Researching for LGBTQ Health

This is Our Community: Bisexual Anti-stigma Poster Campaign

Research in both Canada and the US has shown that bisexuals have poorer mental health and use mental health services more often than heterosexuals, gays, or lesbians (1-7). One possible reason for this may be experiences of stigma, prejudice and discrimination that create a hostile social environment. These experiences can trigger mental health problems or make existing problems worse.

Our pilot research asked 55 bisexual people from across Ontario about factors that they felt affected their mental health, both positively and negatively. These bisexuals reported that discrimination negatively affected their mental health on multiple levels, a finding backed up by other research in the field (7-10). Bisexual people in the pilot study reported several types of stressful experiences:

  1. being discriminated against for being bisexual (biphobia).
  2. being labelled as “really” straight or gay/lesbian and having their bisexuality regarded as illegitimate (monosexism).
  3. feeling that they have to constantly explain and justify their sexual identity to others (monosexism, biphobia).
  4. the media not portraying bisexuality as a legitimate and healthy sexual identity (marginalization, erasure and invisibility).

While experiences of stress makes us sick, relationships with friends, family, partners, and the LGBTQ community help keep us healthy. Research has found that belonging to the LGBTQ community can reduce the effects of minority stress. However, due to biphobia and monosexism, bisexuals may lack access to this support (2, 9, 11).

The “This is Our Community” posters address the issue of bisexual inclusion in LGBTQ communities and provide much needed positive images of bisexuals. The four posters provide visibility to groups identified in our pilot study, and in the literature on bisexual health, as strongly impacted by biphobia. These groups are:

Bisexual mothers

Bisexual mothers: Due to stereotypes, many people think that only straight women have children. As a result, the authenticity of pregnant or mothering women’s bisexuality is often questioned. People may assume a pregnant woman is straight, for example, or may ask a visibly queer woman how she became pregnant.

Bisexual mothers describe feeling invisible within the LGBTQ community, or report that others stop seeing them as queer (8, 12). Yet pregnancy is not uncommon among lesbian and bisexual women. Studies show that over 25% of queer women have been pregnant at some point in their lives (13-14). Statistics Canada found that 16% of female couples in Canada were parenting, and 24.5% of married female couples had children (15-16). A US study found that almost 40% of black lesbians and bisexual women, 15% black gay and bisexual men, and black transgender people have children (17).

Our poster is designed to remind health care providers and LGBTQ community members that bisexual mothers belong in our LGBTQ community. Our bisexual model, Danielle, is 9 months pregnant.

Trans bisexuals

Trans bisexuals: Bisexual-identified trans people have often been doubly stereotyped as confused about their sexuality and their gender identity. As a result, some trans people have been denied access to trans health services if they identified as bisexual. A number of bisexual trans people have had to pretend to be straight or gay/lesbian in order to be approved for needed treatments. Bi trans people were often judged by straight trans people as being either “not really trans” or as “kinky.”

While biphobia among some health service providers has diminished, the stigma associated with being both trans and bi has remained. Bisexual trans people report difficulty getting appropriate and useful health care (9, 18-19).

Our poster aims to remind both health care providers and LGBTQ community members that bisexual trans people belong in our LGBTQ community. Our bisexual trans model, Rupert Raj, is a well-known trans activist and a senior. Currently 59, he makes no apology for his gender, sexuality identity, or age. He is a therapist, both in private practice and at the Sherbourne Health Centre, who provides counselling to LGBTQ people and their loved ones.

Racialized bisexuals & two-spirited people

Racialized bisexuals & two-spirited people: Bisexuals who belong to racialized groups experience stress from multiple oppressions, including racism, ethnocentrism homophobia, biphobia, monosexism, heterosexism and the cultural impact of colonialism and religious evangelism (20-21).

Despite evidence that they are at high risk for certain health problems, racialized bisexual people face multiple barriers to getting adequate medical care (22-23). Health care providers are often dismissive of their health concerns, or make unfounded assumptions about their sexuality and lifestyle.

In addition, racialized bisexuals and two-spirited people face racism and colonialism within their own LGBTQ communities (21, 24-26). People often assume racialized communities are homophobic, and issues of racism and colonialism are often treated as if they are not legitimate LGBTQ issues. Our poster aims to challenge the racism and white supremacy within the health care system and our LGBTQ communities. Our model, Blu, is a two-spirited Cree activist and traditional counsellor who runs a two-spirited group for LGBT people of the First Nations.

Bisexual youth:

Bisexual youth: Bisexual youth experience high rates of sexual harassment, bullying and physical abuse –often higher than their gay and lesbian peers (27-28). Despite these stressors, bisexual youth are active in the LGBTQ community and in LGBTQ activism across the country, fighting for all of our rights. Due to stereotypes about youth as uninvolved or apolitical, this work often goes unnoticed or unappreciated. Within Canada and the US, bisexual youth have organized support groups and gay-straight alliances to combat homophobia in schools and across the country. They have worked helplines, given workshops, done safer sex outreach, and volunteered with LGBTQ organizations, even when those organizations failed to recognize youth contributions or support youth issues. Our poster featuring Aintony, an African-Canadian youth, recognizes the hard work that bisexual youth have done for the LGBTQ community.

