Social Work Bisexuality
by
Ski Hunter
  • LAST REVIEWED: 06 May 2015
  • LAST MODIFIED: 24 July 2013
  • DOI: 10.1093/obo/9780195389678-0187

Introduction

Bisexual women and men are often overlooked in many arenas including therapy and research. What is presented here, however, is research on bisexual women, men, youth, and various other topics related to bisexuals. This shows that some researchers do focus on bisexual persons and want to learn more about them. Not enough is known, however, and considerably more research needs to be done to get a more complete picture of bisexual persons.

General Overviews

The articles in this section focus on the marginalized position of bisexuals, the 21st-century bisexual movement, queer theory, types of relationships, internalized biphobia, and numbers of sex partners for bisexual men. Anderlini-D’Onofrio 2011 provides an overview of the bisexual movement, institutions, society, and how positioned in LGBT communities. Burrill 2009 offers thoughts on whether queer theory is bi-friendly. Oswalt 2009 (cited under Public Schools and Colleges) discovered that a college health center staff overlooks bisexual students. Erickson-Schroth and Mitchell 2009 looks at the erasure of bisexuality. Jeffries 2011 discusses how neither bisexual identity nor attraction predicts the number of recent partners. McLean 2011 discusses the arrangement of intimate partners in Australia. Owen 2011 discusses the marginalization of bisexuals. See and Hunt 2011 discusses the invisibility of bisexuals in Britain. Ripley, et al. 2011 discusses the stigma of bisexual men in the United Kingdom.

  • Anderlini-D’Onofrio, S. 2011. Bisexuality, gaia, eros: Portals to the arts of loving. Journal of Bisexuality 11.2–3: 176–194.

    DOI: 10.1080/15299716.2011.571984Save Citation »Export Citation »E-mail Citation »

    Discusses the current bisexual movement and how bisexuals are positioned in LGBT communities and their institutions and in mainstream society.

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    • Burrill, K. G. 2009. Queering bisexuality. Journal of Bisexuality 9.3–4: 491–499.

      DOI: 10.1080/15299710903316737Save Citation »Export Citation »E-mail Citation »

      Theorists are divided over queer theory and whether it is bi-friendly. But most bisexual theorists and advocates think bisexuality should be included in queer theory and could benefit from this inclusion. The article examines why inclusion in queer theory is advantageous for bisexuals.

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      • Erickson-Schroth, L., and J. Mitchell. 2009. Queering queer theory, or why bisexuality matters. Journal of Bisexuality 9.3–4: 297–315.

        DOI: 10.1080/15299710903316596Save Citation »Export Citation »E-mail Citation »

        The binary system of heterosexual/LG is disrupted by bisexuality. This article discusses bisexual erasure in terms of historical context, contemporary media, and literary representations.

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        • Jeffries, W. L. 2011. The number of recent sex partners among bisexual men in the United States. Perspectives on Sexual and Reproductive Health 43.3: 151–157.

          DOI: 10.1363/4315111Save Citation »Export Citation »E-mail Citation »

          A study of 3,875 bisexually attracted men, aged fifteen to forty-four, after controlling for sexual identity and behavior. Bisexually attracted men have 0.7 fewer partners than gay-attracted men. Neither bisexual identity nor bisexual attraction independently predicted the number of recent partners. Interventions to reduce the number of partners of bisexual men will likely lessen their risk for HIV and other STDs.

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          • McLean, K. 2011. Bisexuality and nonmonogamy: A reflection. Journal of Bisexuality 11.4: 513–517.

            DOI: 10.1080/15299716.2011.620857Save Citation »Export Citation »E-mail Citation »

            Looks at how bisexual participants in Australia arrange their intimate relationships. Some are monogamous; others have some level of openness in their relationships. Those in open relationships dealt with jealousy, setting boundaries, and communicating needs to their partners. They worked to overcome these issues through honesty and communication.

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            • Owen, M. 2011. Still sitting on fences: Reflections on “Overstepping the bounds: Bisexuality, gender, and sociology.” Journal of Bisexuality 11.4: 493–497.

              DOI: 10.1080/15299716.2011.620844Save Citation »Export Citation »E-mail Citation »

              About how bisexuals continue to be in marginalized positions. Many misperceptions of them are still around, according to this study.

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              • Ripley, M., E. Anderson, M. McCormack, A. Adams, and R. Pitts. 2011. The decreasing significance of stigma in the lives of bisexual men: Keynote address, Bisexual Research Convention, London. Journal of Bisexuality 11.2–3: 195–206.

                DOI: 10.1080/15299716.2011.571985Save Citation »Export Citation »E-mail Citation »

                Draws from multiple studies of bisexual men in the United States and the United Kingdom. The keynote address shows a declining significance of biphobia and heterosexism in men’s lives today.

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                • See, H., and R. Hunt. 2011. Bisexuality and identity: The double-edged sword: Stonewall research into bisexual experience. Journal of Bisexuality 11.2–3: 290–299.

                  DOI: 10.1080/15299716.2011.571995Save Citation »Export Citation »E-mail Citation »

                  Study finds that bisexuality is basically invisible in Britain today due to a high degree of biphobia and the ambivalence some bisexual persons feel about bisexuality as an identity.

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                  Textbooks

                  The textbooks listed here are still relevant and provide helpful information about bisexual women and men. Appleby and Anastas 1998 covers many topics including the life course, identities, and sexual and intimate relationships. Bieschke and Perez 2007 presents many topics on counseling and psychotherapy that include bisexual clients. Firestein 1996 focuses on bisexuality, including sexuality and the AIDS crisis. Firestein 2007 studies many topics on bisexual persons at different stages of life. Hunter and Hickerson 2003 discusses bisexual clients in therapy, families, children, and community development. Hutchins and Kaahumanu 1991 features many topics on bisexual clients such as communities and spirituality. Weinberg, et al. 1994 discusses bisexuals in San Francisco. See also Rust 2000.

