Researching for LGBTQ Health

Bisexual Identity: Implications for Mental and Sexual Health

Bisexual men represent a population that is under-represented in research. Studies often pool samples of bisexual men together with those of gay men despite possible differences between the two groups. Indeed, recent studies have shown that bisexual men have different patterns of mental health outcomes and sexual behaviours than gay, lesbian, or heterosexual individuals. The reasons for these differences are not well understood due to the paucity of research on bisexual men. Our team will examine whether popular theories used to explain mental health and sexual risk behaviour in gay men also apply to bisexual men. The theories we will study are: the minority stress theory, the syndemic theory, the theory of planned behavior, and the health belief model.

According to minority stress theory, lesbian, gay, and bisexual (LGB) individuals may experience stress from living in an environment that stigmatizes their sexual orientations. Research has shown that many bisexual individuals live with daily stressors related to their bisexual identity, such as biphobia and social marginalization. These stressors in turn have been shown to affect health. Despite this, many individuals are resilient to these stressors, and so, we are interested in the role of stress-protecting factors such as social support. Like minority stress theory, syndemic theory posits that some individuals’ psychosocial health problems can emerge in response to a stigmatizing environment. When the individual has more than one psychosocial health problem, the overall impact on their health is greater.

Our team will also be examining elements from the theory of planned behavior (TPB) and the health belief model (HBM). These theories have been used extensively in the literature on sexual behaviour. The TPB posits that subjective norms, attitude, and perceived behavioral control toward condom use influence a person’s intention to use condoms. The HBM examines the influences of benefits and barriers to condom use, condom use self-efficacy, and perceived severity and susceptibility to HIV.

Sampling will occur in three locations (200 participants in each location): Montreal, Toronto, and Washington, DC, each of which has similar population sizes. To recruit participants, we will use Respondent-Driven Sampling (RDS), a method of sampling in which participants are asked to recruit members of their own social group. Our definition of bisexual encompasses people attracted to more than one sex and/or gender and may include those who identify with a different label (or none at all).

Using a multiplicity of theories will allow us to determine which theory better explains the health disparities measured in other studies between bisexual men and other men. The results of the proposed research will have important implications for identifying factors of resilience and tailoring interventions to bisexual men.


  • Principal Investigator: Dr. Nathan Smith (McGill University)
  • Co-Investigators: Dr. Lori Ross (CAMH) and Dr. Jonathan Mohr (University of Maryland)
  • Project Coordinator: Marianne LeBreton
  • Research Assistants: Skyler Jackson, Andre Smith (year 1), Nael Bhanji (year 2)

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Canadian Institutes of Health Research

Funded by the Institute of Gender and Health of the Canadian Institutes of Health Research.

Project Outcomes: