Seeing a new doctor is a little unnerving, I'm not sure why. I don't have any chronic health conditions, but sitting there in that exam room while this man in a lab coat assessed me for the first time was not exactly the most comfortable experience, especially since I knew I'd have to disclose some personal matters.
"So, you have a girlfriend," my new doctor began. His back was to me. And I knew he had gotten to the part of the intake form that asked how I heard about his practice.
"But you heard about me through the Gay and Lesbian Medical Association. Do you identify as bisexual?" He finished asking.
"Yes, I do," I replied firmly but nervously. The doctor's reaction to my disclosure would determine if I'd be on the hunt for a new primary care doctor again.
The doctor nodded his head, back still to me, and jotted information down in the chart. The exam went about routinely and smoothly.
I still see the same doctor four years later. Unlike many 20-something men, I see my doctor annually for routine checkups. His reaction is neutral when I ask for an HIV test, adding other tests for sexually-transmitted infections. He asks nonjudgmentally about my sexual activity. We make jokes about ex-partners when the topic comes up.
I have learned that my ongoing experience with my doctor is unusual. First off, I actually came out to my provider and I made a point of doing. Yes, he may be registered with the GLMA, but there are still plenty of biphobicstraight, gay, and lesbian people, and it's not the "LGBT" Medical Association, it's the Gay and Lesbian Medical Association. Many bisexuals do not come out to their doctor for fear that they'll be judged, shamed, denied treatment, or have their bisexual identity erased.
Secondly, my doctorincludes STI and HIV testing as part of routine testing for his patients (well, at least for me). It may seem like he's assuming something about my sexual activity, but he always asks me first. Then, when I consent, he nods his head with a smile, like it's no big deal, which it isn't, and it shouldn't be. Many people who are sexually active don't know their HIV status, and unfortunately, many providers don't routinely include the test in their exams. Many men and women who don't disclose their bisexuality to their provider, or allow the provider to assume they are gay or straight, may be missing opportunities to provide complete and inclusive information regarding testing and prevention.
Thirdly, I am not poor. Twenty-five percent of bisexual men and 30 percent of bisexual women live in poverty, which is more than gay men, lesbians, and straight people, and therefore are less likely to have access to insurance. I am privileged in having access to private health insurance, which my employer pays into as well, giving me access to pretty much any doctor I choose, as long as I have the co-pay up-front, which many people do not have the luxury of affording.
Fourth, I am not a woman. Compared to straight women and lesbians, bisexual women are less likely to have health coverage and means to pay for medical care. Many women, lesbian and bisexual alike, are pushed birth control even if they are in monogamous relationships with women. Depending on what a provider assumes about a bisexual woman, she may not be offered the full breadth of information regarding contraception or STI prevention. Bisexual women are also more likely to have an eating disorder than lesbians. Forty-five percent of bisexual women have considered or attempted suicide (35 percent of bi men have considered or attempted suicide), compared to 30 percent of lesbians and 25 percent of gay men. Additionally, bisexual women are more likely to experience sexual assault, rape, and domestic violence than straight women and lesbians, and many bi women are experiencing violence at the hands of male partners. Medical providers may not be screening mislabeled bisexual women (i.e. a bi woman who was previously in a relationship with a woman or who is not out to her provider) for domestic violence or be unwilling to address it due to stigma and stereotypes.
Also, I am a cisgender man. Transgender and gender-nonconforming people experience detrimental health care disparities. Transgender people have experienced violence at the hands of medical providers, are denied care, and delay seeking care for these reasons. The list of transgender disparities and inequality is unfortunately long and vast. It is important to acknowledge that there are bi trans people, that their experiences are complex and unique, and that what bi cis people experience, bi trans people experience, and then some.
Finally, I am not a youth (nor was I when I first met my current primary doctor). Bi youth are more likely to be told by others that their sexual orientation doesn't exist, contributing to their personal stress and lack of support. Compared to straight and gay/lesbian youth, bisexual youth are more likely to be homeless (specifically due to abuse at home), further complicating access to medical care and increasing risks for physical and mental harm. Bisexual youth also experience the highest levels of bullying and harassment over the Internet as well as in person. Unfortunately, bullying is a universal experience of any out (or in the closet or perceived) LGBT person.
I'm not trying to say that bisexuals are nothing but victims or that bi people need to work harder and get better incomes and health insurance. What I'm saying is that the health and well-being of bisexuals is important. We make up more than half of the LGBT-identified population.
I see my doctor in a few weeks, for a routine visit. I'm glad I'm out to my provider. We'll talk about my sex life openly, freely, and without judgment. I'll get the results of my routine HIV and STI tests from my last appointment, and I'm confident the results, whatever they may be, will be delivered with care and compassion. At the end of the day, that's what any bisexual, any LGBTQ person, and human being deserves: access to an affordable, nonjudgmental medical provider, who will offer and provide tests as requested and needed, without wincing or clenching when we are honest with providers and ourselves.
To find competent medical providers, please consider visiting the website of the Gay and Lesbian Medical Association.
For more information about Bi Health Awareness Month, visit the Bisexual Resource Center.
SAMATI NIYOMCHAI is an HIV/AIDS case manager at Washington University in St. Louis. He is a licensed master social worker with more than four years in case management, working with low-income, vulnerable populations in both emergency medicine and clinic settings, and providing intervention services for individuals experiencing domestic violence. In 2014 he was a contributor to the groundbreaking anthology Recognize: The Voices of Bisexual Men.