                  • Appleby, G. A., and J. W. Anastas. 1998. Not just a passing phase: Social work with gay, lesbian and bisexual people. New York: Columbia Univ. Press.

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                    Covers many topics including childhood and adolescence, midlife and older age, identities, and sexual and intimate relationships.

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                    • Bieschke, K. J., and R. M. Perez. 2007. Handbook of counseling and psychotherapy with lesbian, gay, and bisexual clients. Washington, DC: American Psychological Association.

                      DOI: 10.1037/11482-000Save Citation »Export Citation »E-mail Citation »

                      This is an updated version of this text with many topics on counseling and psychotherapy that include bisexual clients.

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                      • Firestein, B. A. 1996. Bisexuality: The psychology and politics of an invisible minority. Thousand Oaks, CA: SAGE.

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                        The text focuses on bisexual persons with many topics, including diversity among bisexual men and women, sexuality, and the AIDS crisis.

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                        • Firestein, B. A. 2007. Becoming visible: Counseling bisexuals across the lifespan. New York: Columbia Univ. Press.

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                          A text featuring many topics about counseling bisexuals at different stages of life.

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                          • Hunter, S., and J. Hickerson. 2003. Affirmative practice: Understanding and working with lesbian, gay, bisexual, and transgender persons. Washington, DC: NASW.

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                            Has chapters on bisexual clients in therapy, families, having children, and community development.

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                            • Hutchins, L., and L. Kaahumanu, eds. 1991. Bi any other name: Bisexual people speak out. Boston: Alyson.

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                              This is an edited text with multiple topics on bisexual persons. The topics range from spirituality to bisexual communities.

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                              • Rust, P. C., ed. 2000. Bisexuality in the United States: A social science reader. New York: Columbia Univ. Press.

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                                Focuses on bisexual persons with topics such as the basis of sexual attraction, bisexuals in a heterosexual marriage, and coming out.

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                                • Weinberg, M. S., C. J. Williams, and D. W. Pryor. 1994. Dual attraction: Understanding bisexuality. New York: Oxford Univ. Press.

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                                  Covers bisexuals in San Francisco. The topics addressed include: becoming bisexual, the nature of dual attraction, marriage, jealousy, being “out,” intimate relationships, managing identities, facing AIDS, changes in relationships, among other topics.

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                                  Journals

                                  The Journal of Bisexuality is where most articles on bisexuality appear. Once in a while other journals publish an article on bisexuality. Few of the articles here appear outside of the Journal of Bisexuality and usually only appear once in the other journals. For additional resources, see Archives of Sexual Behavior, Journal of GLBT Family Studies, Journal of Gay and Lesbian Social Services, and Culture, Health, and Sexuality.

                                  Youth

                                  Bisexual youth experience biphobia and discrimination. This can happen in their families who may reject them. Support from sexual minority friends is helpful to them. Others seek connection with other bisexual youth through Myspace, although connecting through Facebook may be more popular now than Myspace. These youth need help in improving their well-being, identity integration, and their approach to safe sex. Crowley 2010 addressed young bisexual women who use Myspace to connect with other bisexuals and create communities. Doty, et al. 2010 reports research on support for LGB youth. Sexual minority friends were found to offer the most emotional support and to be a buffer to negative effects of their sexual orientation. Harpers, et al. 2012 is a research project on conceptualizations of being gay/bisexual and resiliency when facing oppression. Kaestle and Waler 2011 studies the risk of STDs for bisexual females. Munoz-Laboy, et al. 2009 studies how familialism shapes sexual decision making among Latino bisexual youth. Rosario, et al. 2011 looks at different patterns of sexual identity development over time among lesbian, gay, and bisexual youths. Willoughby, et al. 2010 examines the role of negative feelings about one’s sexual orientation.

                                  • Crowley, M. S. 2010. Experiences of young bisexual women in lesbian/bisexual groups on Myspace. Journal of Bisexuality 10.4: 388–403.

                                    DOI: 10.1080/15299716.2010.521044Save Citation »Export Citation »E-mail Citation »

                                    The findings in this study suggested that young bisexual women use Myspace to connect with others and create communities for bi-youth. Sometimes lesbians were antagonistic toward bisexuals. But with lesbian allies bisexual women were able to challenge this prejudice.

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                                    • Doty, N. D., B. L. B. Willoughby, K. M. Lindahl, and N. M. Malik. 2010. Sexuality related social support among lesbian, gay, and bisexual youth. Journal of Youth and Adolescence 39.10: 1134–1147.

                                      DOI: 10.1007/s10964-010-9566-xSave Citation »Export Citation »E-mail Citation »

                                      Ninety-eight LGB youth rated support from family, heterosexual friends, and sexual minority friends for problems related and not related to their sexuality. Sexual minority friends provided the highest level of sexuality support. This support was associated with decreased emotional distress and provided a buffer against negative effects of sexuality stress on emotion distress. Sexuality support may be especially relevant to mental health among LGB youth.

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                                      • Harpers, G. W., A. Brodsky, and D. Bruce. 2012. What is good about being gay? Perspectives from youth. Journal of LGBT Youth 9.1: 22–41.

                                        DOI: 10.1080/19361653.2012.628230Save Citation »Export Citation »E-mail Citation »

                                        Looks at gay and bisexual male adolescents’ positive perceptions of their sexual orientation identity. The sample was ethnically diverse and included sixty-three gay/bisexual adolescents in Chicago (N = 42). Two categories were identified: (1) positive conceptualizations of being gay/bisexual and (2) resiliency when facing oppression. Implications were drawn for development of interventions to promote the health and well-being of gay/bisexual youth.

