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issue Summer 2022

Invisible and Stigmatized: What Unique Health Disparities Affect Bisexual Individuals?

By Brian A. Feinstein, PhD

Nationally representative surveys reveal that 3% of adults and 6% of adolescents in the United States identify as bisexual, and these numbers are on the rise. Of concern, bisexual people are disproportionately affected by a range of adverse health outcomes, such as depression and anxiety and suicidal thoughts and behaviors, compared to both heterosexual and gay/lesbian people. These health inequities are rooted in the stigmatization of bisexuality. In the United States, societal acceptance of gay/lesbian people has continued to increase over the past two decades, whereas attitudes toward bisexual people are often negative and remain neutral at best.

As the director of the Sexuality, Health, and Gender Lab at RFU, I lead a team of researchers committed to understanding and addressing the health inequities affecting the bisexual community. Our research has identified unique forms of stigma affecting bisexual people, such as: beliefs that they are confused about their sexual orientation; stereotypes that they are promiscuous and unfaithful in relationships; assumptions that they are heterosexual or gay/lesbian based on the gender of their partner; and pressure from their partners to stop identifying as bisexual. Further, our research has demonstrated that these and other forms of bisexual stigma contribute to adverse health outcomes noted above as well as other psychosocial consequences (e.g., the internalization of negative societal attitudes, expectations of future rejection, concealment of one’s identity).

In recent years, researchers have developed interventions to improve the health of sexual minority people, but there has been a lack of attention to bisexual people in particular.

In recent years, researchers have developed interventions to improve the health of sexual minority people, but there has been a lack of attention to bisexual people in particular. This is problematic for several reasons: bisexual people do not benefit as much as gay/lesbian people do from existing interventions; bisexual people describe negative experiences with healthcare providers; and clinicians report lower competence for affirmative practice with bisexual clients compared to gay/ lesbian clients.

To begin to address the need for affirmative interventions for bisexual people, my colleagues and I have described a multilevel approach for improving bisexual people’s health; we have identified intervention preferences among bisexual men and treatment targets to improve sexual health among bisexual male youth; and we recently developed and tested a sexual health promotion program for bisexual adolescents.

I hope you will join me in taking action to challenge bisexual stigma, to celebrate sexual diversity and, ultimately, to create a more inclusive and affirming society for us all.

Individual interventions have the potential to improve bisexual people’s health, but structural interventions are needed to directly address the root of the problem — societal stigma. Moving forward, we can all be a part of the solution by:

  1. Engaging in self-reflection: What do you believe about bisexuality? Are any of your beliefs reflective of the stereotypes noted here?
  2. Learning more: You can begin to challenge stereotypes that you may have accepted as facts and you can prepare yourself to be a better ally.
  3. Challenging stigma: If you hear someone express a stereotype about bisexuality, let them know it’s harmful. The burden of intervening in situations like this typically falls on bisexual people themselves, which further contributes to health inequities.
  4. Celebrating bisexuality: Bisexual people describe a host of positive experiences related to their sexual orientation (e.g., not feeling limited by gender when it comes to romantic and sexual experiences). Supporting bisexual people not only involves challenging stigma, but also celebrating their unique strengths.

Dr. Brian Feinstein is an associate professor in the Department of Psychology and the director of the Sexuality, Health, and Gender Lab at RFU. His program of research focuses on identifying, understanding, and addressing the health inequities affecting sexual and gender minority populations across the lifespan, with a particular emphasis on bisexual people. He is also a licensed psychologist in Illinois.

Opinions expressed in "Through the Microscope" columns are solely those of the authors and are not intended to represent those of Rosalind Franklin University.

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