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1. Introduction.............................................................................. 4
2. What is bisexuality?................................................................ 5
6. Case studies........................................................................... 18
7. Glossary................................................................................. 21
8. References............................................................................ 22
* You’ll find guidance pages have a yellow tab along the side
Over the last few decades, social awareness Bisexual people exist in mental health services,
and acceptance of lesbian, gay, bisexual and and the workplace, just like anywhere else – and
transgender, queer and non-binary (LGBTQ+) strides need to be made to tackle the prejudices
people have increased phenomenally. Where just and stigma that prevent many bisexual individuals
35 years ago homosexuality was illegal in parts from receiving the support and respect they
of the UK, now same-sex marriage is legal deserve.
across Britain, and the Equality Act 2010 codifies
Whether it’s expressed by someone assuming
anti-discrimination law protecting LGBTQ+ people
different-gender counselling shouldn’t be made
from abuse and harassment. Workplaces across
accessible to bi people, or psychologists
the country, including elite professions, are
interpreting bisexuality as a mental health issue
concerned with becoming more LGBTQ+-friendly,
itself, steps need to be made to stamp out bad
and the life experiences of LGBTQ+ people are
practice, advise on best practice, and make
represented in the media far more often.
mental health services a better place for bi
However, too many issues still exist. Support people to be.
for LGBTQ+ people experiencing mental health
problems is vital, yet too often services do not
put adequate measures in place to ensure fair
access. Mind’s 2016 good practice guide1 led
the way in this regard, detailing the best steps Lesbian, gay
,b
services can make to become more inclusive
trans and qu isexual,
ee
good practic r
and accessible.
or misunderstood.
Oxford dictionaries lists “bisexual” as meaning Bisexual people can come from any background –
“sexually attracted to both men and women”.4 they can come from all generations, be male,
However, key bi advocacy groups such as the female, intersex or genderqueer, can be BAME
Bisexual Index reject this binary understanding, (Black, Asian, and Minority Ethnic), transgender,
instead defining bisexuality as “attraction to more and experience disabilities including mental health
than one gender”. This is because it encompasses conditions, physical or sensory impairments, and
both homosexuality – attraction to the same sex – neurological disorders.10
and heterosexuality – attraction to another sex,
including the “opposite” sex but also non-binary
genders.5 A person does not need to have exactly Common myths
equal, 50-50 attraction to men and women to
Anti-bisexual sentiment (biphobia) exists
identify as bisexual.6 If we assume that this has
to be the case to identify as bisexual, it ignores
only among straight people
those who have a gender preference but are able It is easy to assume biphobia is essentially the
to enjoy and commit to relationships with another same as homophobia, except directed towards
gender. The language of “50-50” also erases the bisexual people, and that lesbian and gay people
potential for attraction towards those who are cannot display biphobia. However, they can –
non-binary. such as by insisting that the person is ‘really gay’
or ‘really straight’ because bisexuality does not
A person may have attraction to more than one
exist (called monosexism), or excluding them from
gender and not identify as bi – this is completely
an LGBT network based on the gender of their
up to the individual.7 Bisexual people may also
current partner.11
find their attraction to different genders changes
over their lives, with fluid attractions becoming Bisexual people themselves can also discriminate
more or less intense as they grow older.8 Being against each other due to internalised biphobia
bisexual is not the same as being polyamorous (e.g. claiming someone isn’t ‘really’ bisexual
or polygamous (being involved in multiple because they prefer one gender to another).12
relationships at once, or one shared relationship
between three or more people).9 This is where
many biphobic stereotypes involving promiscuity
come from; but people of any identity can be
polyamorous.