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                                        • Kaestle, C. E., and M. W. Waler. 2011. Bacterial STDs and perceived risk among sexual minority young adults. Perspectives on Sexual and Reproductive Health 43.3: 158–163.

                                          DOI: 10.1363/4315811Save Citation »Export Citation »E-mail Citation »

                                          Bisexual females had significantly higher odds of STDs than heterosexual females, and females attracted to both sexes had significantly higher odds of STDs than females attracted only to males. None of the sexual minority indicators predicted STDs for males.

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                                          • Munoz-Laboy, M., C. J. Leau, V. Sriram, H. J. Weinstein, E. V. del Aquila, and R. Parker. 2009. Bisexual desire and familism: Latino/a bisexual young men and women in New York City. Culture, Health and Sexuality 11.3: 331–344.

                                            DOI: 10.1080/13691050802710634Save Citation »Export Citation »E-mail Citation »

                                            Families are of major importance for Latino communities in the United States. This study examined how familism shapes sexual decision making regarding behavior and expressions of bisexuality among Latino youth. The researchers conducted twenty-five in-depth interviews and ethnographic observations among bisexual male and female youth (fifteen to nineteen years of age) for nine months in New York City.

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                                            • Rosario, M., E. W. Schrimshaw, and J. Hunter. 2011. Different patterns of sexual identity development over time: Implications for the psychological adjustment of lesbian, gay, and bisexual youths. Journal of Sex Research 48.1: 3–15.

                                              DOI: 10.1080/00224490903331067Save Citation »Export Citation »E-mail Citation »

                                              Reported longitudinally whether different patterns of LGB identity formation and intergeneration are associated with psychological adjustment in an ethnically diverse sample. The sample included 156 LGB youths, ages fourteen to twenty-one, who were living in New York City. They found that greater identity integration was related to less depressive and anxious symptoms, fewer conduct problems, and higher self-esteem.

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                                              • Willoughby, B. L. B., N. D. Doty, and N. M. Malik. 2010. Victimization, family rejection, and outcomes of gay, lesbian, and bisexual young people: The role of negative GLB identity. Journal of GLBT Family Studies 6.4: 403–424.

                                                DOI: 10.1080/1550428X.2010.511085Save Citation »Export Citation »E-mail Citation »

                                                Examines the role of negative GLB identity (negative feelings about one’s sexual orientation) in mediating the relationship between sexuality-related stress (victimization, family rejection) and youth outcomes. Participants were eighty-one GLB persons ages fourteen to twenty-five. They were recruited through college groups, youth organizations, study advertisements, and friend referrals. Victimization and family rejection were related to youths internalizing problems about their negative GLB identity.

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                                                Older Bisexuals

                                                There has not been much research on older bisexuals. Jones 2011, however, shows the usefulness of imagining a positive future.

                                                Ethnic Minorities

                                                Another important area of study concerns the experiences of ethnic minorities. Carrillo and Fontdevila 2011 studies social factors and cultural/sexual patterns of sexual initiation. Feldman, et al. 2011 assesses HIV and substance abuse prevention services for young black and Latino men. Sandfort and Dodge 2008 studies ethnic minority bisexual men for their potential for risk behavior. Zamboni, et al. 2011 studies African American HIV-positive men.

                                                • Carrillo, H., and J. Fontdevila. 2011. Rethinking sexual initiation: Pathways to identity formation among gay and bisexual Mexican male youth. Archives of Sexual Behavior 40.6: 1241–1254.

                                                  DOI: 10.1007/s10508-010-9672-6Save Citation »Export Citation »E-mail Citation »

                                                  Looked at social factors and forms of cultural/sexual patterns of sexual initiation. The importance of studying these patterns in the context of diversity in ethnic/cultural groups of same-sex sexual experiences and sexual identities was confirmed.

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                                                  • Feldman, M. B., S. J. Hile, and G. S. Weinberg. 2011. A community needs assessment to inform HIV and substance abuse prevention services for black and Latino young men who have sex with men in New York City. Journal of Gay and Lesbian Social Services 23.4: 465–506.

                                                    DOI: 10.1080/10538720.2011.616481Save Citation »Export Citation »E-mail Citation »

                                                    A community needs assessment was instituted to inform HIV and substance abuse prevention services for black and Latino young men who have sexual relations with men in New York City. This assessment resulted in recommendations for education about sexual orientation within African American campus communities, LGBT outreach to communities of color, and institutional support for African American campus organizations.

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                                                    • Sandfort T. G. M, and B. Dodge. 2008. “And then there was the down low”: Introduction to black and Latino male bisexualities. Archives of Sexual Behavior 37.5: 675–678.

                                                      DOI: 10.1007/s10508-008-9359-4Save Citation »Export Citation »E-mail Citation »

                                                      There has been relatively little research on bisexual behavior and identity among ethnic minority men. Disproportionate rates of HIV/AIDS among black and Latino men make scientific information urgent. In this article the authors provide empirical and theoretical perspectives on black and Latino male bisexuality. This involves their individual, social, and sexual lives and the potential for risk behavior.

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                                                      • Zamboni, B. D., B. B. E. Robinson, and W. O. Bockting. 2011. HIV status and coming out among African American gay and bisexual men. Journal of Bisexuality 11.1: 74–84.

                                                        DOI: 10.1080/15299716.2011.545309Save Citation »Export Citation »E-mail Citation »

                                                        Compared to those without HIV, African American HIV-positive men who had sex with men reported using more mental health services, having lower levels of internalized homonegativity, and lower levels of experienced stigma associated with same-sex activity. This pattern was more pronounced with African American men who identified as bisexual. Disclosure of one’s HIV status may be associated with coming out. Minority stress, however, may minimize the benefits.