Our model, Aintony, is 18-years old, and volunteers with the Connect-Us-Mentoring Program and Malvern Action For Neighborhood Change. He is starting his own business and aspires to run a youth group.


References:

(1) King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, et al. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people., BMC Psychiatry 2008; 8:70.

(2) Meyer IH. “Prejudice, social stress, and mental health in lesbian gay, and bisexual populations: Conceptual issues and research evidence. Psychology Bulletin 2003; 129(5):674-679.

(3) Case P, Austin SB, Hunter DJ, Manson JE, Malspeis S, Willett WC, et al. Sexual orientation, health risk factors, and physical functioning in the Nurses' Health Study II. Journal of Womens’ Health 2004; 13:1033-1047.

(4) Tjepkema M. Health care use among gay, lesbian and bisexual Canadians. 2008. Statistics Canada: Health Reports.

(5) Koh AS, Ross LK. Mental health issues: a comparison of lesbian, bisexual and heterosexual women. Journal of Homosexuality, 2006; 51:33-57.

(6) Steele LS, Ross LE, Dobinson C, Veldhuizen S, Tinmouth J. Women's sexual orientation and health: Results from a Canadian population-based survey. Women & Health 2009; 49(5):353-367.

(7) Jorm AF, Korten AE, Rodgers B, Jacomb PA, Christensen H. Sexual orientation and mental health: Results from a community survey of young and middle-aged adults. British Journal of Psychiatry 2002; 180(5):423-427.

(8) Ross LE, Dobinson C, Eady A. Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health 2010; 111(3):496-502.

(9) Eady A, Ross LE, Dobinson C. Bisexual People's Experiences with Mental Health Services. Community Mental Health Journal 2010; 1-12.

(10) Dobinson C, Macdonnell J, Hampson E, Clipsham J, & Chow K. Improving the access and quality of public health services for bisexuals. 2003. Toronto: Ontario Public Health Association.

(11) Sheets RL, Mohr JJ. Perceived social support from friends and family and psychosocial functioning in bisexual young adult college students. Journal of Counseling Psychology 2009; 56:152-163.

(12) M. Robinson. Turning Points in Identity and Theology: Bisexual Women Choosing Between Polyamorous and Monogamous Relationships. University of St. Michael’s College; 2009.

(13) Bailey JV, Farquhar C, Owen C, Whittaker D. Sexual behaviour of lesbians and bisexual women. Sexually Transmitted Infections 2003; 79:147-150.

(14) Cochran SD, Mays VM, Bowen D, Gage S, Bybee D, Roberts SJ, et al. Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women. American Journal of Public Health 2001; 91(4):591-597.

(15) Milan A, Vézina M, Wells C. Family portrait: Continuity and change in Canadian families and households in 2006: Findings. 2006; 97-553-XWE2006001.

(16) Statistics Canada. 2006 Census: Families, marital status, households and dwelling characteristics. 2007.

(17) Battle, J., Cohen, C., Warren, D., Fergerson, G. and Audam, S. (2002). Say It Loud: I’m Black and I’m Proud; Black Pride Survey 2000. New York: National Gay and Lesbian Task Force Policy Institute.

(18) Califia P. Sex Changes: The Politics of Transgenderism. San Francisco: Cleis Press; 1997.

(19) Namaste V. Invisible Lives: The Erasure of Transsexual and Transgendered People. Chicago: University of Chicago Press; 2000.

(20) Bisexual Anthology Collective editor. Plural desires: Writing bisexual women's realities. Toronto: Sister Vision: Black Women and Women of Color Press; 1995.

(21) Warner T. Never going back: A history of queer activism in Canada. Toronto: University of Toronto Press; 2002.

(22) 2-Spirited People of the 1st Nations. Our Relatives Said: A Wise Practices Guide, Voices of Aboriginal Trans People; 2008.

(23) Ryan B, Brotman S, Baradaran A, Lee E. The colour of queer health care: Experiences of multiple oppression in the lives of queer people of colour in Canada. In: Brotman S, Lévy JJ, editors. Intersections: cultures, sexualités et genres Québec City: Presses de l'Université du Québec; 2008. p. 307-317.

(24) Boodram C. Building the Links: The Intersection of Race and Sexual Orientation. 2011. Egale Canada.

(25) van der Meide W. The Intersection of Sexual Orientation & Race: Considering the Experiences of Lesbian, Gay, Bisexual, Transgendered (“GLBT”) People of Colour & Two-Spirited People. 2001. Egale Canada.

(26) van der Meide W. The Intersections Of Sexual Orientation, Race, Religion, Ethnicity And Heritage Languages: The State Of Research. 2002. Canadian heritage, multicultural program.

(27) Lindley LL, Kerby MB, Nicholson TJ, Lu N. Sexual Behaviors and Sexually Transmitted Infections Among Self-Identified Lesbian and Bisexual College Women. Journal of LGBT Health Research 2007; 3(3):41-54.

(28) Rainbow Tobacco Intervention Project. The Toronto Rainbow Tobacco Survey: A Report on Tobacco Use in Toronto's LGBTTQ Communities. 2007.