Several studies have shown bisexual people Some of the reasons why bisexual (as well as
are at far more risk of developing mental health other LGTQ+ people) often experience poor
problems such as depression and anxiety, mental health include: difficulty being open about
obsessive compulsive disorder (OCD) and bipolar their own sexuality; stress built up from having to
disorder, than gay and lesbian people.22 They are remain closeted and therefore tell “white lies”
also six times as likely as the average person to about what they’re doing in their downtime; stress
report feeling suicidal.23 Bisexual men in particular resulting from discriminatory behaviour, whether
experience more psychological distress than gay overt or subtle and whether due to conscious or
men and cited their sexuality as a reason to unconscious bias.31
self-harm or feel suicidal far more.24 This may be
due to the increased public distrust of bisexuality, When I came out as bisexual to my
including myths that men cannot be bisexual or
that all bisexual people are promiscuous and
therapist they recommended me CBT
unable to be faithful in relationships, and the to be cured
resulting stress of either having a part of their
identity routinely disbelieved or remaining At work, it may be appropriate for line managers
closeted.25 Bisexual people are far less likely to to pay extra attention to the mental health of
be out to family, friends and colleagues. As the openly bisexual colleagues, and/or to make a
Bisexuality Report notes, this is true both in the point of informing them of services available and
UK26 and internationally.27 the benefit to their productivity of wellbeing and
mindfulness. However, this could also be seen as
The report28 also includes accounts of singling them out, so the best response depends
professionals treating bisexuality as a mental on the situation.
health problem itself and not a legitimate
sexuality29 Anecdotes include therapists who saw
a patient coming out to them as a sign that they The importance of a supportive
were “confused” and “had unresolved issues with
[their] sexuality”, and refused to speak with an
culture, at work and in services
openly bisexual patient about gender dysphoria A growing body of research indicates the benefit
until their sexuality had “stabilised””.30 of employee satisfaction upon business
performance, including the ability for employees
Even worse, when one patient revealed that they
to be able to “bring their whole selves to work”,
were bisexual in the context of finding it difficult to
or when accessing a service, and not feel they
“fit in” with everyday life, their therapist assumed
have to pretend to be somebody they are not.32
they must want to become straight – and so
This is very relevant to bi people specifically,
recommended the person undergo cognitive
especially given their extra difficulties (mental
behavioural therapy to be “cured”.
health problems, co-workers not being aware
As a result, bisexual people are also more likely of or not believing their sexuality, negative
to have negative experience of counselling and stereotyping). If people feel they need to lie about
other therapies, which will make them less likely their sexuality (which statistics show bisexual
to be open about their mental health – whether in people do far more than gay or lesbian people)33,
wider society, at work, or when considering future or conceal the gender of their partners or even
counselling. keep them secret, they will be using up energy
doing so and therefore putting less into their job.
2015
AL STAFF
compared to 3 per cent of lesbians and gay men.
Nearly half (45 per cent) of bisexual men won’t TOP 100 EM
PLOYERS
It is important not to assume that everyone who than the woman herself – women who are
is bisexual experiences life the same; bisexual bisexual find it easier to come out, and are more
people come from all walks of lives, and often recognised when they do.
have multiple identities which makes their lives –
Meanwhile, because men are expected to be
and their mental health – more complex (also
either straight or gay, with the existence of
often defined as intersectional identities).
bisexual men routinely disbelieved, they find it
more difficult to come out – perhaps worried that
Bisexuality and gender women will assume they’re actually gay and
closeted, or that gay men will view them as
Nearly every single study on bisexuality and unreliable and uncommitted – both of which would
gender shows women identifying in greater impact on their ability to enter and maintain a
numbers than men – sometimes far greater.34 healthy relationship with men or women. Many
It has been proposed that female sexuality is therefore either remain wholly closeted or identify
simply more “fluid” than men’s, explaining this as gay instead.
discrepancy as well as the fact many more men As a result of either remaining closeted or facing
tend to define as gay as women define as lesbian. negative societal attitudes if they choose to be
However, this is over-simplistic and ignores open, bisexual men face increased pressures.
social factors.
Stonewall research indicates that bisexual men
In fact, a growing body of evidence suggests that are twice as likely to have self-harmed (due
because women’s sexuality is viewed socially as to mental strain and experiencing biphobia) and
more fluid than men’s – and as less autonomous, far less likely to test themselves for sexually
revolving more around what men find attractive transmitted infections (STIs) and HIV.