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                                                        Mixed Orientation Marriages

                                                        Mixed orientation marriages can be enhanced and supported with understanding of the bisexual partner and bisexual issues. Therapists can get help in how to treat people in mixed orientation marriages, and personal growth is possible for the heterosexual partner. Buxton 2006 offers suggestions of how to work with partners of bisexual persons. The author of Buxton 2011 puts what she has learned into practice in counseling partners in mixed orientation marriages and feels that her approach could be helpful to other professionals who counsel bisexuals, especially those in mixed marriages. Buxton 2012 reports that many gay, lesbian, and bisexual partners of heterosexual men open up about their private lives: heterosexual husbands cared for their wives, worried about their children’s well-being, and parented actively. Reinhardt 2011 studied bisexual women in a heterosexual relationship. One half of the women were maintaining sexual relationships with other women while in heterosexual relationships.

                                                        • Buxton, A. P. 2006. Counseling heterosexual spouses of bisexual men and women and bisexual-heterosexual couples: Affirmative approaches. Journal of Bisexuality 6.1–2: 105–135.

                                                          DOI: 10.1300/J159v06n01_07Save Citation »Export Citation »E-mail Citation »

                                                          For therapists working with heterosexual partners of bisexual persons or bisexual-heterosexual couples, they need to inform the heterosexual partner about bisexuality. They can help these couples resolve issues and develop individual strength and mutual understanding.

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                                                          • Buxton, A. P. 2011. Reflections on bisexuality through the prism of mixed-orientation marriages. Journal of Bisexuality 11.4: 525–544.

                                                            DOI: 10.1080/15299716.2011.620864Save Citation »Export Citation »E-mail Citation »

                                                            The author feels she has developed a realistic understanding of bisexuality, bisexual individuals, and bisexual/heterosexual marriages. She uses what she learned while counseling partners in mixed marriages and feels that her approach could be helpful to other professionals who counsel bisexuals, especially those in mixed marriages.

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                                                            • Buxton, A. P. 2012. Straight husbands whose wives come out as lesbian or bisexual: Men’s voices challenge the “Masculinity Myth.” Journal of GLBT Family Studies 8.1: 23–45.

                                                              DOI: 10.1080/1550428X.2012.641369Save Citation »Export Citation »E-mail Citation »

                                                              Many gay, lesbian, and bisexual partners of heterosexual men make frank admissions here. The findings suggest that heterosexual husbands felt deep emotions and cared for their wives. They worried about their children’s well-being and were active parents. They found outside support mostly from peers and reported personal growth.

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                                                              • Reinhardt, R. U. 2011. Bisexual women in heterosexual relationships: A study of psychological and sociological patterns: A reflective paper. Journal of Bisexuality 11.4: 439–447.

                                                                DOI: 10.1080/15299716.2011.620472Save Citation »Export Citation »E-mail Citation »

                                                                Examines bisexual women in an ongoing heterosexual relationship and finds that bisexual women and their male partners maintained a satisfactory relationship. One half of the women were maintaining sexual relationships with other women while in heterosexual relationships. Most of the women were satisfied with the sexual experiences they had with their male partner and had sexual intercourse an average of three times a week.

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                                                                Public Schools and Colleges

                                                                Youth in public schools and college want more attention to bisexuality in their courses as well as in the college health center. Elia 2010 gives reasons to include bisexuality in sexuality education and other courses, and Oswalt 2009 provides health issues of bisexuals and strategies to address them.

                                                                • Elia, J. P. 2010. Bisexuality and school culture: School as a prime site for bi-intervention. Journal of Bisexuality 10.4: 452–471.

                                                                  DOI: 10.1080/15299716.2010.521060Save Citation »Export Citation »E-mail Citation »

                                                                  Gives reasons why bisexuality should be included in sexuality education and other courses in the curriculum and in extracurricular settings. One of the reasons for this recommendation is the invisibility of bisexuality.

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                                                                  • Oswalt, S. B. 2009. Don’t forget the “B”: Considering bisexual students and their specific health needs. Journal of American College Health 57.5: 557–560.

                                                                    DOI: 10.3200/JACH.57.5.557-560Save Citation »Export Citation »E-mail Citation »

                                                                    Although many college health center staff are addressing cultural competency, the needs of one group, bisexuals, are overlooked. The author provides an overview of health issues related to bisexuals and strategies to address the needs of bisexuals within college health.

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                                                                    Work

                                                                    Work is a central focus for most adults. But bisexual persons may be silenced at work, and physicians may be discriminated against as well. It may be helpful for bisexuals to tell others about themselves, their lives, and to disclose their bisexuality if it had been a secret. Bell, et al. 2011 gives strategies for inclusion of LGBT persons at work. Eliason, et al. 2011 looks at LGBT physicians’ experiences in the workplace, and Green, et al. 2011 studies the experience of bisexual persons in the workforce, as well as nondiscrimination policies.

                                                                    • Bell, M. P., M. F. Ozbigin, T. A. Beauregard, and O. Surgevil. 2011. Voice, silence, and diversity in 21st century organizations: Strategies for inclusion of gay, lesbian, bisexual, and transgender employees. Human Resource Management 50.1: 131–146.

                                                                      DOI: 10.1002/hrm.20401Save Citation »Export Citation »E-mail Citation »

                                                                      LGBT employees are often silenced in work organizations. The feeling is that speaking up is futile or dangerous. This is widespread among LGBT employees. Specific recommendations are made for HR managers to facilitate the expression of voice for LGBT employees.

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                                                                      • Eliason, M. J., S. L. Dibble, and P. A. Robertson. 2011. Lesbian, gay, bisexual and transgender (LGBT) physicians’ experiences in the workplace. Journal of Homosexuality 58.10: 1355–1371.

