Currents

After long being overlooked or amalgamated with LGBT issues as a whole, the tide is turning when it comes to bisexual health. There has been an increasing focus in recent years on the health issues bi people face and how to address them. The latest research on the topic comes from Anglia Ruskin University and the Brighton and Sussex Medical School, which led an analysis of more than 835,000 adults in England. What they found is that bi people experience poorer physical and mental health outcomes compared to any other sexuality. The study paints a disheartening picture to be sure, but when pieced together with other research in the field, we can see a path forward. It's clear that bi health issues and disparities are finally being taken seriously, and the groundwork for improving them is being laid.

In the last few years, we’ve seen a wealth of studies document a dreary outlook for bi people and their health. Rice University concluded that bi people are more likely to live in poverty or have poor health than other groups. The UK’s Office of National Statistics likewise found that bi folks are more likely to suffer from mental health issues and are 40% more likely to describe themselves as unhappy. While some may be inclined to despair in the face of such research, there is ample reason for optimism. The first step to solving a problem is admitting that there is one. Yes, there are negative health disparities at the moment, but with a little focus and investment, we can solve these issues — and 2023 may be the turning point.

One of the problems in this area of research is that it’s difficult to tell if bi health outcomes are getting better or not. While studies on public health commonly look at demographics such as age, sex, ethnicity, and nationality, data broken down by sexual orientation has been comparatively scarce. Studies on specific facets of bisexual health have also not been repeated regularly enough to get a good sense of the direction in which trends are moving. From what we do know, however, it’s clearly not all bad. We know, for example, that there has been a 71% drop in HIV among gay and bisexual men between 2012 and 2018 alone. Rates have fallen so much, in fact, thanks to public safety campaigns and the wider availability of PrEP and other prophylactics, that HIV now infects fewer gay and bi men in the UK than it does heterosexual people.

Given the fact that gay issues tend to attract more attention than bi issues, however, it’s worth pointing out that we probably only know about these stats because they also affect gay men. If it were a bi-specific issue, we would likely not have such regular reporting. It would be great to see research looking at bi health conducted annually by one body that could chart improvements and declines, and for health researchers generally to begin including breakdowns by sexuality as commonly as they do by race. This would give us a much more robust understanding of bi health and allow us to quickly see if our approaches to improving the situation were having the desired impact.

As we increasingly accumulate data suggesting that we need a tailored approach to bisexual healthcare, we must address how and why bisexuality could correlate with negative health outcomes to begin with.

Reflecting on my own experience, those early years after realising I was bi were a very stressful time. Not exactly knowing where you belong, falling in between the more visible straight and gay communities, and facing stigma and bias, unhealthy behaviours can become a way to help cope. They were for me. When you feel that society has an issue with your bisexuality, a night out drinking can take your mind off it; a cigarette can take the edge off. Grabbing some unhealthy food at 3 a.m. on the way to a secret hook-up becomes a way of life. Thankfully for me, as I became more comfortable in my own skin, I became less ashamed. My bisexuality was no longer something I had to cope with — it was something I was proud of. That is just my experience, but the research does seem to suggest that the stress associated with bisexuality can directly encourage unhealthy behaviours.

The American Journal of Preventive Medicine found that bisexual people had almost double the rate of past-year alcohol use disorders compared to straight people. Another study titled “The Pot at the End of the Rainbow” reported that young bi people not only use cannabis more frequently but are also more likely to use it to self-medicate mental health issues. Similarly, the University of Manchester found that bisexual people are up to six times more likely to engage in non-suicidal self-injury compared to other sexual orientations. Symptoms of anxiety and depression were often associated with self-injury in bi people, who also experienced more physical assaults, bullying, and feelings of not belonging.

These are just some of the many studies that suggest coping with biphobia can be a gateway to unhealthy activity. What is important here is that the case is now undeniable that bi people face negative health outcomes more often than other groups. The next step is for healthcare professionals to begin developing tailored approaches to improve the situation.

From my own travels, I have seen how much room for improvement there is in the healthcare system. From a therapist who seemed to want to avoid using the word bisexual, to a sexual health nurse who seemed shocked that I'd had sex with both men and women, I know firsthand that bisexuality is often not understood by healthcare professionals. My experience isn’t uncommon, either.

As a result of all the naysaying by the general public and sexologists alike, male bisexuality has even been put through the wringer of being tested in the lab to demonstrate that bisexual arousal actually exists in men. While the bi community let out a collective groan that such a study even happened in the first place, it did fill in a gap and address many people’s blindspots. Still, a report by the London Assembly Health Committee found that bi people report that their sexuality is frequently misunderstood or simply erased by doctors and medical staff. Similarly, Stonewall’s LGBT in Britain Health report, found that while 19% of LGBT people aren’t out to any healthcare professional about their sexual orientation, the number rises to 29% of bi women and 40% of bi men. This can be easily fixed by ensuring that healthcare professionals are educated on bisexuality and understand that greater attention to the bi health gap could dramatically reduce health disparities. Creating programs that bi people could be signposted to where they know that they will not be made to feel uncomfortable and also receive help customised especially for them, can also be a difference-maker.

When it comes to LGBT groups, these recent bi health studies should help lead to more funding. Bi organisations are severely underfunded relative to orgs that serve the LG and T. Imagine the progress that could be made toward addressing biphobia and bi erasure in healthcare if we began to significantly close this money gap. We can all play a role in this. If everyone reading this asks, “Tell me about your specific bisexual health programs” the next time we come across an LGBT organisation, it will shift the dial. They’ll come to recognise that if they want to keep calling themselves an LGBT organisation, bi health needs to be moved up the agenda.

More people are out and proud about their bisexuality than ever before. We have become more visible in popular culture, and more visible to health researchers. The time to act is now. With a bit of pressure, we could be on the verge of a sea change that could help the next generation of bi folks enjoy better health and well-being. Yes, we can choose to view the current statistics as depressing, but we could just as easily view it as a challenge accepted. The LGBT community has achieved incredible progress over the past few decades. There’s no reason we can’t tackle the bi health gap too. If we seize this moment and transmute grievance into action, we can build on past successes and check off another victory in the “win” column.

Published Sep Sep 26, 2023