Bisexual Health: A Daily Diary Analysis of Stress and Anxiety

Psychology of Women Quarterly

London

2018

Bisexual individuals experience increased risk of mental health disorders compared to lesbian, gay, and heterosexual populations. This increased risk is theorized to arise from the stigmatization of bisexuality (i.e., anti-bisexual stigma). Research has linked anti-bisexual experiences with higher internalized binegativity (i.e., internalized anti-bisexual stigma), sexual identity uncertainty, and anxiety and depression. However, researchers have almost exclusively used cross-sectional designs, limiting our ability to draw conclusions about processes through which anti-bisexual stigma affects mental health. In the current study, we longitudinally examined a proposed bisexual-specific minority stress process in a sample of predominately White (92.2%), self-identified bisexual, cisgender women. Results provide support for the proposed process, indicating that experiencing more frequent anti-bisexual stigma predicted subsequent increases in internalized binegativity and sexual identity uncertainty. In turn, these increases in internalized binegativity were associated with concurrent decreases in strength of identification as bisexual, increases in strength of identification with monosexual identity labels (i.e., heterosexual, lesbian), and changes in visibility management strategies. These changes in identification were associated with concurrent increases in symptoms of anxiety and depression, and changes in visibility management were associated with increases in anxiety. Clinicians should consider this process when treating bisexual clients who present with psychological distress arising from anti-bisexual stigma.

Section: Association Between Anti-bisexual Stigma Experiences and Mental Healthmentioning

confidence: 93%

Longitudinal Examination of a Bisexual-Specific Minority Stress Process Among Bisexual Cisgender Women

Psychology of Women Quarterly

London

2018

“…For instance, monosexual individuals may question the validity and stability of a bisexual individual’s identity or refuse to date a bisexual individual due to fear that the bisexual partner will cheat on them. A recent study found that bisexual individuals reported experiencing an average of 1.3 microaggressions per day and that experiencing more frequent microaggressions was associated with increased anxiety (34). Several studies have confirmed that experiences of binegativity are associated with psychological distress and anxiety (30, 35, 36).…”

Section: Bisexual Minority Stressmentioning

confidence: 99%

Bisexuality, Minority Stress, and Health

Feinstein

2017

Curr Sex Health Rep

307

182

Purpose of review Bisexual individuals are at increased risk for negative health outcomes compared to heterosexual individuals and often compared to gay/lesbian individuals as well. The goal of this article is to summarize the current evidence-base on bisexual health disparities, to describe factors that influence them, and to review interventions designed to improve the health of bisexual individuals. Recent findings Based on our review of the literature, we conclude that there is strong evidence that bisexual individuals are at increased risk for mental health and substance use problems. These disparities are evident across dimensions of bisexuality (identity, attraction, and behavior), but there are important nuances to these findings. There is also evidence that bisexual men are at increased risk for sexually transmitted infections (STIs) compared to heterosexual men and that bisexual women are at increased risk for STIs compared to both lesbians and heterosexual women. Although there are numerous causes of these disparities, a leading contributor is stress related to stigma and discrimination. Most of the interventions that have been developed for bisexual individuals are HIV prevention programs for behaviorally bisexual men of color. Despite less attention to mental health and substance use interventions for bisexual individuals, recent developments show promise in their potential application to this population. Summary Bisexual individuals are at increased risk for mental health, substance use, and sexual health problems, and this is due, in part, to stigma and discrimination. Future research should continue to examine how different dimensions of bisexuality relate to health disparities and factors that influence them. There is also an urgent need to develop, test, and disseminate interventions to improve the health of bisexual individuals.

“…Bisexual individuals also experience unique stressors, such as discrimination from both heterosexual and gay/lesbian individuals and unique stereotypes about bisexuality (Brewster & Moradi, 2010). In regard to external stressors, bisexual individuals experience frequent microaggressions (e.g., behaviors that insult or invalidate their identity), which are associated with anxiety (Flanders, 2015). The prevalence of victimization is also high among bisexual individuals, and for some types of victimization (e.g., threats of violence, physical assault, assault with a weapon) it is higher for bisexual individuals compared to gay/lesbian individuals (Katz-Wise & Hyde, 2012).…”

Section: The Role Of Minority Stress In Bisexual Health Disparitiesmentioning

confidence: 99%

A Multilevel Approach for Reducing Mental Health and Substance Use Disparities Affecting Bisexual Individuals

Feinstein

Cognitive and Behavioral Practice

Pachankis

2019

Despite bisexual individuals being at increased risk for mental health and substance use problems, clinicians' ability to provide affirmative and competent care to bisexual clients is limited by their lack of bisexual-specific training. To address this common gap in training, this article provides a brief review of bisexual health disparities and the factors that influence them. Then, we describe a multi-level approach for improving the health and well-being of bisexual individuals. This approach addresses factors that influence health at the micro-level (e.g., strategies that clinicians can use to help bisexual clients cope with stigma-related stressors), mezzo-level (e.g., adaptations to clinical environments and training programs that promote bisexual-affirmative care), and macrolevel (e.g., advocating for political change and implementing strategies to reduce prejudice against bisexual individuals at the population-level). Specifically, we describe how clinicians can adapt evidence-based interventions to tailor them to the needs of their bisexual clients. Additionally, we discuss the need for bisexual-affirmative clinical training and provide recommendations for how clinical training can be adapted to prepare clinicians to work effectively with bisexual clients. Finally, we describe how population-level interventions can be used to reduce prejudice against bisexual individuals in order to reduce bisexual health disparities. Given the striking health disparities affecting bisexual individuals, there is a critical need to develop, test, and disseminate interventions to improve the health of this population and to prepare clinicians to provide bisexualaffirmative care.