                                                                        DOI: 10.1080/00918369.2011.614902Save Citation »Export Citation »E-mail Citation »

                                                                        Reported discriminatory situations among physicians. They found that 10 percent were denied referrals from heterosexual colleagues, 15 percent were harassed by a colleague, 22 percent were socially ostracized, 65 percent heard derogatory comments about LGBT persons, 34 percent witnessed discriminatory care of an LGBT patient, 36 percent witnessed disrespect toward an LGBT patient’s partner, and 27 percent had witnessed discriminatory treatment of an LGBT coworker.

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                                                                        • Green, H. B., N. R. Payne, and J. Green. 2011. Working bi: Preliminary findings from a survey on workplace experiences of bisexual people. Journal of Bisexuality 11.2–3: 300–316.

                                                                          DOI: 10.1080/15299716.2011.572007Save Citation »Export Citation »E-mail Citation »

                                                                          Reported the experience of bisexual people in the workplace. Bisexuality was viewed as separate from lesbian, gay, or heterosexual. Workplace and discrimination policies were more effective for bisexual persons if they include gender identity and expression instead of sexual orientation alone. Dissatisfaction in the workplace and in life in general related to keeping one’s bisexuality a secret.

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                                                                          Sports

                                                                          Sports is not a subject often written about in an LGBT context. An example includes Anderson and Adams 2011, which looks at male soccer players from three universities. The soccer players in this study accept bisexuality and even recognize a measure of it in themselves.

                                                                          • Anderson, E., and A. Adams. 2011. “Aren’t we all a little bisexual?” The recognition of bisexuality in an unlikely place. Journal of Bisexuality 11.1: 3–32.

                                                                            DOI: 10.1080/15299716.2011.545283Save Citation »Export Citation »E-mail Citation »

                                                                            The authors interviewed sixty male soccer players from three US universities. These athletes accept bisexuality as a legitimate and nonstigmatized sexual identity. Most players recognize some bisexuality in their identities.

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                                                                            Mental Health

                                                                            Quality of life is important to anyone. Bisexual women show more mental distress than lesbians, especially if living in urban areas. Bisexuals can learn skills to increase optimism and well-being. Having a positive identity is most helpful. Examples include: Fredriksen-Goldsen, et al. 2012 (cited under Disability) found that for both lesbians and bisexual women, frequent mental distress and poor general health were associated with poverty and lack of exercise. Poor general health was associated with obesity and mental distress. Bisexual women showed more frequent mental distress and poor general health than did lesbians. Jacobs and Kane 2012 studies a sample of 802 self-identified gay and bisexual men ages forty to ninety-four years in southern Florida. They found skills building helpful in increasing self-efficacy and optimism and lowering the effects of internalized homonegativity. Luhtanen 2003 found that having a positive LGB identity was the most robust predictor of psychological well-being. Ross, et al. 2010 looks at fifty-five bisexual people in Ontario, Canada: in this study, biphobia was perceived as having a far-reaching impact on mental health. In other words, discrimination was an important determinant of mental health problems.

                                                                            • Jacobs, R. J., and M. N. Kane. 2012. Correlates of loneliness in midlife and older gay and bisexual men. Journal of Gay and Lesbian Social Services 24.1: 40–61.

                                                                              DOI: 10.1080/10538720.2012.643217Save Citation »Export Citation »E-mail Citation »

                                                                              Uses a sample of 802 self-identified gay and bisexual men aged forty to ninety-four living in southern Florida. They found skills building helpful in increasing a sense of self-efficacy and optimism and lowering the effects of internalized homonegativity. These skills may have lasting effects in reducing loneliness and improving mental and physical well-being in these men.

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                                                                              • Luhtanen, R. K. 2003. Identity, stigma management, and well-being: A comparison of lesbians/bisexual women and gay/bisexual men. Journal of Lesbian Studies 7.1: 85–100.

                                                                                DOI: 10.1300/J155v07n01_06Save Citation »Export Citation »E-mail Citation »

                                                                                A survey was given to 168 lesbians and bisexual women and 152 gay and bisexual men in Buffalo. Results were similar for lesbians/bisexual women and gay/bisexual men. Having a positive LGB identity was the biggest predictor of psychological well-being. Also rejection of negative stereotypes predicted positive LGB identity.

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                                                                                • Ross, L. E., C. Dobinson, A. Eady. 2010. Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health 100.3: 496–502.

                                                                                  DOI: 10.2105/AJPH.2008.156307Save Citation »Export Citation »E-mail Citation »

                                                                                  The research here involved fifty-five bisexual people in Ontario, Canada. Perceived determinants of emotional well-being were classified as macrolevel (social structure), mesolevel (interpersonal), and microlevel (individual). Biphobia was perceived as having a far-reaching impact on mental health, and discrimination was an important determinant of mental health problems.

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                                                                                  Disability

                                                                                  This is also a topic that is fairly under-studied. What is needed are ways to reduce disabilities in bisexuals and improve the quality of life for those with disabilities. Fredriksen-Goldsen, et al. 2012 finds that the prevalence of disability is higher among LGB persons than heterosexual persons. Efforts are needed to increase the quality of life with LGB adults with disabilities.

                                                                                  • Fredriksen-Goldsen, K. I., H-J. Kim, and S. E. Barkan. 2012. Disability among lesbian, gay, and bisexual adults: Disparities in prevalence and risk. American Journal of Public Health 102.1: 16–21.

                                                                                    DOI: 10.2105/AJPH.2011.300379Save Citation »Export Citation »E-mail Citation »

                                                                                    Compared to heterosexual counterparts, disability is more prevalent among lesbian, gay, and bisexual adults. And these adults are significantly younger than heterosexual adults with disabilities. Efforts are needed to prevent, delay, and reduce disabilities. And efforts are needed to improve the quality of life for lesbian, gay, and bisexual adults with disabilities.