14
With clear evidence that biphobic comments are These individuals may not call themselves bi, but
often shared, or allowed to be shared, by mental their needs in work and mental health services
health staff at work, mental health services, and will be similar. If they are not able to feel included,
professionals, need to come a long way in their they will not be able to achieve the best support.
acceptance of bisexuality.55
This can be addressed with inclusive policies that
Occasionally, mental health services do attempt to accept bisexual people for who they are.
be bi-inclusive, but this is often through small
gestures such as rebranding gay men’s services
as “gay and bi men’s services”. This recognises Five do’s and don’ts for
not all men who have sex with men (MSM) are inclusive services
gay, but ignores the fact that bi people are not just
another “kind” of gay person. Five do’s:
In fact, bi men are just as likely to need to use a 1) Do feel free to use the terms “bi” and
“straight” service (though it will not, of course, be “bisexual” interchangeably and using “bi” on
called that) than one for “gay and bi men”. its own is perfectly accessible – just like it’s
fine to use “straight” and “gay” as well as
Targeted bi awareness training could be given
“heterosexual” and “homosexual”. Try to also
to mental health services. For the greatest
include terms from the bi+ umbrella such as
effectiveness, this should focus on distilling down
pansexual, fluid and non-binary.
what is for many a new and complex topic to a
set of clear, understandable principles: 2) Do be open to hosting or organising bi-specific
events if this is a request that comes from
1) Bisexual people already use services. bisexual people themselves. Some might view
2) Their needs are similar to, but different and this as unfairly excluding other LGBTQ+
at times more acute than, gay or straight people, but in reality these help foster
people. understanding and acceptance. Similar trans-
specific events are being held ever more
3) When appropriate and meaningful, bisexual
frequently without controversy as workplaces
people should be visibly included as much as
and services are developing more awareness
possible in existing LGBTQ+ campaigning or
of the specific challenges faced by trans
promotional initiatives.
people. The same needs to happen to address
4) While bi people are not just another “kind” of the issues of lack of visibility and support
gay (or straight) person, there is no need to experienced by bisexual people.
create separate services to engage with and
support bi individuals, as the aim should be 3) Do remember that bi-specific events or
to offer services that are genuinely inclusive services don’t always need to be bi-only
(which is of course a concept that goes much (exclusively for bisexual people). Some
deeper than what the service is called). organisers and bi people may prefer these,
and bi-only events or services can be justified,
5) Bisexuality is a key part of the LGBTQ+
but having bi-focused initiatives open to others
spectrum, and an identity in its own right, so
allows awareness to spread. The London
it is reasonable to expect services are fully
Bisexual Network holds events open to people
accessible to bi people.
of all sexualities for this reason, and has allies
on its executive committee.
Statistics on young peoples’ sexuality demonstrate
this is a mainstream issue for mental health 4) Do consider extending any “allyship” program
services, and businesses, to consider. In a recent you may have for non-LGBTQ+ people to
YouGov poll, while only two per cent of 18–24s different parts of the LGBTQ+ community.
defined as bisexual, 48 per cent defined with For example, a gay man or trans person can
terms under the bi+ umbrella, such as pansexual, be a bi ally, who wants to learn more about the
fluid, non-binary or bi-romantic, among others, issues facing bi people and to work to tackle
and their combined total was more than those these. Likewise a bi person can be an ally for
who defined as straight.56 trans and non-binary people. Cultivating cross-
Chloe
My name’s Chloe. I’m 26 a country where I didn’t know anyone –
and I have depression, or the language – because I felt I had to get
anxiety, PTSD and a those years of my life that I’d “lost” back. But I
history of eating couldn’t escape what had happened and I feel
problems. I am also into a deep, deep depression and had to move
bisexual. When I was back home. I felt like I was getting better with
14 I met a boy from a medication and the help of my family but two
neighbouring school years ago I developed delayed-onset PTSD.
online and he made my
life in a rural English village a little bit more The flashbacks and high anxiety levels
exciting. It was the first time anyone had looked made me realise I needed to finally deal with
at me in a romantic way. Before we were it. I tried counselling but I found that I needed a
officially “going out” I’d often talk to him about more specific domestic abuse service to help
how beautiful I thought my female friends develop my sense of self. Since then I’ve been
were. He was convinced I was a lesbian and going to a support group for women affected
I had to reassure him over and over again by domestic violence. I have made amazing
that I wasn’t. The idea of being bisexual friendships and grown into a much kinder,
hadn’t even occurred to me. When we did get compassionate person. I’ve developed my
together officially when I was 15 he’d often talk self-esteem and been able to look after myself
about how bisexual women were “sluts” and much more – meaning my mental health is the
how he’d never date one because you’d have best it’s ever been.
to worry about them cheating on you with I am very aware though that I haven’t
girls as well as boys. Looking back I think he mentioned to the group that I’m bisexual.
