LGBTQ Health

Bisexual Health

Welcome to the bisexual health page of the Health Education web site. The web site is designed to be sensitive to bisexual students on every page and to address the health information needs of bisexual students throughout the site, not just on this page. For example, we use gender neutral language in the Sexual Health section (unless we're talking about things like pregnancy), and our dating violence pages include information on same-sex dating violence and resources for LGBT students. This page was designed as an introduction to some health issues for bisexual students and as an easy way to find information, links, student groups, and campus resources. 

What is bisexuality?

Bisexuality is the capacity for physical, romantic and emotional attraction to more than one gender. Generally, bisexuals identify as being attracted to both males and females, but this doesn't necessarily mean that bisexuals are equally attracted to both men and women. The level of attraction can be static or can change over time, possibly switching between periods of finding either gender or sex exclusively attractive, preferring one gender or sex over others, or choosing to disregard sex and gender as a qualifier. 

What does it mean to be bisexual?

As an identity label, the word 'bisexual' can have a variety of meanings. Self-perception is the key to a bisexual identity. Many people engage in sexual activity with people of both sexes, but do not identify as bisexual. Other people engage in sexual activity only with people of one sex, or do not engage in sexual activity at all, and do identify as bisexual.

Some bisexuals make a distinction between gender and sex. Gender can be defined as a social or psychological category characterized by the common practices of men and women in society; for example, the notion that dresses are worn by females in Western society is a gender issue. Sex is defined as the biological differences between males and females. A bisexual person could be attracted to more than one gender but only to one sex: for example, a female who considers herself bisexual may be attracted to aspects of masculinity but not to the male body.

Bisexuality, like homosexuality and heterosexuality, may be either a transitional step in the process of sexual discovery, or a stable, long term identity. Many people have transitional phases of heterosexuality or homosexuality in their coming out process as bisexual.

Bisexual people, like any other sexual orientation group, can be monogamous or non-monogamous. For those with more than one partner, these partners might be of any sex or gender identity. 

What is biphobia? What is "bi-invisibility"?

Biphobia is a term used to describe the fear of or aversion to bisexuality, or discrimination against LGBT people who are bisexual or perceived to be bisexual. It can also mean hatred, hostility, disapproval of, or prejudice towards LGBT people, sexual behavior, or cultures. It need not include or exclude homophobia, as there are specific stereotypes linked to bisexuality.

Bisexual stereotypes can include the ideas that bisexuals are more promiscuous, practice polygamy, are "swingers", or that they are sexually "confused," "greedy," or "slutty." Couched in these terms is an imagined sexual irresponsibility, particularly in terms of STI exposure. Bisexual people may be the target of homophobia from those who consider only heterosexuality an appropriate sexual orientation. Biphobia can also come from within the LGBT community: where some might see bisexuals as being in "denial," "conforming," or maintaining privilege and collaborating with heteronormative society while simultaneously taking advantage of opportunities in LBGT communities.

Some may also think that people are either heterosexual or homosexual, and thus that bisexuality does not truly exist. This is called "bi-invisibility," and many advocacy groups for bisexual rights identify it as an important contributing factor to a lack of bisexual awareness and acceptance. Conversely, there is a school of thought that says that "everyone is bisexual," and that only social mores restrict people's sexual attraction to specific genders or sexes. 

How do I respond to biphobic or homophobic remarks?

It's a shame that we have to deal with this sort of thing, but sometimes we do. Biphobic or homophobic words, threats, or even violence can be very damaging to our sense of safety. It's good to be prepared with a response before it happens.

Each person's response will be unique and may be different from situation to situation. Addressing homophobia and biphobia without escalating the situation is the best option, but that's not always possible if you feel intimidated, threatened, or if you're not out of the closet. Fortunately at Brown you have allies in students and student groups, in the administration, and in the faculty. Here are some ideas for ways to handle these situations:

  • Assess your situation. Are you alone? Are you in any physical danger? Do you feel comfortable addressing the homophobia/biphobia or do you have a more immediate need to see to your safety?

