What does your sexual orientation mean for your health?
More and more ladies are opening up about their bisexuality, according to a national survey by the Centers for Disease Control and Prevention that was released last month. Over 5 percent of women said they're bisexual this time around, compared with 3.9 percent when the survey was last conducted in 2011. But being bisexual can still be a struggle. "When one identifies as straight or gay, it's easy to find a community that's accepting, but with bisexuals, there are fewer opportunities," says Aron C. Janssen, M.D., clinical assistant professor at NYU Langone Medical Center, who specializes in gender and sexuality. "Bisexuals often find stigma and bias from both groups."
What's more, researchers from the London School of Hygiene & Tropical Medicine surveyed almost 1,000 bisexual women and over 4,500 lesbians in the UK and found some major demographic differences between the two groups—namely that bisexual women were younger and less well off financially than lesbians. More serious mental health differences surfaced too. Compared with lesbians, bisexuals were 64 percent more likely to report eating issues, 26 percent more likely to feel sad or depressed, and 37 percent more likely to have inflicted self-harm in the past year. (Did you know that the combination of exercise and meditation can reduce depression?)
It's hard to make a sweeping generalization of why these issues affect bisexuals more than lesbians or heterosexuals since plenty of bisexuals are perfectly happy. But double discrimination coming from both straight and gay communities plays a big role. "There's a concept called minority stress in which being a disadvantaged minority leads to increased stress and that can lead to poor outcomes in mental health and medical domains," says Janssen.
In many cases, this stress can be traced back to adolescence. Bisexuality, even more than homosexuality, can lead to bullying at school. "Often, early childhood trauma can predict traumatic experiences in adulthood," says Janssen. "If you're abused in childhood, you're more likely to continue that cycle in adulthood and find yourself in a relationship where you're the victim of abuse." Over 46 percent of bisexual women experience rape in their lifetime, according to the most recent National Intimate Partner and Sexual Violence Survey from the Centers for Disease Control and Prevention. That's a significant increase from the 13.1 percent of lesbian women and 17.4 percent of heterosexual women that do.
On top of it all, nearly a quarter of bisexuals don't have health insurance, compared with 20 percent of heterosexuals and 17 percent of lesbian or gay individuals, finds a report from the Kaiser Family Foundation. This may be due to differences in income or simply an unawareness of the insurance options out there, says Alina Salganicoff, Ph.D., vice president and director of women's health policy at the Kaiser Family Foundation.
Luckily, bisexual women can take several precautions to protect themselves—and their health—against these risks.
The good news is the act of getting insurance has gotten easier thanks to the Affordable Care Act and the overturning of the Defense of Marriage Act, says Salganicoff. It's now against the law to deny insurance based on a pre-existing condition—such as a mental illness or an HIV infection. And bisexuals now have increased coverage among same-sex partners with employers; the overturning of the Defense of Marriage Act means same-sex couples who are married can benefit from their partner’s health insurance. And the outlook of the uninsured might not be as grim as it seems. The data we have is from before the Affordable Care Act and the turning down of the Defense of Marriage Act really had an effect, Salganicoff says. These days, it’s easier to get insured, so it’s likely there are fewer uninsured bisexual women than there were in 2013.
Protect Your Mental Health
Take it a step further and protect yourself mentally too. "The goal with any individual treatment plan is that it is individualized," says Janssen. That means being treated for mental health, whether you're bisexual, straight, or gay, should be approached with the same personalized care. There are also ways to boost your mental health outside of a doctor's office. Bisexuals are less likely to come out to their friends and family because they feel more of a stigma, according to the UK researchers. Coming out to friends and family could be a positive move—and help the bisexual community on a larger level. "Stepping forward and saying, 'This is my identity,' will help break down those barriers," says Janssen. "Building a community of bisexual individuals is a really important thing, and it's important to be open and honest about who you are." (Health Concerns? The Best Online Support Systems.)
Guard Against Domestic Violence
Bisexual women who have been abused in the past should treat their increased risk for domestic violence the way women with a lineage of breast cancer history do: by recognizing the risk and taking extra precautions to stay safe, says Salganicoff. If a violent relationship already exists, straight, lesbian, and bisexual women alike should dial the domestic violence hotline at 800-787-3224 to put a safety plan into motion.