LGBT rights may be moving forward, but bisexual acceptance is trailing far behind.
That’s the harrowing message behind a new study from researchers at Drexel University, which found that young bisexual women score significantly higher on a survey measuring current suicidal thought than both straight women and lesbians.
The study, published in the Journal of Adolescent Health, analyzed responses from a survey distributed by primary care physicians to over 2,500 young people ages 14 to 24, dividing them by sexual orientation and measuring factors such as depression, anxiety, substance use, and suicidal ideation.
As lead author Annie Shearer, a research assistant in Drexel’s College of Nursing and Health Professions, noted in a press release, lesbian respondents were “actually no more at risk” than straight women for depression, anxiety, substance abuse, and current levels of suicidality.
“This may reflect an increasing societal acceptance of same-sex attraction and relationships,” she speculated.
But while the social acceptance of gays and lesbians increases, bisexual people seem to be excluded from these gains. Bisexual women in Shearer’s study reported significantly higher current suicide scores than any other orientation, lesbians included. Women who were unsure about their sexual orientation also reported more depression and anxiety than straight women.
In addition, Shearer’s team examined mental health outcomes among young gay and bisexual men, finding that they scored significantly higher on depression and traumatic distress surveys than their straight peers, with bisexual men reporting particularly high lifetime suicide scores.
In contrast to the women, differences between gay and bisexual men’s mental health were still present but not as stark, although it should be noted that men constituted a minority of the larger sample.
In an interview with The Daily Beast, Shearer called the results “sobering.” Poor mental health outcomes among bisexual women are not new, but her team’s study paints a particularly stark picture of the divides between them and lesbians.
“It’s one thing to hear about and another thing to see that there are these kinds of implications,” she said.
Her team’s study points to several possible explanations for this disparity. Bisexual people, they note, face “unique stressors such as stereotypes that bisexuals are promiscuous or that bisexuality is ‘just a phase.’” More troubling is the fact that bisexual people encounter these stubbornly persistent stereotypes both inside and outside of the broader LGBT community.
As The Daily Beast reported in January, a study published in the Journal of Bisexuality found that bisexual people reported experiencing different but still comparable levels of discrimination from lesbians, gay men, and straight people alike.
Not feeling at home in the LGBT community could be a major contributor to the mental health differences between bisexuals and other sexual minorities.
In their study, the Drexel researchers noted that “although the LGBT community has been shown to buffer against mental health problems in sexual minority populations, bisexual individuals may be less involved in this community because of perceived discrimination from gay and lesbian persons.”
“[S]ome people still refuse to acknowledge bisexual and other non-binary identities as legitimate, which I think can be very harmful to those who can’t—and shouldn’t have to—identify as exclusively heterosexual or homosexual,” said Shearer.
The cultural invisibility and erasure of bisexual people could also help explain the study’s troubling results, Shearer told The Daily Beast. Despite outnumbering gay men and lesbians in the United States, bisexual people are drastically underrepresented on film and television. When bisexual characters do appear, they often perpetuate the harmful stereotypes that bi people are confused, deceitful, or universally promiscuous.
Bisexual people are also much less likely to be out of the closet than gay men or lesbians, as Pew research shows.
At present, some bisexual people even face discrimination in the doctor’s office. In 2015, a study from an LGBT group in Scotland found that nearly half of bisexual respondents had experienced biphobic comments in a health-care setting, leading some to hide their identities when they visit their physicians.
“Invisibility and a lack of community support may contribute to the higher incidence of mental health problems among bisexual persons,” the Drexel researchers concluded.
Moving forward, Shearer hopes to see physicians treat young LGBT people with greater sensitivity and respect. Both her study and past research suggests that youth are forthcoming about their identity if doctors “simply ask.”
One inclusive question she told The Daily Beast they could pose to their patients: “Who are you attracted to: men, women, both, or neither?”
If that query makes doctors uncomfortable, Shearer’s Drexel colleague and study co-author Dr. Gary Diamond developed a 55-question survey called the Behavioral Health Screen (BHS), which asks patients general information about their health, including their sexuality, substance use, and mental health.
“In practice, many providers do not ask questions about mental health or adolescent sexuality,” Shearer and her co-authors concluded. “This research underscores the importance of asking both.”