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The B in the LGBT community often comes as an afterthought.

There are fewer groups and resources dedicated to bisexual individuals than to gay, lesbian and transgender individuals. The 40th annual LGBT Funders Report, which tracked funding to LGBT organizations from 1970 to 2010, found that, of the $487 million that went to programs and organizations that serve the overall LGBT population, a mere $84,000 went to groups that specifically serve bisexuals.

Bisexual folks are in desperate need of resources and support. In the past decade, there has been a slew of research consistently finding that bisexual individuals have worse health outcomes than the general population and are worse off when compared with the LGBT community as a whole.

Bisexual individuals have higher rates of depression and anxiety and are at a higher risk for suicide than gay and lesbian folks. They also report more experiences of physical pain than their gay and lesbian peers.

I spoke to three bisexuality researchers to help understand why bisexual individuals are experiencing more mental and physical problems than the rest of the population, as well as how to address these poorer health outcomes.

Double discrimination from both heterosexual and homosexual communities was a common theme mentioned by all three researchers. Sabra L. Katz-Wise, an assistant professor at Boston Children’s Hospital and Harvard Medical School, mentioned that bisexuals are “often experiencing discrimination from both heterosexual and sexual minority communities, where the same may not be true for lesbian and gay individuals.”

Ethan Mereish, a licensed psychologist and associate professor at American University, said that this double discrimination can lead to negative health outcomes.

“We know that bisexual people are often invisible, invalidated and stigmatized — experiencing multiple forms of discrimination from the heterosexual community and lesbian and gay community,” Mereish said. “This creates pressure to conceal their identity as well as internalize these stigma[s]. … These types of stressors and double discrimination are related to increased feelings of loneliness, and it’s these feelings of loneliness that heavily contributed to experiencing depression, anxiety and suicidality.”

Perceptions of gay and lesbian individuals have improved drastically over the past two decades, and stigma has lessened. But Brian Dodge, associate professor at Indiana University’s School of Public Health, noted that members of the bisexual community haven’t seen such large improvements. In a 2016 study, Dodge and his fellow researchers “we only saw a little shift” in attitudes toward bisexual men and women. “The only other study similar to ours was conducted in 1999,” Dodge said, “and people in that study rated bisexual people more negatively than any other group except injecting drug users. So we moved up a little bit, from rock bottom, but still, attitudes [toward bisexuals] are ambivalent at best.”

The question then becomes: How can we address these negative health disparities? How can both the LGBT community and straight allies help decrease the feelings of loneliness plaguing bisexual individuals, create more bisexual-specific support groups, dispel negative bisexual stigmas and, lastly, shift perception of bisexual people from ambivalent to positive?

The first step, both Katz-Wise and Dodge noted, is through altering health-care practices to address the specific needs of bisexual individuals. “We need to address the assumptions that providers are making about their patients regarding bisexuality, as well as [change] how questions are asked of their patients to be inclusive of bisexual orientation,” Katz-Wise said.

Dodge mentioned that while he would love for more bisexual men to come out to their doctors, to increase visibility in the medical field, he acknowledges that we need to be realistic. “That’s going to require a context where the doctor isn’t engaging in implicit forms of biphobia, like giving a strange look [when a patient discloses being bisexual], or the doctor assuming you’re straight because you’re dating a woman and you don’t need an STI test,” Dodge said, adding, “While they seem like small things, cumulatively, they build over time. I think this does take a toll on mental health and contributes to why we see these health disparities.”

Dodge said he finds that men do want to talk about their bisexuality, but often don’t know how. “They might not have had anyone in their lives say to them: ‘It’s okay to be bisexual,’ ” Dodge noted. “Additionally, the social context is challenging. If you know that your partner is going to break up with you, or we’ve even heard stories where guys are afraid to tell their partner about their sexuality because of threats of violence, then you’re not likely to disclose.”

Thus, the second step, as Mereish noted, is “having support groups and spaces where bisexual people can connect with other bisexual people who’ve had similar experiences.” While also addressing the stigma and biphobia that exists at systemic levels. “We want to accurately and positively depict bisexual individuals in the media [in order] to debunk bi myths.”

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