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                                                                                    Substance Abuse

                                                                                    Bisexual women drink significantly less than heterosexual women but have as many problems related to drinking, including contemplating suicide. Bisexual youth also may make suicide attempts. Both lesbian and bisexual women have elevated uses of drugs, and interventions to reduce these problems are needed. Rosario 2008 finds elevated rates of substance abuse in lesbian and bisexual women compared to heterosexual women.

                                                                                    • Rosario, M. 2008. Elevated substance use among lesbian and bisexual women: Possible explanations and intervention implications for an urgent public health concern. Substance Use and Misuse 43.8–9: 1268–1270.

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                                                                                      Lesbian and bisexual women have elevated rates of substance use relative to heterosexual women. Implications are discussed for interventions to reduce substance use and abuse among lesbian and bisexual women.

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                                                                                      Suicide Attempts

                                                                                      Bostwick, et al. 2007 studies drinking patterns and problems among collegiate bisexual women in a large Midwestern university. The bisexual women were significantly more likely to contemplate suicide after drinking than were heterosexual women. Hatzenbuehler 2011 studies 11th grade students in Oregon and finds that LGB youth were significantly more likely to attempt suicide than heterosexual youth.

                                                                                      • Bostwick, W. B, S. E. MCabe, S. Horn, T. Hughes, T. Johnson, and J. R. Valles. 2007. Drinking patterns, problems, and motivations among collegiate bisexual women. Journal of American College Health 56.3: 285–292.

                                                                                        DOI: 10.3200/JACH.56.3.285-292Save Citation »Export Citation »E-mail Citation »

                                                                                        In a large Midwestern university, researchers found that bisexual women drank significantly less than heterosexual women. Few differences occurred in the two groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to drinking and were significantly more likely to contemplate suicide after drinking than heterosexual women.

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                                                                                        • Hatzenbuehler, M. L. 2011. The social environment and suicide attempts in lesbian, gay, and bisexual youth. Journal of the American Academy of Pediatrics 125.5: 896–903.

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                                                                                          In a study of 11th grade students in Oregon, it was found that lesbian, gay, and bisexual youth were significantly more likely to attempt suicide in the previous twelve months, compared to heterosexual youth. For these students, the risk was 20 percent greater in unsupportive environments. More supportive environments were significantly associated with fewer suicide attempts.

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                                                                                          HIV Testing

                                                                                          Siconolfi, et al. 2011 did a survey on HIV testing with gay, bisexual, and other young men who have sex with men.

                                                                                          • Siconolfi, D. E., P. N. Halkitis, R. W. Moeller, S. C. Barton, and S. M. Rodriguez. 2011. HIV testing in a New York city sample of gay, bisexual, and other young men who have sex with men. Journal of Gay and Lesbian Social Services 23.3: 411–427.

                                                                                            DOI: 10.1080/10538720.2011.590781Save Citation »Export Citation »E-mail Citation »

                                                                                            A survey of HIV testing took place in a New York City sample of gay, bisexual, and other young men who have sex with other men. Black men, Latino men, and young men who have homosexual relations were more likely to report a recent HIV test than white or Asian/Pacific Islander men.

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                                                                                            Homelessness

                                                                                            This is another area that does not get the coverage it deserves as it relates to bisexual youths. But many bisexual young people are homeless. Interventions are needed to help them cope with homelessness, plus substance abuse and sexual abuse if it has occurred. Rosario, et al. 2011 finds that risk factors for homelessness were child abuse and substance abuse.

                                                                                            • Rosario, M., E. W. Schrimshaw, and J. Hunter. 2011. Risk factors for homelessness among lesbian, gay, and bisexual youths: A developmental milestone approach. Child Youth Services Review 34.1: 186–193.

                                                                                              DOI: 10.1016/j.childyouth.2011.09.016Save Citation »Export Citation »E-mail Citation »

                                                                                              In a group of 156 LGB youths, 48 percent reported being homeless. They either ran away from home or were evicted from their home. Sexual orientation awareness and sexual behavior came earlier in homeless rather than non-homeless LGB youths. Child sexual abuse and substance abuse were also related to being homeless.

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                                                                                              Treatment

                                                                                              If a therapist is bisexual, it is best to make this known to bisexual clients. Bisexual clients may not reveal their sexual orientation unless they feel accepted by the therapist. Ecological intervention is helpful, as is cultural competence of the therapist. Treatment to reduce HIV and AIDS is also needed. Borden, et al. 2010 studies perceptions of self-disclosing counselors working with LGB persons. Chun and Anneliese 2010 uses an ecological perspective to explore intersecting identities for bisexual youth of color. Eady, et al. 2011 discusses the importance for mental health service providers to provide culturally competent care for bisexual clients. Keppel 2006 discusses how therapists can be most helpful with older bisexual persons. They need to provide understanding, acceptance, and a supportive attitude toward bisexuality. Martinez, et al. 2011 shows that bisexual Latino men can benefit from positive and affirmative support in therapy. Poelzl 2011 focuses on surrogate partner therapy and its use in therapy with bisexuals in sex therapy. Reisner, et al. 2001 developed a group intervention to reduce HIV sexual risk for gay and bisexual men age forty and older. Poelzl 2011 studies the use of surrogate partners with bisexual clients in sex therapy. See also American Psychological Association 2012.

                                                                                              • American Psychological Association. 2012. Guidelines for psychological practice with gay, lesbian, and bisexual clients. American Psychologist 67.1: 10–42.

                                                                                                DOI: 10.1037/a0024659Save Citation »Export Citation »E-mail Citation »

                                                                                                These guidelines provide a frame of reference for treatment of gay, lesbian, and bisexual clients. They provide information on assessment, identity, relationships, diversity, and interventions. Education, training, and research are also discussed.

