Bisexual People Have Worse Health Outcomes Than LGTQ+ People — Why?

Recently coming off of Bi+ Health Awareness Month, annually in March, we’ve been pointed to our Bi+ population who not only contend with the challenges commonly experienced by their LGTQ+ peers, but also must overcome a host of obstacles specific to their community. There has been immense progress in LGBTQ+ equality over the previous decades, yet too many Bi+ community members continue to suffer under the yoke of age-old prejudices.

While these 31 days are designated to focus on complications confronting and negatively impacting Bi+ people, as well as creating awareness around better meeting the population’s needs, our efforts to stand in solidarity with the Bi+ community cannot simply begin and end each March. More must be done for a community that our society has ignored and overlooked for decades.

According to Gallup, Bi+ people actually make up more than half of LGBTQ+ Americans, who now represent 7.1 percent of our country’s population. However, this community experiences significantly worse physical, mental, and social health outcomes compared to their gay, lesbian, and heterosexual peers.

Our Bi+ neighbors often experience a wider array of negative medical conditions compared to heterosexual adults that are frequently aggravated by the unique discriminations they face related to their sexual orientation. These conditions range from higher rates of elevated cholesterol and asthma, as well as increased prevalence of smoking and alcohol use that can also heighten the risk for other health problems.

Our health care system and the oft unchecked anti-LGBTQ+ biases ingrained within it make it even more difficult to address these issues. Many Bi+ people refrain from disclosing their sexual identity to healthcare practitioners based on past negative interactions with their physicians, which results in delaying or avoiding necessary appointments and procedures. Adding to the matter, 80 percent of physicians assume patients would decline to disclose their sexual identity to their doctors, making the health care process for the Bi+ more difficult.

And above all else, Bi+ people are immensely understudied in health research and underserved in terms of programming. This further limits the abilities for health care and nonprofit organizations to fully understand the community’s needs and how to properly serve them.

On top of these complicated realities, Bi+ elders contend with still more community-specific challenges. With the aforementioned disparities and discriminations derived from their orientation, along with the novel concerns that may arise with aging, it’s a treacherous time to a Bi+ elder in the U.S.

Working at SAGE, my colleagues and I see these exact instances constantly with the Bi+ elders we engage with, along with the other elders who utilize our services and resources across the LGBTQ+ community. Bi+ elders are significantly more likely to live at or below 200 percent of the federal poverty line and more likely to have lower income levels as compared to their gay and lesbian peers. We also see higher rates of depression and worse health outcomes as well among Bi+ people, creating further complications they must navigate.

You may be asking why this is the current state of the Bi+ community in the U.S., especially for our elders. It is likely, at least in part, attributable to multifaceted discrimination. Bi+ people are at risk of marginalization by anti-LGBTQ+ sentiment while simultaneously seeing their voices and narratives erased or disbelieved within LGBTQ+-centric circles.

So while those who would oppose equal protection under the law for LGBTQ+ people — those who have found ever more vociferous champions of their prejudices among our elected officials over the past several years — do not hesitate to denigrate the BI+ community, other members of the LGBTQ+ community are necessarily creating spaces that are inclusive of Bi+ people.

We must do better — those in the community; those outside of the community; those leading our health and nonprofit organizations; those elected into office and beyond. We all must do better at standing in solidarity with communities other than our own.

Improvement in this area can begin with two crucial steps — inclusivity and increasing resources. You might assume that inclusivity wouldn’t be an issue for the LGBTQ+ community, but those same assumptions are what often lead to the sidelining of Bi+ people and their narratives. Listening to, understanding, and respecting other people’s identities and experiences is the foundation of inclusivity, and this must be remembered as more pro-LGBTQ+ programs are developed.

We must also make mental health programming more accessible for Bi+ people given that they are at greater risk of experiencing protracted isolation and loneliness. The community’s elders are more likely to experience social isolation compared to other LGTQ+ adults, and LGBTQ+ elders as a whole are twice as likely to be single and live alone when compared to their non-LGBTQ+ peers. Mental health concerns and their treatment has become more known and accepted worldwide, but this focus and investment must be nuanced to be as inclusive as possible of all demographics.

The positives here are that we have clear steps for creating more welcoming spaces for the Bi+ community, avenues to guide future research and paths for creating more accessible and comprehensive resources. However, time must not be wasted. Addressing the specific needs of Bi+ people can no longer be a second thought, as it has been for far too long.

It is long past time to critically reevaluate and rethink how we as individuals and professionals stand with Bi+ people in America and elsewhere.

Kylie Madhav is the Senior Director of Diversity, Equity, and Inclusion at SAGE where she defines the strategic vision for SAGE’s external-facing DEI work and leads in designing the organization’s DEI action plans, goals, and benchmarks.