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Sexual Orientation

4 Stressors That Impact Bisexual+ Mental Health

Bisexuality is real, and so is biphobia.

Key points

  • Bisexual plus (bi+) people have the highest rates of mental health struggles, depression, and suicide.
  • Bi+ stressors include "double discrimination" and bi-erasure.
  • To combat these stressors, bi+ people can seek out LGBTQ+ or bi-affirmative environments and resources.

March is Bi+ Health Month, an annual mission of the Bisexual Resource Center and allied organizations to spread awareness about the many health disparities faced by the bisexual plus (bi+) community (i.e., people who identify as bisexual, pansexual, fluid, etc.). Within the LGBTQ+ community, bi+ people face unique experiences and stressors that can negatively impact their mental health.

If you’re a bi+ person (or know and love a bi+ person), you should be aware of these unique stressors. Understanding and addressing them could help you improve your mental health.

Background on LGBTQ+ and Bi+ Mental Health

LGBTQ+ people face higher rates of mental health struggles compared to heterosexual and cisgender people [1]. Research repeatedly demonstrates that these mental health disparities are not due to some underlying mental illness related to being LGBTQ; rather, they appear to be caused by minority stress—the personal discrimination and stressful experiences that LGBTQ+ people face in homophobic and transphobic cultures [2].

Notably, bi+ people seem to have the highest rates of mental health struggles, including depression, suicide, and nonsuicidal self-injury [1, 3]. Again, research supports the idea that these disparities are caused by unique minority stressors that bi+ people face [1, 3, 4]. Let’s break some of these down.

Bi+ Stress 1: Double Discrimination

While all LGBTQ+ people face discrimination related to homophobia/heterosexism and transphobia/cissexism, bi+ people face specific prejudice related to biphobia and monosexism. Monosexism is the belief that attraction to people of one gender (i.e., heterosexuality or homosexuality) is more legitimate, more valid, or better than being attracted to people of multiple genders.

It leads to inaccurate beliefs such as bisexual people are greedy, promiscuous, or untrustworthy; these beliefs lead to bisexual people experiencing discrimination at fairly high rates at the hands of heterosexual people and lesbian/gay people [3, 4, 5]. This experience of prejudice within/from both straight and queer communities is called double discrimination.

Bi+ Stress 2: Internalized Binegativity

Many bi+ people struggle with internalized binegativity, or internalized monosexism, as a result of repeatedly facing biphobic and monosexist discrimination. If a person hears negative messages about themselves enough, they can start to believe them. When bi+ people have internalized the messages that bisexuality is immoral, wrong, or unnatural, they report higher levels of mental health difficulties like depression and anxiety [6]. Bi+ people can experience internalized binegativity on top of any internalized heterosexism or internalized cissexism they also experience.

Bi+ Stress 3: Bi-Erasure

Monosexism fuels another specific pattern of prejudice: bi-erasure or bi-invisibility. There are many cultural messages that bisexuality is only a phase of experimentation. Bi+ people are often told that they’re just too afraid to come out “all of the way,” that they’re “actually straight’ or “actually gay,” or that they’re “trying to be trendy” by identifying as bisexual [3].

Similarly, bi+ people are usually assumed to be straight when they’re dating people of the opposite gender or assumed to be gay when with people of the same gender. These statements and assumptions remove or explain away evidence of bisexuality. Bisexuality+ is real, but bi+ people often face experiences that deny, ignore, or invalidate their lived experiences. Invalidation is particularly tied to mental health difficulties [7].

Bi+ Stress 4: Identity Uncertainty

Again, if you hear something enough, you may start to believe it. Many bi+ people struggle with identity uncertainty, uncertainty that their chosen bi+ identity is accurate or appropriate. Bi+ people may struggle with feeling “queer enough” for queer spaces, or they may worry that they are “faking” being bi+. Particularly when dating someone of the same gender, they may doubt their queer attractions and identities based on the bi-erasure they experienced. This identity uncertainty is inherently stressful, and it can cause bi+ people to disconnect from the queer community. Both of these can harm bi+ people’s mental health.

What Bi+ People Can Do About Stressors

Of course, bi+ mental health would likely improve if we eliminated all monosexist, heterosexist, and cissexist messages, laws, and systems in our communities and societies. In the meantime, bi+ people can also improve their mental health in a few ways.

First, research shows that bi+ people benefit from being a part of LGBTQ+ communities [4, 8, 9]. Given double discrimination, bi+ people may particularly benefit from being a part of bisexual-specific communities. Regularly participating in a bi+ community may help reduce the mental health impact of biphobia and monosexism [9].

Second, bi+ people may enjoy and benefit from reading books or watching TV shows with realistic, positive bi+ characters [3]. Observing bi-affirmative messages may help bi+ people feel more connected or validated in their queer identities. Increasing pride in one’s LGBTQ+ identity is associated with positive impacts on mental health [10].

Finally, bi+ people may benefit from attending therapy with a licensed mental health professional. Many evidence-based therapies, particularly delivered by LGBTQ-affirmative therapists, can help bi+ people overcome various mental health struggles and feel more comfortable with and proud of their bi+ identities. The Psychology Today therapist directory is one option for finding therapists, and it has the option to search for therapists who explicitly identify as bi+ or bi-affirmative.

References

1. Mongelli, F., Perrone, D., Banducci, J., Sacchetti, A., Ferrari, S., Mattei, G., & Galeazzi, G. M. (2019). Minority stress and mental health among LGBT populations: An update on the evidence. Minerva Psichiatrica, 60(1), 27-50.

2. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological Bulletin, 129(5), 674.

3. Doan Van, E. E., Mereish, E. H., Woulfe, J. M., & Katz-Wise, S. L. (2019). Perceived discrimination, coping mechanisms, and effects on health in bisexual and other non-monosexual adults. Archives of sexual behavior, 48, 159-174.

4. Persson, T. J., & Pfaus, J. G. (2015). Bisexuality and mental health: Future research directions. Journal of Bisexuality, 15(1), 82-98.

5. Friedman, M. R., Dodge, B., Schick, V., Herbenick, D., Hubach, R. D., Bowling, J., ... & Reece, M. (2014). From bias to bisexual health disparities: Attitudes toward bisexual men and women in the United States. LGBT health, 1(4), 309-318.

6. Paul, R., Smith, N. G., Mohr, J. J., & Ross, L. E. (2014). Measuring dimensions of bisexual identity: Initial development of the Bisexual Identity Inventory. Psychology of sexual orientation and gender diversity, 1(4), 452.

7. Hong, P. Y., & Lishner, D. A. (2016). General invalidation and trauma-specific invalidation as predictors of personality and subclinical psychopathology. Personality and Individual Differences, 89, 211-216.

8. Pollitt, A. M., & Roberts, T. S. (2021). Internalized binegativity, LGBQ+ community involvement, and definitions of bisexuality. Journal of bisexuality, 21(3), 357-379.

9. Lambe, J., Cerezo, A., & O'Shaughnessy, T. (2017). Minority stress, community involvement, and mental health among bisexual women. Psychology of sexual orientation and gender diversity, 4(2), 218.

10. Perrin, P. B., Sutter, M. E., Trujillo, M. A., Henry, R. S., & Pugh Jr, M. (2020). The minority strengths model: Development and initial path analytic validation in racially/ethnically diverse LGBTQ individuals. Journal of clinical psychology, 76(1), 118-136.

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