Being bisexual can impact your mental health. Here's what you can do about it.

[NelsonG]

"I’ve never said this to anybody," a bisexual person who requested anonymity confessed in my Twitter DMs. "I’m so sorry if it sounds like a drama."

It didn't sound like a drama at all — not to me, at least. This person, who reached out to me after a call-out I tweeted for this story, said it was difficult to accept her bisexuality. She began questioning whether she liked women at age 11, but went to great lengths to hide this attraction from her parents. That's when her anxiety began; it only heightened as she matured, which led to weight loss.

She continued to suppress her attraction to women, even undergoing plastic surgery to appear more desirable to men. "Proving I didn’t like women was something that really hurt me," she said. She tried to deny her own bisexuality because she was never in love with a woman, "but then when I fell for one I knew — as always — I wasn't straight… In my heart I always knew I was bisexual."

This inner tug of war is one I know personally, and one some of the other bisexual people I spoke to experienced as well. The anxiety and other mental health impacts bisexuals face is evident in data, too.

According to a 2011 report from the San Francisco Human Rights Commission (HRC), bisexual people have a greater likelihood of depression, anxiety, and other mood disorders. More recent data supports these figures, as well. The Journal of Affective Disorders published a paper that concluded that "Bisexual individuals are at greater risk of poor mental health than lesbians and gay men" in Jan. 2020.

In a factsheet on mental health of bisexual populations released at the beginning of this year, the American Psychiatric Association explained that bisexuals report increased experience of depression or suicide in comparison to monosexuals (hetero or homosexual). Substance use rates are also higher. In August, the University of Manchester released a study that claimed bisexual people are six times more likely to self-harm than people of other orientations.

Multiple bisexual people I spoke to mentioned anxiety and depression, and two mentioned suicidal ideation. "I've contemplated death before because I truly felt like I was broken," one said. What is it about being bisexual that impacts mental health — and what can we do about it?

The data doesn't always capture the true picture

These statistics are alarming, but could be at least partially explained by the way research is conducted on bisexual people. It comes down to the difficulty researchers have correctly identifying the population they're trying to study, and with an indeterminate group like bisexuals, that's easier said than done.

Dr. Geoffrey Ream, an associate professor at Adelphi University’s School of Social Work who has conducted research on suicide rates of LGBTQ youth populations, explained to Mashable that researchers decide to code subjects as bisexual using various methods. The HRC data, for example, deals with people who self-identified as bisexual. But other studies code people based on how they answer questions about behavior and attraction — say, whether they've had sex with members of their or other genders.

Dr. Sarah Noble, author of the APA's factsheet, told Mashable that research on bisexuality is difficult to capture in general. "The thing about sexuality is that there is fantasy and attraction, there's sexual behavior, and there's sexual identity," said Dr. Noble. "Demarcating those different aspects of sexuality is often complicated and not necessarily perfectly identified for every study." Thus, each study isn't comparable, according to Noble.

So while the coding issues can certainly lead to self-identified bisexual people and "coded" bisexual people being lumped together, this is ultimately okay. "You're always working with imperfect data," Ream said. He quoted his PhD advisor Ritch Savin-Williams, who specializes in LGBTQ research: "Something Ritch always told me is that you can never get a representative sample of a stigmatized and invisible population." Therefore, you combine different sources. Ream continued, "So you take a bunch of different data sources and triangulate. Or quadrangulate. Quintangulate, even."

bisexuality mental illness Credit: bob al-greene / mashable

Recruiting can also be a roadblock

Sarah Jen, assistant professor in the school of social welfare at the University of Kansas, agreed with Ream about the imperfect nature of the data. Jen, who worked on the Aging With Pride study, the largest study of LGBTQ midlife and older adults in the U.S., told Mashable it's why we need more bisexual-specific research. "Recruitment methods that we use for LGBTQ communities broadly aren't as generalizable and aren't as reflective of the full diversity of the bisexual population," she said.

Jen also pointed out that non-monosexual people are more likely to use multiple terms to identify themselves, such as queer, pansexual, and omnisexual. This further impacts bisexual representation in research.

Another factor is that many studies on queer people use LGBTQ community organizations to help with recruitment. "Bisexual people have historically and continue to say that they don't feel as welcome and they don't feel as much of a sense of belonging in those spaces," said Jen, "because they've faced bi negativity or biphobia…and they don't feel like that space is for them."

The result, Jen argued, is that researchers are missing a large swath of people who not only identify as various non-monosexual terms, but also those people who don't identify as any of those but still exhibit "bisexual behaviors" (i.e., having sex or dating people of both their and other genders), histories, and romantic relationships throughout their lives.

"It's really hard to recruit people that way," Jen said. "How do you write a recruitment statement that says, 'Have you ever done all of these things?'"

While bisexual people are the largest self-identified group within the LGBTQ community, the proportion of bisexual-focused research is small. Ream said this conglomeration of bisexual data results in skewed mental health research. Jen argued that, if anything, we're not getting the full picture.

