The “B” has often been left out of LGBT research; studies that lump together LGBT people when comparing them to heterosexual people often overlook the unique experiences of each population, particularly the “B” (and the “T ”). Research that does explore the health of bisexual people indicates that bisexual people often have poorer health outcomes compared to both lesbian and gay populations and heterosexual populations (1). This is particularly the case for bisexual women (2). The poor health outcomes of bisexual people may be attributed to biphobia and the impact of myths and stereotypes about bisexual people (i.e., that bisexuality is a phase or a transition; that bisexual people can’t make up their minds; that bisexuality isn’t a legitimate sexual identity; that bisexual people must have a 50/50 attraction to men and women; that bisexual people are dishonest, promiscuous, or cheat on their partners).
Our definition of bisexual includes people attracted to more than one sex and/or gender. This may include those who self-identify as bisexual, queer, pansexual, omnisexual, two-spirited, fluid, or who choose another non-heterosexual identity label.
Understanding the context of bisexual mental health
We conducted a qualitative study with 55 bisexual people from across Ontario to learn more about their experiences of mental health services and care (3-5). From our pilot study, Understanding the context of bisexual mental health, we learned that bisexuality was dismissed, made invisible, and at times, degraded based on assumptions and stereotypes: “The stereotype is that bisexuals are confused, because they don’t know who they are, and what I’ve actually realized is that society is confused, because they don’t know who we are.” Participants of our pilot study described how their family members and friends similarly expressed these assumptions about bisexuality, resulting in challenges maintaining supportive relationships: “My sister said to me . . . I would prefer it if you were just my gay brother, and not this slutty person who just sleeps with everyone.” While many participants noted the benefit of supportive friends and the value of access to a community of other bisexual people, some reported experiences of biphobia associated with involvement in predominantly gay and lesbian communities: “I remember being at a party…a bunch of people started talking about someone who wasn’t at the party, and why wasn’t she there. And she had ‘turned straight’ and was dating a man.” Finally, some participants discussed how they too internalized common beliefs about bisexual people, as they worked to understand and accept their bisexuality. Participants described self-acceptance as essential to their mental health: “I’ve found that my biggest struggle over the years was accepting myself. And then once I did that, I felt a lot less weight on my shoulders.” In short, our pilot study revealed that bisexual people perceive experiences of discrimination as important determinants of mental health problems.
With regard to bisexual people’s mental health service use, the participants of our pilot study reported negative experiences with providers who they perceived as being uneducated around bisexuality; who made judgments about their clients’ sexual identity or practices; who pathologized bisexuality; or who focused exclusively on the client’s identity to the exclusion of other issues considered relevant by the client. The experiences of the participants in this study are consistent with previous findings that, while most providers no longer view same-sex behaviour as inherently pathological, some still express attitudes and beliefs toward gay, lesbian, and bisexual clients that may decrease the likelihood of a positive outcome from therapy. These negative experiences with mental health providers reflect many of the common social beliefs about bisexuality that have been described as prevalent in the society at large. It appears that some mental health providers have internalized the same beliefs and ideas about bisexuality that have been reported to be problematic for bisexuals in the context of other social relationships (i.e., with family members, friends, partners and potential partners). The resulting negative encounters sometimes led bisexual people to terminate their relationships with providers, which could contribute to the elevated likelihood of bisexual people having unmet health and mental health care needs relative to people of other sexual orientations.
Pilot Study Project Team
Principal Investigators: Lori Ross and Anna Travers
Co-Investigator: Cheryl Dobinson
Funded by the Centre for Addiction & Mental Health
Community Research Capacity Enhancement Program
Please visit our Projects page to learn more about our research:
- Risk and Resilience among Bisexual People in Ontario: A Community-Based Study of Bisexual Mental Health
- Pathways to Effective Depression Treatment
- Creating our families: A pilot study of the experiences of lesbian, gay, bisexual and trans people accessing assisted human reproduction services in Ontario
- Access to primary care for people with serious mental health and/or substance use issues: A qualitative study
Please visit our Resources page for more resources about bisexual health and parenting.
2. Steele, L.S., Ross, L.E., Dobinson, C., Veldhuizen, S., & Tinmouth, J. (2009). Women’s Sexual Orientation and Health: Results from a Canadian Population-Based Survey. Women & Health, 49(5), 353-367.
3. Canadian Mental Health Association, Ontario. (2010). “Study explores bisexual people’s experiences with mental health services in Ontario”.
4. Ross, L.E., Dobinson, C., & Eady, A. (2010). Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health, 100(3), 496-502, doi: 10.2105/AJPH.2008.156307.
5. Eady, A., Dobinson C., & Ross, L.E. (2010). Bisexual peoples’ experiences with mental health services: A qualitative investigation. Community Mental Health Journal, doi: 10.1007/s10597-010-9329-x.