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                                                                                                • Borden, L. A., C. T. Lopresto, M. F. Sherman, and H. Z. Lyons. 2010. Perceptions of self-disclosing counselors among lesbian, gay, and bisexual individuals. Journal of LGBT Issues in Counseling 4.2: 54–69.

                                                                                                  DOI: 10.1080/15538605.2010.481958Save Citation »Export Citation »E-mail Citation »

                                                                                                  A national sample of 275 LGB university students was recruited for an online survey. They were randomly assigned to read a vignette with varying levels of counselor self-disclosure. Those who received professional and personal background disclosure rated the counselor as significantly more expert, trustworthy, and attractive than those who only received professional background information. These findings are consistent with previous research on counselor self-disclosure.

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                                                                                                  • Chun, K. Y. S., and A. Anneliese. 2010. The bisexual youth of color intersecting identities development model: A contextual approach to understanding multiple marginalization experiences. Journal of Bisexuality 10.4: 429–451.

                                                                                                    DOI: 10.1080/15299716.2010.521059Save Citation »Export Citation »E-mail Citation »

                                                                                                    These researchers used an ecological perspective to explore intersecting identities for bisexual youth of color. The model seeks to change clinical, empirical, and pedagogical conversations about the identity development of bisexual youth of color.

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                                                                                                    • Eady, A., C. Dobinson, and L. E. Ross. 2011. Bisexual people’s experiences with mental health services: A qualitative investigation. Community Mental Health 47.4: 378–389.

                                                                                                      DOI: 10.1007/s10597-010-9329-xSave Citation »Export Citation »E-mail Citation »

                                                                                                      It is important for mental health service providers to provide culturally competent care for bisexual clients. A survey of fifty-five bisexual participants in Canada found that they had both positive and negative experiences with mental health providers. The article provides the practices that contribute to the perception of positive and negative services.

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                                                                                                      • Keppel, B. 2006. Affirmative psychotherapy with older bisexual women and men. Journal of Bisexuality 6.1–2: 85–104.

                                                                                                        DOI: 10.1300/J159v06n01_06Save Citation »Export Citation »E-mail Citation »

                                                                                                        Bisexual clients are likely to bring bisexual aging issues to a therapist. Many of them have been ignored, patronized, or discounted because of their bisexual orientation. They are not likely to reveal their bisexuality until the therapist provides understanding, acceptance, and supportive attitude toward bisexuality. The article also discusses how therapists can be most helpful with these clients.

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                                                                                                        • Martinez, O., B. Dodge, M. Reece, et al. 2011. Sexual health and life experiences: Voices from behaviorally bisexual Latino men in the Midwestern USA. Culture, Health and Sexuality 13.9: 1073–1089.

                                                                                                          DOI: 10.1080/13691058.2011.600461Save Citation »Export Citation »E-mail Citation »

                                                                                                          Shows that behaviorally bisexual Latino men can benefit from positive and affirmative individual- and structural-level support. This is in regard to their experiences in life.

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                                                                                                          • Poelzl, L. 2011. Reflective paper: Bisexual issues in sex therapy: A bisexual surrogate partner relates her experiences from the field. Journal of Bisexuality 11.4: 385–388.

                                                                                                            DOI: 10.1080/15299716.2011.620454Save Citation »Export Citation »E-mail Citation »

                                                                                                            Focuses on surrogate partner therapy and its use in therapy with bisexuals. A surrogate partner is a trained professional and works with bisexual clients in sex therapy.

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                                                                                                            • Reisner, S. L., C. O’Cleirigh, S. Ellen, et al. 2001. “40 & Forward”: Preliminary evaluation of a group intervention to improve mental health outcomes and address HIV sexual risk behaviors among older gay and bisexual men. Journal of Gay and Lesbian Social Services 23.4: 523–545.

                                                                                                              DOI: 10.1080/10538720.2011.611113Save Citation »Export Citation »E-mail Citation »

                                                                                                              A group intervention was developed to reduce HIV sexual risk for gay and bisexual men age forty and older. These men reported problems with depression, isolation/loneliness, and social anxiety. Eighty-four participants (mean age fifty-one, HIV infected) who completed the intervention had statistically significant reductions in depression, social anxiety, loneliness, and fear of negative evaluation. Use of condoms increased.

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                                                                                                              Public Health Services

                                                                                                              Dobinson, et al. 2005 proposed improving public health services for bisexuals.

                                                                                                              • Dobinson, C., J. MacDonnell, E. Hampson, J. Clipsham, and K. Chow. 2005. Improving the access and quality of public health services for bisexuals. Journal of Bisexuality 5.1: 39–77.

                                                                                                                DOI: 10.1300/J159v05n01_05Save Citation »Export Citation »E-mail Citation »

                                                                                                                Bisexuals have specific experiences and needs in health and wellness that should be addressed. Information needs to be gathered from bisexuals about their health and wellness needs and experiences, gaps in health-care services, and barriers to getting their needs met with appropriate services and support.

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                                                                                                                Media Portrayals

                                                                                                                The media affects all of us. For bisexuals the media can either hide bisexuality or offer positive role models for bisexuals. Films can also teach people about sexuality and gender while subverting conventional thinking on these topics. Gormillion and Giuliano 2011 studied LGB persons in Texas: it finds that the media was an influence on their self-realization, coming out, and identities. Meyer 2010 studies bisexuality on TV. Pramaggiore 2011 concludes that cinema and television erases bisexuality; Watson 2008 examines the portrayal of bisexuals in various films developed in Australia.

                                                                                                                • Gormillion, S. C., and T. A. Giuliano. 2011. The influence of media role models on gay, lesbian, and bisexual identity. Journal of Homosexuality 58.3: 330–354.