Although bisexual data is imperfect, as Ream reiterated, researchers are always working with imperfect data when it comes to sexual orientation. This doesn't invalidate the studies done on the bisexual population; if anything, it's proof that more bisexual-focused research needs to be done. For now, the data and resulting statistics — worrisome ones at that — are all we have.

The unique, but shared, mental health experiences of being bi

Regardless of how complicated it is to gather "true" data on the bisexual population, it's clear that bisexual mental health is distinct from that of monosexuals.

Minority stress theory, developed by Ilan H. Meyer, can contribute to this. The theory states that instances of social stigmatization don't directly lead to mental health problems. Rather, these instances result in stress for the minority, and this stress accumulates over time. This accumulation can lead to long-term mental health concerns. (As one can imagine, this theory extends to other minority groups as well.)

Minority stress stems out into external stress (distal) and internal stress (proximal). An example of distal stress is a bisexual person being told they're lying, or that their sexuality doesn't exist. An example of proximal stress is internalized biphobia, or not even coming out at all for fear of backlash.

"Minority stress falls very hard on bisexual folks," said Noble. Tricia, a bisexual grad student I spoke to for this piece, said she's felt weighed down by internalized biphobia, and biphobia in general.

Biphobia, bi-erasure, and monosexism — the belief that people can only be straight or gay — exist in both the straight and LGBTQ communities. As I discussed in my piece on feeling "queer enough" earlier this year, bisexuals may not feel at home in either because of these factors. "Part of identity development is finding your people, and that's particularly difficult for bisexuals," said Ream.

Tricia said she feels like an invalid member of the LGBTQ community. Recognizing her privilege as someone white, cis, and in her words "extremely straight passing," she's been reluctant to make space for herself. "I’ve found that in my efforts to make space for and pass the mic to members of the LGBTQ community whose sexualities overlap less with heterosexuality than mine does, I don’t make any space for myself at all," she said. "And that constant self-invalidation really takes a toll on me."

"Minority stress falls very hard on bisexual folks."

Another bisexual woman, Julia, feels similarly. "Because I’m femme, I’ve been lucky to not stand out and get bullied or harassed," she said. "But I feel like I don’t deserve to be in queer spaces or even call myself bi." Some members of her family have also accused her of "faking" her bisexuality.

Our culture struggles with things that don't fit into neat boxes, according to Noble. "We as a culture have come to accept homosexuality," she said, as it is a "box" that is the opposite of heterosexuality. Bisexual people — as well as those who don't fit into the gender binary like nonbinary and trans people — don't fit into these boxes society has constructed.

Society's black-and-white thinking impacts stigma against bisexuals, who occupy the gray area, Jen said, and also people's ability to understand the bisexual experience.

"It leads to some sense of othering," she said. "We can't understand an identity [so we think] we shouldn't adhere [to] it…when it doesn't fit into our cleanly-cut categories, we don't know how to make sense of it."

Jordyn, another bisexual I spoke to, said that people told her her sexuality was "wrong" and "didn't work like that." When Jordyn confided in some straight female friends, they stopped talking to her. "They were scared I would try to hook up with them," Jordyn told me. "Some even started spreading rumors about me trying to kiss them or claiming I confessed my feelings to them (which never happened)."

Jordyn fell into a depression and had anxiety attacks whenever someone questioned her sexuality or tried to discuss it with her.

When Jen herself came out as bi in college and started to find a queer community, she remembers being told that bisexuals were "doing fine" due to factors like passing privilege, the ability for some bisexuals to "pass" as straight in everyday life and thus avoid discrimination people who "look queer" face. "What we end up finding through Aging With Pride was just the opposite," she said. "Some of our bisexual participants reported more mental health concerns than the lesbian-identified and gay-identified participants we were talking to."

It doesn't help matters that there's been a debate about whether bisexuality exists within the scientific community itself. Until recently, according to Ream, medical sexologists couldn't observe bisexual arousal in a lab and thus argued it doesn't exist. That is, until last month when scientific journal PNAS published "Robust evidence for bisexual orientation among men" which shows — surprise! — that bisexual arousal, particularly in men in this study's case, does exist.

"Took you long enough," Ream joked.

Unfortunately, however, scientific proof doesn't erase the stigma against bisexual people. Jen pointed out that bisexual people experience both invisibility and hypervisibility, which she defined as negative depictions of bisexuality like hypersexualization.

Jordyn experienced hypersexualization by way of her ex-boyfriend, who called her a slut when she tried to explain her bisexuality. "[He] said I only enjoyed being with women because I am trying to impress more men," she said.

Ashley, another bisexual woman I spoke to, also experienced this. "I felt fetishized by my cishet ex who I began dating during a depressive episode sophomore year of college," she told me. This came after her first bout of depression her freshman year, when her former abuser threatened to out her. Because of experiences like this as well as her biphobic/homophobic family, Ashley kept her bisexuality a secret until this January; she's still not out to her family.

