Mental illness is common among the bisexual population. This is typically due to the stigma, oppression, and discrimination they and others face in LGBTQIA+ communities. These factors can all contribute to negative consequences for mental health.
Bisexuality is a type of sexual orientation. A person is bisexual when they experience sexual attraction, romantic attraction, or both to more than one gender.
Bisexual people make up the largest population in LGBTQIA+ communities. But there is a lack of research on mental health issues among bisexual people.
This article explores existing research on mental illness in bisexual people. It is also looking at where these populations could find support.
Mental health statistics for bisexual people
An older report from the San Francisco Human Rights Commission states that bisexual people make up the largest single population within LGBTQIA+ communities. According to the American Psychiatric Association (APA), approximately 3.9% of the adult population in the United States is bisexual.
But there is a lack of significant research on mental health among bisexual people. This is despite research that suggests bisexual people are at higher risk of mental illness than lesbian women and gay men.
In a 2020 study that looked at the mental health of Australian bisexual people, 72% of participants reported high or very high levels of psychological distress. Other research also shows that bisexual people have higher or equivalent rates of poor results for depression and anxiety compared to gay and lesbian people.
Bisexual women in particular suffer from higher lifetime rates of mood and anxiety disorders than lesbian and heterosexual women. Similarly, bisexual men suffer from higher lifetime rates of mood and anxiety disorders than straight men.
Research also shows that bisexual people are at higher risk of suicide and non-suicidal self-harm than heterosexual, gay, and lesbian people.
Depression and bisexuality
The APA notes that bisexual people are more likely to suffer from depression than straight, gay, and lesbian people.
The Centers for Disease Control and Prevention (CDC) also notes that bisexual and gay men are at higher risk of severe depression.
A 2015 study suggests that bisexual women are 26% more likely to feel depressed than lesbian women.
A review from 2018, which looked at various studies, also found that depression scores were higher among bisexual people than among straight, gay, and lesbian people. The review suggests three possible causes of depression:
- Discrimination based on sexual orientation: Bisexual people may experience stigma, prejudice, and discrimination that is qualitatively different from lesbian and gay people.
- Bisexual invisibility and extinction: These are related to the delegitimization of bisexual identity, e.g. people who perceive bisexual people more as heterosexual, gay, or lesbian as bisexual.
- Lack of bisexual positive support: This can include a lack of support from bisexual individuals’ partners as well as lack of support within LGBTQIA+ communities and society as a whole.
A study from 2020 also highlights that healthcare professionals may not be as familiar with the health needs of bisexual people, which can lead to negative consequences for this population.
anxiety and bisexuality
A systematic review from 2018 highlights the increased anxiety rate among bisexual people. This is in line with a 2020 study that found higher anxiety symptoms in bisexual people.
According to the CDC, gay and bisexual men are at higher risk of generalized anxiety disorder. Similarly, bisexual women are 20% more likely to be afraid than lesbian women.
Stress and bisexuality
A 2015 study suggests that bisexual women are more likely to experience stress from social environments due to discrimination based on heterosexism and monosexism. This can result in bisexual women having poorer mental health than lesbian women.
Bisexual people are also likely to suffer stress from minorities. This concept is based on the fact that bisexual people have sexual minority status. This leads to psychological stress, which can result from:
- internalized monosexism
- Discrimination and violence
A study from 2020 also finds that bisexual people are likely to suffer from sexual identity stress on multiple levels. This includes stress caused by:
- identity uncertainty
- Need to hide their sexual orientation
- , a weaker sense of connection with LGBTQIA+ communities
Substance abuse and bisexuality
Bisexual people can also experience substance abuse. This may be a response to their experiences of discrimination, stress, and violence.
A 2017 review suggests that bisexual people are generally at increased risk of substance abuse, with bisexual people more likely to drink heavily and use drugs illegally.
This is consistent with other findings that suggest that bisexual men are more likely to abuse tobacco and alcohol than the general population. Similarly, bisexual women drink more than straight women and are at higher risk of developing an alcohol use disorder.
The CDC also points out that bisexual men may also use other illegal drugs, such as methamphetamines. This may contribute to a higher chance of contracting sexually transmitted infections, such as HIV.
Low self-esteem and bisexuality
Low self-esteem in bisexual people can result from a number of scenarios. This may result from rejection from society, family and friends, as well as religious pressure and social discrimination.
An older report finds that bisexual people experience more stigma when their identity is delegitimized, such as being told that their sexual identity is a “phase.” This can result in bisexual people having lower self-esteem and less security about their sexual identity.
An older study shows that bisexual women reported significantly lower self-esteem than straight women. A 2017 study yielded similar results, with bisexual women reporting lower self-esteem. This study also finds that self-esteem hasn’t risen among bisexual women from puberty to adulthood.
A 2019 study of bisexual men finds that low self-esteem and low self-esteem had an impact on substance abuse and mental health. It also suggests that people in this population are more likely to contract HIV.
Eating Disorders and Bisexuality
A variety of factors can influence the development of eating disorders in bisexual people, including low self-esteem, discrimination, poor mental health, and impractical body standards.
Bisexual men may be at higher risk of body dysmorphia and eating disorders. This is in line with a 2020 study that also suggests that bisexual men are at higher risk of developing eating disorders than straight men.
There is evidence that bisexual women are twice as likely to have an eating disorder than lesbian women. A study from 2020 found that bisexual people are also more likely to suffer from disturbed eating habits such as cleansing and binge eating than heterosexual people.
Where to find support
Psychological complications are common among bisexual people, but support is available. A few options that people should consider include:
- Community: Building connections with other bisexual people and others within LGBTQIA+ communities can help people feel more secure and welcome.
- Identity: Involvement and pride in one’s own bisexual identity can help prevent delegitimization. For example, people might want to join interest groups.
- Therapy: Seeking a therapist who supports and validates bisexual identities can help improve a person’s well-being.
- Healthcare: Finding a doctor who not only supports bisexual identities but is also familiar with complications that bisexual people may face may contribute to better health outcomes.
In addition, there are many organizations that can support bisexual people. This includes the following:
- American Institute of Bisexuality
- biNet USA
- Bisexual Resource Center
- Boston Bisexual Women’s Network
- The Trevor Project
Click here to learn more about available mental health resources.
Some evidence suggests that bisexual people may be at higher risk of suicide than heterosexual, gay, and lesbian individuals.
Bisexual people can access national hotlines for free, confidential support from trained professionals. These hotlines are available 24 hours a day and can benefit anyone who is struggling with their mental health or who wants or needs to talk about their feelings.
People who may not feel comfortable talking on the phone or verbally discussing their emotions can try online messaging and text-based support options instead.
If a person believes someone is at immediate risk of suicide, they should call 911 or a local emergency number. People should try to provide as much accurate information as emergency services need.
If you know someone who is at imminent risk of self-harm, suicide, or harm, another person:
- Ask the tough question: “Are you considering suicide?
- Listen to the person without judgement.
- Call 911 or the local emergency number, or send TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove weapons, medicines, or other potentially harmful objects.
If you or someone you know is having suicidal thoughts, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 and then 988.
Click here for more links and local resources.
Mental illness is common in the bisexual community. Many factors — such as stigma, discrimination, and oppression — can contribute to these negative consequences for mental health.
More research is needed to provide better, personalized care and solutions to bisexual individuals who are more vulnerable to mental illness due to stigma and discrimination.
However, support is available. Bisexual people can get support and advocacy from multiple organizations. Additionally, finding supportive communities and healthcare professionals who confirm bisexual identities can contribute to wellbeing.