realised I was bisexual before I did. So I buried I’m afraid that the wonderful women I’ve
any feelings and convinced myself that my
met in the group might turn out to be not-so-
attraction to girls was purely aesthetic (even
wonderful if I mention it. My sessions are
to this day I sometimes have trouble believing
coming to an end soon so I’m looking for other
it’s more than that).
ways to get support. This makes me nervous,
Over time our relationship got more and partly because I’m worried any mental health
more toxic. By the time I was 18 I couldn’t professional I meet will either focus too much
even look another man in the eye and didn’t on my sexuality or ignore it completely. I also
feel like I had any thoughts of my own. It don’t know if I am welcome at LGBTQ+ specific
wasn’t until years after I had broken up with domestic violence groups. Will they turn me
him that I realised he had been emotionally and away because my abuser was a man? These
sexually abusing me the whole time. Those are the things I have to consider when I should
years afterwards I found a few ways to cope, be focusing on getting better. But I wouldn’t
some were more useful (feminism) than others change being bisexual. It’s an important part
(alcohol, binge eating). I even moved abroad to of who I am and I feel privileged to be able to
Sanisha
My name is Sanisha the majority of us had our hair chemically
Wynter, I am 24 years straightened. A lot of us were going through
old, bisexual, and I issues at home or were being bullied at school
have mental health and it was a very lonely time. I remember
issues. I was recently feeling very misunderstood and silenced. I was
diagnosed with in high school from 2004–2009, so I started
Emotionally Unstable just after Section 28 ended. We were not
Personality Disorder taught about anything other than heterosexual
and Depression. When relationships in sex education. We had no
I found out I had a personality disorder I was LGBT networks, being gay was something we
shocked at first, then I read the symptoms of saw in magazines or TV. It was not something
my disorder, reflected on how I behave and it openly discussed at school. I knew it existed
all made sense. but it was very much a taboo. I did not
understand my own feelings, I knew I felt
I was born in South London. My mum was
attracted to people regardless of what their
17 when she had me, she was very young but
gender was.
determined to do her best as a single parent.
When I was seven, my mum was a victim of One of my friends came out, her life was
domestic violence and we moved into a refuge turned upside down, she was bullied and she
in the suburbs on the outskirts of London. was kicked out of the family home. Her family,
I went from a diverse school with multiracial like mine, was Jamaican. We were used to
students to a school where I was the only black hearing homophobic language used by family
girl in my class. I did not want to start a new members or in music that was blasted out in
school and talk about the fact I was homeless, parties, it was normalised. I witnessed how
so I kept a lot of my emotions internalised. hard my friend had it, and even though she
I was a very quiet child, very afraid of being was so brave, I couldn’t do it yet, I pushed my
myself, I just wanted to blend in. I was bullied, feelings to the side, hoping they would go and
did not make many friends and developed a hid who I was. Hiding my sexuality was a lot
stutter. I started to have an identity crisis from easier than hiding my race.
then and this only got worse in high school.
When I went to university I was not visibly out,
I went to an all-girls high school, it was clear there is such pressure to come out and be
from a young age that black students tended visible when it really was not possible. However,
to be treated unfairly, considered louder, our I was living the most authentic life I could live.
natural hair was criticised to the point that I was educating my peers about my history,
Now I realise the more I accept who I am, the Although Sanisha is currently in an opposite
less depressed I feel, the less I am confused sex relationship it is important to recognise her
about my identity. I am now able to bisexual identity as valid regardless of current
acknowledge that my emotions, memories relationship status. It is necessary to think about
and experiences are real and valid. I am on how bi erasure and biphobia can affect a
medication for my depression, I am receiving person’s mental health.
For a full glossary of terms please refer to Mind’s Intersex – A person born with chromosomes or
Good practice guide. genitals which do not fit neatly into male or female
categories. Often confused with non-binary,
In addition, here is a list of terms that specifically
however this is not the case – someone born
relate to the bisexuality topic covered by this
intersex can identify as male, female or non-
publication:
binary, and refers more to biological sex than
LGBTQ+ – Lesbian, Gay, Bisexual, Transgender gender identity.
and Queer/Questioning, plus other sexual
Polyamory – Having a sexual or romantic
and gender minorities (intersex, non-binary,
relationship which involves more than two people,
pansexual etc.)
or having multiple partners. Often preferred to
Biromantic – Seeking romantic relationships ‘polygamous’ as this technically refers to
with more than one gender, but not necessarily marriage, not relationships in general, and has
being sexually attracted to all or any. A biromantic several negative cultural associations.
person could be bisexual, or straight, gay,
Mono-sexism – The belief everyone is either 100
or another definition.
per cent gay or 100 per cent straight.