The need for bi spaces and positive framing

"I believe it’s important to note that my depression exists outside of my sexuality," Ashley said. "However, it is at times worsened by the difficulty I’ve had navigating life as a bisexual person and as part of a greater community at large."

Despite it being 2020 — and despite bisexuals being a large portion of the LGBTQ population — biphobia exists even in the "woke" corners of the internet. Last month, for instance, a now-deleted viral tweet stated, "I understand the argument against biphobia, but I also understand the argument for lesbians not wanting to date bisexual women. Man Residue™ is a real thing that affects the relationships of all women who deal with men romantically."

man residue tweet Credit: thotscholar on twitter

In addition to biphobia, this tweet displays transphobia (some trans men identify as lesbians); trans misogyny (the specific hatred of trans women) if "Man Residue™" refers to sperm and a woman has a dick; and ignorance of compulsory heterosexuality, the assumption that women are attracted to men due to society's push of heterosexuality (so some lesbians may have sex with men before figuring out they're lesbians). The user acknowledged their biphobia and continued to be biphobic. This tweet encapsulates some of the othering bisexuals experience in the queer community, as if bisexual women are somehow tainted by their experiences with cismen.

"I hate the idea of being considered a queer tragedy because my life has been full of joy that I’m lucky to have experienced," Ashley said. "I don’t think my sexuality makes me tragic, but I do think it’s tragic that I'm not alone in struggling with how it impacts my mental health, or lack thereof, and how I simultaneously don’t receive the care or support I deserve in order to healthily cope."

Resources for handling bisexual minority stress

So how can bisexual people cope with minority stress, with either external or internal cries that their sexuality is wrong, or that it doesn't even exist?

For Bisexual Awareness Week 2020, The Trevor Project released a guide on How to Support Bisexual Youth. The guide not only breaks down bisexuality and biphobia, but also offers ways to support and celebrate one's bisexuality — which, in my opinion, is useful for anyone, young or not.

All my expert sources recommended that bi people find their own community, their own space, their own people. During the pandemic, making friends online can arguably be smoother than ever. If you don't know where to start, VICE made a helpful guide on how to make more LGBTQ friends.

While this may run the risk of being a negative experience — as seen above, biphobia does exist within the online queer community — you can focus on, say, the "#bisexual" TikTok tag, or peruse through Twitter trends like #beautifullybisexual that highlight bisexual people specifically.

"I don’t think my sexuality makes me tragic, but I do think it’s tragic that I'm not alone in struggling with how it impacts my mental health."

What's more is that bisexual people can have a meaningful role in the broader queer community, according to Jen. Focusing on our commonalities with other queer people, regardless of orientation or expression, can lead to community building. Further, those who have access to passing privilege can act as allies and advocates to queer people who don't, Jen said.

The knowledge that you're not alone anecdotally — in my and others' experiences, that is — can be not only reassuring, but freeing as well. An anonymous bisexual said it was a cathartic experience when they spoke to queer friends they made through the Doctor Who fandom on Tumblr.

Jordyn told me that before she graduated college, she met a girl who was struggling in the same way she was. "It was in that moment I realized I was not alone," she said. "We helped each other find our way and understand that there's a whole world of people out there struggling to understand and find acceptance for their sexuality."

While Jordyn hasn't fully come out yet, she's no longer ashamed of who she is. She said, "I've surrounded myself with people who love and accept me for me, and I'm so grateful for that, and I hope everyone in the world struggling to find themselves understands they're not alone."

Jen advises building a network for yourself, as one fellow bisexual may relate to certain parts of your experience but not all, and that's okay. As we were chatting on the phone, for instance, Jen said we both can relate and talk about passing privilege — but as she's married and I'm single, we don't relate on that level.

Jen also said there are ways bisexual people can positively internally process their identity. When she performed a study on older bisexual women in 2018, she observed that they described their identities negatively. Their bisexuality created a division; it made their lives more challenging, especially relating to lesbians — it was like a political and emotional divide they couldn't cross.

But when they perceived bisexuality as a life, as a way of living — not just an identity — it was seen positively. "It allowed for capacity, openness, fluidity," Jen said. The word that came up most often was freedom.

Internalized biphobia (or queerphobia or homophobia), like any ingrained belief, takes time to unlearn — but that doesn't mean it can't be done. Jen suggests positive reframing, as these subjects reframed their bisexuality. You can do this yourself, or seek guidance of a queer-affirming therapist if you have access to one.

"It allowed for the freedom of a non-traditional life," Jen said. "And I think whenever we come against identities where there isn't a script for how to be, there isn't a way laid out for us, that actually gives us a lot of potential to lay our own path."

This isn't to say positive reframing is a sudden cure-all for anxiety and depression, or that bisexual people going through mental health struggles shouldn't seek help. But, like community building, reframing is a step bisexual people can take to affirm themselves, to see their sexuality as something other than an affliction."

"Folks could see [bisexuality] as a freedom, as a capacity that they have," said Jen. "One woman actually described it as a superpower that most people didn't have, but that she had, to see the world in a more open way."

If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. For international resources, this list is a good place to start.

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