health, smoking, and risky drinking than heterosexuals or lesbian women/gay men.
  • Bisexuals are also far more likely to feel suicidal than heterosexuals, gay men, and lesbian women. Two recent studies based on the Canadian Community Health Survey (a national population-based survey using a representative sample) determined that almost half of bisexual women and more than a third of bisexual men had seriously considered (or attempted) taking their own lives.[3]

What is driving these health disparities?  Two factors are marginalization and societal insistence that an individual must be gay or straight.  Much of the research on bisexuality, as an apt illustration, has centered (and continues to focus) on its very existence. There are many who claim bisexuality does not exist, is a passing phase, or is a purposeful attempt to lay the groundwork for coming out as a gay man or lesbian woman. A telling 2013 survey of college students found the majority believed males engaging in bisexual activity are transitioning to homosexuality and females engaging in bisexual activity are participating in a new rite of passage or feigning bisexual interest to please males.[4]  A quote from one study participant illustrates the latter belief:

Some people will pretend to be bisexual only to get attention. I know there are many girls who kiss each other to please men, things like that … When I hear that at every party, there are always girls kissing each other. I am suspicious. Are these girls all bisexuals?[5]

The authors of the study found that subjects’ requirements for bisexuality were so stringent that “it was almost impossible to be a ‘real’ bisexual” (for example, subjects reported bisexuals must have an equal attraction to both genders).   Likewise, a 2013 survey of adults in the United States found 15 percent of participants outright disagree that bisexuality is an authentic sexual orientation.[6]

A 2014 report by the Human Rights Campaign evaluated the responses of 10,000 LGBT youth, ages 13–17, in the United States. Nearly 40 percent of survey participants identified themselves as bisexual.[7] The study found that bisexual youth struggle with the same challenges facing lesbian and gay peers (e.g., bullying, family rejection, community acceptance) but that they also experience unique additional challenges. One striking concern is a lack of awareness of their existence by people and institutions that could aid them in their identity development. Another was the pervasiveness of myths and stereotypes about bisexuals, including:[8]

  • Their sexuality doesn’t exist.
  • Bisexuality is just a phase.
  • They are confused.
  • They are seeking attention.
  • They are hypersexual.

In 2011 the San Francisco Human Rights Commission released Bisexuality Invisibility: Impact and Recommendations, the first-ever document released by a U.S. governmental agency examining bisexuality. According to the document, “Despite years of activism and the largest population within the LGBT community, the needs of bisexuals still go unaddressed and their very existence is still called into question. This erasure has serious consequences on bisexuals’ health, economic well-being, and funding for bi organizations and programs.”[9] Bisexual Invisibility reiterated concerns previously expressed by the Fenway Institute (an agency dedicated to ensuring quality and culturally competent medical and mental-health care for LGBTs and those affected by HIV/AIDS) that the general public and gays and lesbians continue to ignore “clear evidence that bisexuals exist.”[10]

In sum, many bisexuals experience physical- and mental-health complications arising from a conflux of invisibility, lack of acceptance by lesbian women, gay men and heterosexual individuals, and limited support, even in settings that are otherwise affirmative for other sexual minorities.

[1] U.S. Department of Health and Human Services. The Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020. Phase I report: Recommendations For The Framework And Format Of Healthy People 2020 (Washington, DC: U.S. Department of Health and Human Services, 2008): 28.

[2] San Francisco Human Rights Commission. Bisexual Invisibility: Impact and Recommendations (San Francisco: Author, 2011).

[3] Brennan, David J., Lori E. Ross, Cheryl Dobinson, Scott Veldhuizen, and Leah S. Steele. "Men's sexual orientation and health in Canada." Canadian Journal of Public Health 101, no. 3, (2010): 255-258. (2010); Steele, Leah S., Lori E. Ross, Cheryl Dobinson, Scott Veldhuizen, and Jill M. Tinmouth. "Women's sexual orientation and health: Results from a Canadian population-based survey." Women & Health 49, no. 5 (2009): 353-367.

[4] Alarie, Milaine, and Stéphanie Gaudet. "“I don't know if she is bisexual or if she just wants to get attention”: Analyzing the various mechanisms through which emerging adults invisibilize bisexuality." Journal of Bisexuality 13, no. 2 (2013): 191-214.

[5] Alarie et al, I Don’t Know: 205.

[6] Castillo, Michelle. “15 Percent of People Don’t Think Bisexuality Is Real Sexual Orientation: Study.” CBS News, November 6, 2013.  Accessed October 5, 2015.

[7] Andre, Amy, Jay Brown, Allison, Delpercio, Ellen Kahn, Anne Nicoll, and Beth Sherouse. Supporting and Caring for Our Bisexual Youth (Washington, DC: The Human Rights Campaign Foundation, 2014).

[8] Ibid.

[9] San Francisco Human Rights Commission. Bisexual Invisibility: Impact and Recommendations: 1.

[10] Miller, Marsha, Amy André, Julie Ebin, & Leona Bessonova. Bisexual Health: An Introduction and Model Practices for HIV/STI Prevention Programming  (Washington, DC: National Gay and Lesbian Task Force Policy Institute, the Fenway Institute at Fenway Community Health, and BiNet USA, 2005): 4.