Bisexual Health Awareness Month: Is Biphobia Affecting Sexual Health Outcomes?
By Kaitlyn Traber
Bisexual people as a collective seem to face worse sexual health outcomes. This can be traced to a number of things: socioeconomic status, healthcare provider stigma, minority stress and more.
Bisexuality is defined by Robyn Ochs as “The potential to be attracted to - romantically and/or sexually - to people of more than one sex and/or gender, not necessarily at the same time, not necessarily in the same way, and not necessarily to the same degree”. Due to it’s flexibility (anyone can be bi, and that looks different for many), it is harder to put into a box, and this can lead people to develop stigmatizing ideas about it and spread misinformation.
Recent studies suggest that bisexual individuals can experience what is called ‘double stigma’. This is when an individual faces discrimination or poor treatment from people outside of the 2SLGBTQ+ community but also within it. To put this into perspective, studies show that “30% of bisexual men and 8% of bisexual women say that they cannot be open about their sexual orientation with any of their friends, compared to 2% of gay men and 1% of lesbians.”
This has effects on sexual health outcomes because if they are not able to come out in their personal life, it is unlikely they will go to healthcare providers and, therefore, receive the care they need. A supportive community is crucial in enhancing health outcomes in general, but in regard to sexual health, it can be very beneficial. Lesbians commonly use tools like dental dams to reduce STBBI infection, as well as PReP (an HIV prevention medication) which is most commonly used by gay men. Both are beneficial tools bisexual people can use to decrease the risk of infection. However, this is not widely known, especially among straight people. If bisexual people are not coming out due to stigma, they are less likely to hear about things like dental dams, PrEP and other STBBI prevention methods in their communities or from healthcare providers.
Here’s what studies show us:
Viral STBBI rates for bisexual women were almost 3x higher than for women who have sex with women exclusively.
However, it is hard to nail down a truly exact statistic because more than half of women who had sexual encounters with both men and women identified as heterosexual.
This also extends to sexual health. Bisexual people have a higher risk of STBBIs comparatively. A leading contributor to this is stress related to stigma and discrimination. But how does this affect sexual health outcomes?
bisexual men are less likely to come and get tested for HIV, which has caused them to be disproportionately affected by HIV
bisexual women are less likely to get mammograms/pap tests
decreased rates of HPV screening amongst bisexual men and women, which increases the risk for cervical and anal cancer
The risk is already high due to stigma. Still, STBBI transmission spreads even faster when healthcare providers provide testing under the assumption that their patients only have sex with the opposite sex. STBBIs can be passed vaginally, orally, anally and through sexual skin-to-skin contact, highlighting the need for full panel testing.
In the doctor’s office
When seeking STBBI testing, providers will often only conduct a urine test. However, only bacterial STBBIs like chlamydia and gonorrhea can be detected in the urine. This leaves infections like HIV or syphilis unaccounted for, only adding to the increased risk. This is especially concerning because it means that individuals can potentially get tested and think they are all clear when they pass the urine test, unaware of the other STBBIs they could possibly be carrying. It is also especially hard for bisexual men to get full testing panels because asking for an anal swab could possibly out them to their provider- highlighting the need for inclusive, safe, and informed healthcare providers. Next time you get testing, be sure to get a full panel. This is what you can ask for:
Urine Test
Blood Test
Throat swab
Vaginal/Anal swab
To help address these disparities, it’s crucial for healthcare providers to offer inclusive and comprehensive care that acknowledges the diverse sexual identities and practices of their patients. Access to full panel testing, including blood and swab tests, is vital in ensuring that bisexual people receive the care they need without fear of being outed or stigmatized.
Organizations like Pro-Choice YQL are committed to providing resources, support, and advocacy to all individuals, regardless of sexual orientation, ensuring that everyone can access the care they deserve. Through education, outreach, and a non-judgmental approach, we aim to create a safer, more inclusive environment where people can make informed choices about their sexual health.
