Bisexual invisibility isn't just a social problem—it's a public health issue

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A new report from the University of Vanderbilt has reaffirmed what many LGBTQ health policy advocates have concluded the United States' population of self-identified bisexual people: bisexual invisibility is a real phenomenon with very harmful, concrete effects. According to Gilbert Gonzales, Ph.D, the study's lead researcher, bisexual people are at significantly higher risk of abusing alcohol and cigarettes as compared to their gay, lesbian, and straight counterparts.

“Findings from our study indicate that LGB adults experience significant health disparities—particularly in mental health and substance use—likely due to the minority stress that LGB adults experience as a result of their exposure to both interpersonal and structural discrimination,” Gonzales wrote. “Combined with the relative scarcity of bisexual communities and organizations, this ostracizing may lead to social isolation, a risk factor for psychological distress."

Oftentimes, when we talk about the current LGBTQ civil rights movement, we're only actively thinking about people who identify as lesbian, gay, or transgender because, historically, their sexualities and gender presentations have read as the most non-normative or transgressive.


Bisexual people are in a unique position considering that, in some instances, their sexualities don't immediately read as non-heterosexual. A bisexual man dating a woman might, to those who don't know him, appear to be straight and the same can be said of a bisexual woman dating a man. For some people, going "stealth" is preferable given the stigma that is still attached to same-sex couplings.

As many bisexual people will explain, however, even in those instances where they do let people know about their sexual orientation, their assertions are often dismissed as confusion or denial. A 2013 study conducted by a team of researchers at Indiana University and the University of Pittsburgh found that 15% of people refused to accept bisexuality as a "legitimate sexual orientation."

Between being treated like myths and outright demonized, bisexual people have described the feeling of bi-invisibility—the erasure of their identities by both mainstream heterosexual culture and the queer subculture that bisexual people supposedly belong to.

“There’s a lot of prejudice against [bisexual people]" Dr. Lisa Lindley, Associate Professor of Global and Community at George Mason University said in 2011. "They’re told ‘You’re confused—pick one.’ There tends to be this expectation or standard that a person picks one sexual identity and sticks with it."


Lindley's research into the effects of bisexual invisibility found that bi-identified men and women were both more likely to report having dealt with depression and binge-drinking as teenagers, but that bisexual women were more likely to continue dealing with those problems as adults.

Gonzales' research compared the drinking habits and experiences of moderate to severe psychological distress reported by bisexual men and women to those of straight people and found that, once again, there were strong indicators that bi-invisibility led to self-abuse.


On average, bisexual women were nearly four times as likely to report severe psychological distress, twice as likely to drink heavily, and just over 1.5 times more likely to smoke. The numbers were higher for bisexual men who reported being nearly five times as likely to experience severe psychological distress, three times more heavy drinking, and two times more heavy smoking.

While there have been calls for increased acceptance of bisexual people from voices within the larger queer community, Gonzales and his team assert that the most effective method of dealing with the public health needs of the bisexual community begins with more in-depth attention from health care providers.


"[Our findings] should serve as a call to health care professionals and public health practitioners to pay particular attention to the current and future health outcomes of this small, diverse, and vulnerable population," he said.