Bisexual Health Month: what we need to know

On Bisexual Health Month, Stephanie Farnsworth examines the health issues bisexual people are facing

Often under the radar is that March is Bisexual Health Month. Awareness dates tend to draw as much enthusiasm as scepticism; while the attention on a novelty event does help increase awareness it is often also viewed as a cynical ploy that allows these issues to be forgotten for much of the year. Bisexual Health Month is rarely acknowledged by those outside of the bisexual community however, so even having the month dedicated to this specific issue it’s impact is often limited. LGB issues are rarely separated, and this is particularly true when it comes to matters of health as few even realise the distinct risks that bisexual people face compared to gay, lesbian and straight people. The assumption is often (falsely) that bisexual people face half the issues in life of gay people.

Studies however have isolated potential risks that bisexual people face to their health. The issue with the vast majority of such studies though is that often they fail to recognise bisexual people of colour, bisexual people who are deaf or disabled and bisexual transgender people. Even today, the best “LGBT” studies don’t look at what gay, straight bi or transgender people specifically face. They they examine what gay, bisexual or transgender people face but don’t acknowledge that a trans person can be gay or bisexual. It’s hugely problematic as stats therefore focus on only gay or bi cisgender people or straight trans people and this ignores the increased risk factors of being both gay/bisexual and transgender. For instance, people of colour and transgender people are commonly found to be at higher risk of poverty and suffering hate crimes. Bisexual people also have been found to suffer disproportionately from these issues – but white, cisgender bisexual people are given primacy.

One study in the US found that 40% of bisexual people were also people of colour and around one half were transgender so any omission of these identities in studies clearly skews the picture of what bisexual people are facing. The stats suggest that bisexual trans people of colour would be at an even higher risk yet their identities are not taken into account as it is routinely forgotten that a person can have more than one facet to their identity. The result is that many bisexual people may be at greater risk of certain health events or conditions which have not yet been identified. Due to the limited number of studies (and funding) when it comes to supporting bisexual people this is unlikely to change but there are certain facts that we are aware of. Furthermore, many studies are embedded with cissexism and so even identifying risk groups for numerous genders because a much more difficult task.

The stats suggest therefore that bisexual trans people of colour would be at an even higher risk yet their identities are not taken into account as it is routinely forgotten that a person can have more than one facet to their identity.

A major barrier to maintaining good health for bisexual people is that they are far less likely to be out to their doctor: only one third in the UK are. Doctors (and health care practitioners in general) are supposed to be confidantes who deliver care based on all of the information they can gather. Not being able to be out limits the care that one can obtain. Health care services have seemed unwilling to tackle disparities when it comes to marginalised groups, and within the LGB world this is especially true when it comes to bisexual people. The lack of studies and research into the health of bisexual people also means that even when someone is able to be out to their healthcare provider, the person giving the care may not necessarily understand what that means and what health issues may be at risk of occurring.

Sexually transmitted infections and diseases unfortunately  seem to be the only health issue that is ever addressed when it comes to gay and bisexual people, but health care even in this area is failing. Bisexual men are far less likely to be screened for HIV while there are lower rates of screening for HPV in women which can lead to cervical cancer. Furthermore, bisexual men seem to have elevated rates of HPV which can lead to anal cancer. The onus therefore needs to be on wider availability (or any in most countries) of the HPV vaccine for men and people of other genders and not exclusively contained to cisgender women.

Sexually transmitted infections and diseases unfortunately  seem to be the only health issue that is ever addressed when it comes to gay and bisexual people, but health care even in this area is failing.

Cancer is often talked about whenever health is mentioned but it is never associated with sexuality, despite evidence that bisexual people are at higher risk of developing certain types. Anal and cervical have already been mentioned, but bisexual people are also at risk for others. Bisexual people are far more likely to smoke tobacco and this inevitably increases the risk of lung cancer (around 85% of all lung cancers are directly caused by smoking). Unfortunately, this is a double edged sword and smoking is commonly a response to stress and bisexual people are at high risk of facing stress, mental health issues, biphobia and trauma. One study in the US also indicated that bisexual women are more likely to develop breast cancer, this is believed in part to be because bisexual women are less likely to have given birth before the age of thirty.

Bisexual people are also more likely to experience substance abuse, and this can lead to cancer such as alcohol being linked with cancer of the liver. However, this is often also a product of long term trauma and stress which further suggests that biphobia is the overwhelming contributing factor to bisexual people experiencing poorer health and poorer health care. Furthermore, substance abuse is still treated in a very narrow way. Medications aren’t easily available and there is still a great deal of stigma towards addiction and substance abuse in society. Often, the only support for people are AA or NA groups but this is one model which does not work for everyone. A more flexible approach is needed for those with different needs and experiences. It’s time health care moved beyond narrow stereotypes as it can be evidenced by the entire history of the LGBTQ community that this approach always fails.

It’s time health care moved beyond narrow stereotypes as it can be evidenced by the entire history of the LGBTQ community that this approach always fails.

Mental health issues are a common reality for bisexual people due to long term stresses such as entrenched biphobia in society. Mental health issues and the experiences of bisexual people were recently analysed for The Queerness, which identified higher levels of suicidal ideation, self harm, depression, anxiety and substance abuse among bisexual people. Long term stress also has a major impact on health and can manifest itself in a variety of ways: digestive problems, autoimmune diseases/conditions, strokes, and blood pressure problems have all been identified with being triggered by stress.

Health also goes beyond the responses of our bodies and the conditions they can develop but it also is about what other people do to our bodies. Bisexual people are also at risk of being directly harmed by domestic violence or intimate partner violence. Bisexual people are also at a much higher risk of experiencing sexual assault in general.

While Bisexual Health Month is a strong tactic to try to raise awareness of an issue that has never gotten any attention, the issue is so chronic that it is imperative that medical professionals recognise the different experiences and conditions that bisexual people are likely to experience so that they can be given proper treatment and support. Sexuality does not just direct how one may be more likely to be exposed to certain STIs; it is something that can impact many aspects of health from physical, to mental and emotional. In ten years (with hopefully more targeted studies at the bisexual population) this information may well not be relevant because we will simply have a better idea of what bisexual people face. There haven’t been enough studies to suggest we’ve done anything but scratch the service when it comes to the health of bisexual people.

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