Bisexual – Attraction to more than one gender.
1. Lesbian, bisexual, gay, trans and queer good 16. Recently, academics have begun to identify
practice guide, Mind, 2017. mind.org.uk other forms of discrimination against bisexual
2. Personal well-being and sexual identity in the people, such as bisexual denial (similar to erasure
UK, 2013–2015, ONS. ons.gov.uk but more extreme, refusing to believe in the
concept of bisexuality at all and refusing to
3. See for example ‘The Bisexuality Report’, Open
consider bi-identifying people as such), bisexual
University, 2011. open.ac.uk
invisibility (referring only to homophobia without
4. ‘Bisexual’, Oxford Dictionaries, considering biphobia or pressuring bisexual
oxforddictionaries.com people to ‘become’ gay), bisexual exclusion
5. The Bisexual Index, bisexualindex.org.uk (providing no bi-specific events or including ‘B’
6. ‘7 Misconceptions about bisexuality’, Lea Rose in an LGBT group name/mission statement but
Emery, Bustle, 2016. bustle.com not referring to bisexual issues or people) and
bisexual marginalisation (not challenging biphobic
7. Are men sexually fluid?, Ian Kerner, The Chart,
comments, asking intrusive sexual questions to
2012. thechart.blogs.cnn.com
bisexual but not lesbian or gay people). However,
8. ‘How fluid sexuality fits into the LGBTIQ many of these overlap, and fall within the wider
spectrum’, Jarune Uwujaren, Everyday Feminism, range of ‘erasure’ or ‘phobia’ anyway, so it is
2012. everydayfeminism.com more practical to distil them into these two well-
9. ‘Are all bi people polyamorous?’, Bi.org, recognised categories.
bisexual.org 17. ‘Erasure of Bisexuality’, GLAAD, glaad.org.
10. ‘Around half of the attendees at a national UK 18. ‘What is Biphobia?’, The Bisexual Index,
event (BiCon) reported that they used more than bisexualindex.org.uk.
one of the terms: bisexual, queer, heterosexual/
19. For more information, see: ‘I’m pansexual –
straight, lesbian/gay/homosexual’. ‘British
here are the five biggest misconceptions about my
bisexuality: A snapshot of bisexual identities in the
sexuality’ Farhana Khan, Independent, 2016,
UK’, Barker, M., Bowes-Catton, H., Iantaffi, A.,
independent.co.uk.
Cassidy, A., & Brewer, L. (2008). Journal of
Bisexuality, 8 (1&2), 141–162. p.155. 20. Queer vs Bi Identity, uncharted-worlds.org/bi.
11. ‘Report: Bisexual people face discrimination at 21. Please refer to the Glossary at the end of this
the doctor’s office, LGBT groups’ Eliel Cruz, publication for explanations of these terms.
Advocate, 27 May 2015. advocate.com. 22. ‘Sexual orientation and mental health: Results
12. ‘Biphobia’, Robyn Ochs, Getting Bi: Voices of from a community survey of young and middle-
Bisexuals Around the World, ed. Robyn Ochs and aged adults’, Jorm, A., Korten, A., Rodgers, B.,
Sarah E. Rowley (Bisexual Resource Center, Jacomb, P., & Christensen, H. (2002). British
2005), pp.201–205. Journal of Psychiatry, 180, 423–427.
13. Busting myths around bisexuals in the 23. Count me in too: LGBT lives in Brighton and
workplace’, Matthew Jenkin, The Guardian, 2013. Hove, Browne, K., & Lim, J., 2008.
theguardian.com 24. Bisexual invisibility: Impacts and
14. ‘Role Models: Being Yourself: Sexual recommendations, San Francisco Human
Orientation in the Workplace’, Stonewall. Rights Commission, 2010.
stonewall.co.uk 25. Mental health and well-being of gay men,
15. Stonewall Top 100 Employers 2016, p.28. lesbians and bisexuals in England and Wales,
King, M., & McKeown, E., 2003. mindout.org.uk