                                                                                                                  DOI: 10.1080/00918369.2011.546729Save Citation »Export Citation »E-mail Citation »

                                                                                                                  In a study of 126 LGB respondents in Texas, it was found that the media influenced their self-realization, coming out, and identities. The media provided role models and inspiration. In a second study of fifteen respondents, it was revealed that media role models provided sources of pride, inspiration, and comfort.

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                                                                                                                  • Meyer, M. D. E. 2010. Representing bisexuality on television: The case of intersectional hybrids. Journal of Bisexuality 10:366–387.

                                                                                                                    DOI: 10.1080/15299716.2010.521040Save Citation »Export Citation »E-mail Citation »

                                                                                                                    According to this study, bisexuality increased on TV in the early part of the 21st century. The representation, however, has been generally been non-white, and outside of traditional coming-out stories associated with lesbian and gay persons. Bisexuals are presented as hybrids.

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                                                                                                                    • Pramaggiore, M. 2011. Kids, rock and couples: Screening the elusive/illusive bisexual. Journal of Bisexuality 11.4: 587–593.

                                                                                                                      DOI: 10.1080/15299716.2011.620889Save Citation »Export Citation »E-mail Citation »

                                                                                                                      The cinema and television basically erases bisexuality. It is treated as an impossibility or an enigma.

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                                                                                                                      • Watson, J. 2008. Representations of bisexuality in Australian film. Journal of Bisexuality 8.1–2: 97–114.

                                                                                                                        DOI: 10.1080/15299710802142267Save Citation »Export Citation »E-mail Citation »

                                                                                                                        Examines the portrayal of bisexuals in various Australian films. Particularly films such as Priscilla, Sirens, and Dallas Doll undermine binary assumptions of male/female and heterosexual/LG. They subvert conventional ideas about sexuality and gender.

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                                                                                                                        Visibility

                                                                                                                        More articles talk about the invisibility of bisexuals than their visibility. Kangasvuo 2011 is an exception: this study finds that Finnish bisexuals worked to get visibility and equality in their country.

                                                                                                                        • Kangasvuo, J. 2011. “There has been no phase in my life when I wasn’t somehow bisexual”: Comparing the experiences of Finnish bisexuals in 1999 and 2010. Journal of Bisexuality 11.2–3: 271–289.

                                                                                                                          DOI: 10.1080/15299716.2011.571989Save Citation »Export Citation »E-mail Citation »

                                                                                                                          A researcher studied forty Finnish self-identified bisexual people in 1999. Most were active in sexual minority subcultures and politics and wanted to increase the visibility of bisexuality. By 2010, the visibility and equality of sexual minorities had improved considerably.

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                                                                                                                          Research

                                                                                                                          Research on bisexuality is important to make bisexuals less invisible and to find out more about their lives. Carr 2011 proposes that research that does not study lesbian and bisexual women together is best since bisexual women have distinct experiences in health, discrimination, and substance abuse, as well as in other areas. Dodge, et al. 2008 indicates that Alfred Kinsey and his colleagues provided a legacy of work to explore human sexual behavior, including bisexuality. But bisexuality research has not taken advantage of the frameworks provided by Kinsey’s work. Galupo 2011 suggests the need for more research on bisexuals. Hartman 2011 discusses strategies to recruit a bisexual research sample. Steinman 2011 looks at the invisibility of (male) bisexuality and use of grounding (queer) theory.

                                                                                                                          • Carr, C. Lynn. 2011. Women’s bisexuality as a category in social research revisited. Journal of Bisexuality 11.4: 550–559.

                                                                                                                            DOI: 10.1080/15299716.2011.620868Save Citation »Export Citation »E-mail Citation »

                                                                                                                            In some research studies lesbian and bisexual women are studied as one group. And in other studies, they are dealt with separately. This distinction is useful because bisexual women have different experiences in health, discrimination, and substance abuse, as well as in other areas.

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                                                                                                                            • Dodge, B., M. Reece, and P. H. Gebhard. 2008. Kinsey and beyond: Past, present, and future considerations for research on male bisexuality. Journal of Bisexuality 8.3–4: 175–189.

                                                                                                                              DOI: 10.1080/15299710802501462Save Citation »Export Citation »E-mail Citation »

                                                                                                                              Alfred Kinsey and his colleagues provided a legacy of work that explored human sexual behavior, including bisexuality. But bisexuality research has not taken advantage of the innovations in Kinsey’s work.

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                                                                                                                              • Galupo, M. P. 2011. Bisexuality: Complicating and conceptualizing sexual identity. Journal of Bisexuality 11.4: 545–549.

                                                                                                                                DOI: 10.1080/15299716.2011.620866Save Citation »Export Citation »E-mail Citation »

                                                                                                                                The focus is on including bisexuality in research on sexual orientation because it would lead to new ways to conceptualize sexual orientation. The author suggests that more research should focus on material relations, social structures, and everyday interactions of bisexuals.

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                                                                                                                                • Hartman, J. E. 2011. Finding a needle in a haystack: Methods for sampling in the bisexual community. Journal of Bisexuality 11.1: 63–73.

                                                                                                                                  DOI: 10.1080/15299716.2011.545306Save Citation »Export Citation »E-mail Citation »

                                                                                                                                  Discusses several strategies for recruiting a bisexual sample. Those samples that worked and those that did not were identified.

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                                                                                                                                  • Steinman, E. 2011. Revisiting the invisibility of (male) bisexuality: Grounding (queer) theory, centering bisexual absences and examining masculinities. Journal of Bisexuality 11.4: 399–411.

                                                                                                                                    DOI: 10.1080/15299716.2011.620460Save Citation »Export Citation »E-mail Citation »

                                                                                                                                    The author recommends that more attention in research should be given to male bisexuals. Again, this is because of the continuing invisibility of male bisexuals.

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