Good Bi Love: Examining Physical Health Disparities in Bi People
In my last column, I spoke with Dr. Ethan Mereish about the various health disparities that bi folks face. Specifically, Dr. Mereish delved further into his research, which revealed how feelings of loneliness contribute to the mental health disparities of bisexual folks.
In other words, the “double discrimination” we face from both gay and straight folks, along with other explicit and implicit forms of biphobia increase feelings of loneliness. This in turn contributes to the higher rates of depression, anxiety, and suicidal thoughts we see in the bi community.
This week, I would like to further build on bi health disparities research. Though instead of looking at negative mental health outcomes, I would like to focus on the negative physical health outcomes that bi individuals often face.
Dr. Sabra Katz-Wise
Dr. Sabra Katz-Wise, a researcher of both Boston Children’s Hospital and Harvard Medical School, sought to analyze the physical health disparities bi folks face, including physical pain, physical functioning, role limitations due to physical pain, and overall general health. Her study, published in The Journal of Sex Research, exclusively recruited cisgender and transgender (including gender non-binary) bisexual-identifying individuals and individuals who reported attractions to more than one gender. In the end, the data were analyzed from a survey of 488 bisexual folks.
Akin to Dr. Mereish’s research, Dr. Katz-Wise utilized the minority stress theory in her work. She explains it in her paper as, “[The] minority stress theory proposes that sexual minorities experience prejudice and discrimination related to their stigmatized identity, which negatively affects health via a psychological stress response pathway.”
When I spoke with Dr. Katz-Wise and asked her to give a common example of when the mental component of discrimination turns into physical pain, she said, “A good example is that a lot of people, when stressed, get stomach aches. People get these digestive problems from how the stress is affecting their psychology and their body.”
The results from her research did indeed support the minority stress model theory, as bi individuals reported poorer overall physical health and greater physical pain that was related to higher levels of bisexual-specific stress.
There were, however, large gender differences between bi folks. Cisgender women reported more bisexual-specific stress and worse physical health, including pain, than cisgender men. This was a little surprising, as bi men often experience additional forms of discrimination for being bi that bi women often don’t experience. Bi men have to deal with people denying their sexual orientation, thinking they’re actually gay. However, bi women are often fetishized and excommunicated from lesbian communities for being bi, which isn’t the same for bi men. This, along with the sexism bi women face, may also contribute to why cisgender, bi women reported higher levels of stress and worse physical health than cisgender, bi men.
Additionally, Dr. Katz-Wise stated, “The adverse affects of stress related to being bisexual actually ended up being stronger for transgender individuals than cisgender women, which was already stronger than [for] cisgender men.”
She continued, “This speaks to the intersectionality of experience and discrimination. If they’re experiencing stress related to being transgender as well as having a bisexual orientation, those may compound each other to lead to even worse physical outcomes.”
“There are large implications for this study,” Dr. Katz-Wise explained, “Particularly for doctors, who not only don’t ask about a patient’s sexual orientation, but then [also] don’t connect that psychological and physical well-being may be directly related to being a sexual minority.”
There is still a lot of biphobia in the medical world. Just a few months ago, I encountered a severely biphobic doctor in Brooklyn, when trying to find a new primary care provider. Here is what I posted on Facebook, directly after the horrifying experience.
Mine is just one example of how doctors aren’t equipped to handle the needs of sexual minorities, and in some cases, are further worsening our health.
When I told Dr. Katz-Wise my story, she replied,
“This sets the stage for why this [research] is important. Bisexual people are experiencing this unique form of stress related to being bisexual that’s adversely affecting their physical health. You could imagine a bisexual person going into their doctor’s office, with different types of physical health complaints, and no one [in the doctor’s office] is thinking to make the connection that this bisexual person may be experiencing prejudice based on their bisexual orietantion. [They may] even be experiencing prejudice in that office which isn’t going to help their health, just like you did. Therefore, one of the implications for health care providers, beyond examining what’s going on with anti-bisexual prejudice within their own practice and systems, is having the knowledge that there is this connection. This is something they need to screen for and explore more with their patients. This could help [the doctors] figure out what the underlying cause is of the pain and discomfort their patient is feeling.”
Hopefully, doctors will use this research to examine their own biphobia and to address the specific needs of bisexual individuals.