Researching for LGBTQ Health

Risk and Resilience among Bisexual People in Ontario: A Community-Based Study of Bisexual Mental Health

Bisexual people are often left out of research. When we are included, we are often lumped in with heterosexuals, gays, or lesbians rather than being studied as a distinct group. This makes it next to impossible to get statistics about our health, to compare bisexual health with the heath of non-bisexuals, or to identify health issues that are unique to our community. As a result, bisexuals often receive little benefit from the research in which they have participated.

Those studies that do focus on bisexual people have found that bisexuals report poorer mental health and use mental health services more often than heterosexuals do. These studies also found that bisexuals report higher rates of anxiety, depression, poor self-rated mental health, suicidality and self-harm behaviour, than gay and lesbian people do. However, we have little understanding of why bisexuals experience these mental health disparities. Understanding the context of bisexual mental health, a pilot study conducted by our research team identified homophobia, biphobia, and monosexism as factors affecting the mental health of bisexuals in Ontario. Many reported a lack of in-group community support, and many felt marginalized in both the heterosexual community and the lesbian and gay community (see Note 4).

The Risk & Resilience project surveyed bisexual people from across Ontario about their mental health and their experiences with mental health services. For this study, our definition of bisexual included people attracted to more than one sex and/or gender. This also included those who self-identified as bisexual, queer, pansexual, omnisexual, two-spirited, fluid, or who choose another non-heterosexual identity label (see Note 5).

The Risk & Resilience study used respondent-driven sampling (RDS), a method by which people who completed the survey recruited new participants from their own social networks (see Note 6). For a visual of how recruitment went, see the image below. Respondent-driven sampling allows us to calculate statistics to represent all bi people in Ontario by looking at how difficult each person who completed the survey was to recruit. This method has been found to reduce sampling bias.

In total, 421 bisexual people participated in the online survey, and over 40 people were interviewed in person. We have published a number of academic articles based on these data, describing mental health outcomes among bisexual people, as well as their experiences accessing support related to their mental health (see Project Outcomes, below).

Recruitment for Risk And Resilience study

Visual:  The blue squares are key, initial individuals that participated in our study. These key individuals helped spread the word and invited people from their network to participate. The people who participated (purple circles) then invited people from their network (more purple circles). This is how our survey spread across Ontario!

This project was guided by a community Advisory Committee made up of a diverse group of bisexuals from across the province. These dedicated committee members helped to shape the language and content of the survey questions, interpret our findings, and share the results. Working with advisory committees helps keep our research relevant to the community that is being studied, and is one of the ways we put our values of partnership and accountability into practice.


  • Principal Investigator: Dr. Lori Ross
  • Co-Investigators: Dr. Greta Bauer, Loralee Gillis and Ishwar Persad
  • Research Analyst: Jenna MacKay
  • Project Coordinator: Dr. Margaret Robinson
  • Consultant: Cheryl Dobinson
  • Thank you to our provincial Advisory Committee: PhebeAnn Wolframe, Laurel O'Gorman, Zelda Marshall, Arena Thomson, Dionne A. Falconer, Dick Moore, Louis Cruz, Laureen Waters, Tim Hill, Marion Arthur and Stephen Harvey.


Canadian Institutes of Health Research

Funded by the Canadian Institutes of Health Research Operating Grant

Project Outcomes:



4. To learn more about bisexual mental health and bisexual peoples’ experiences with mental health services, you can read these articles based on the data from our pilot study Understanding the context of bisexual mental health.

Ross, L.E., Dobinson, C., & Eady, A. (2010). Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health, 100(3), 496-502, doi: 10.2105/AJPH.2008.156307.

Eady, A., Dobinson C., & Ross, L.E. (2010). Bisexual peoples’ experiences with mental health services: A qualitative investigation. Community Mental Health Journal, doi: 10.1007/s10597-010-9329-x.

Canadian Mental Health Association, Ontario. (2010). “Study explores bisexual people’s experiences with mental health services in Ontario”.

Boon, M. (2008). Study explores link between bisexuality & poor mental health: Bisexuals face prejudice from straight and queer communities, lack bi-specific services: report. Xtra!.

5. This includes trans people who identify as bisexual or any of the above terms.

6. A detailed description of Respondent-Driven Sampling can be found here. Also see Heckathorn, D.D. (1997). Respondent-Driven Sampling: A New Approach to the Study of Hidden Populations. Social Problems, 44(2), 174-199. Alternatively, check out the Trans PULSE project as an example of a community-based research project that uses RDS.