  • If you feel that you're in any danger, try to leave the situation and get to a blue phone to call Public Safety (401.863-4111). If that's not possible look around and see if there's anyone else's help you can enlist. Don't be afraid to be loud and draw attention to yourself.

  • If you feel you can respond safely, try to respond in a way that does not escalate the situation. Insulting your harasser or casting aspersions on his/her own humanity or sexuality typically isn't a good method either.

  • You can also report homophobic and biphobic harassment to Brown through the Office of Student Life (401.863-3800 Dean Carla Hansen) or the Special Victims Unit of the Department of Public Safety (863-2542).

  • Get support from the LGBTQ Center (863-3062, Campus Center, Room 321) or the student group Queer Alliance.

  • Remember that if you've been harassed it's normal to feel upset, angry, or sad. Talk to someone you trust to help you work through your feelings and decide if there's something more you want to do. There is help on campus for getting through this including Counseling and Psychological Services, and the Office of Student Life.

How do I prepare for a visit to Health Services as a bisexual student?

Sometimes you might feel uncomfortable seeking health care because of a fear of homophobia or biphobia. This can make it harder to seek health care when you need it. This can be even more difficult if you are a person of color and fear racial prejudice as well. At Health Services we want to be a safe space for bisexual students to seek appropriate, sensitive, non-discriminatory health care.

On a visit to Health Services you can expect to receive comprehensive care that is sensitive to you as a bisexual person and knowledgeable about health care concerns you might have. This includes, but is not limited to, concerns you might have about sexual health and sexuality. Questions about sexual activity are not intended to stereotype you as a promiscuous person and are not based on assumptions about how you behave. Rather, they're a standard part of care at Health Services. A good medical provider will ask questions about your health behavior in a sensitive way, not making any assumptions, but assessing your level of risk. However, if you ever don't feel comfortable answering a question, just say so. Remember that your visits to Health Services are covered by medical confidentiality laws.

You play an integral part in the health care you receive. Communicating openly and honestly with your medical provider is an important way to receive comprehensive and sensitive medical care. This includes talking about issues like sex and gender. It's also important that you feel like you can ask questions of your provider. We suggest that you find a provider at Health Services that you feel comfortable with to take the lead on your medical care. While all providers are available to you, this provider will know your history well and, by building a relationship with this provider, you will optimize your health care and feel safer discussing your concerns and issues. Ask around about which providers your friends use or make a point of meeting different providers when you schedule appointments.

One way to approach a trip to Health Services if you're nervous is to do some research before you come in. Think about and research any specific health concerns you may have. See the health concerns list below for specifics that you might not have thought about. If you have questions for your provider, write them down and bring them in -- sometimes it's hard to remember all of your questions once you're in the exam room. Remember that you can tell your provider that you are nervous and they can help you through the questions.

Finally, patient comments are very important to us. If you have any feedback about our services, good or bad, please fill out a patient comment form and put it in the boxes that are in the waiting rooms. We address all complaints, and the more specific you are, the better we will be able to fix the problem. If you choose to leave your name, we will follow up with you.

Health Services is located at 13 Brown Street on the corner of Brown and Charlesfield Streets. Call 401.863-3953 to make an appointment. 

What health concerns are specific to the bisexual community?

The bisexual community is a diverse group with diverse health concerns. Your own specific circumstances and behaviors determine which health issues it makes sense to research further. Generalizations about bisexual health necessarily rely on generalizations about bisexual identity and behavior. The list of health concerns below, therefore, is not prescriptive, but for your information. It may be that some or even many of the health issues do not apply to you simply because you identify as bisexual. It is most important for bisexual students, as with other students, to find a medical provider that you trust to respond to your questions and concerns.

This list of health issues has been developed based on what people who identify as bisexual have reported in studies. Discussions of bisexual health issues are limited by the small number of research studies done specifically with and about bisexual people. Many more studies have been done with people who identify as heterosexual, lesbian or gay, so there is more information about health concerns for those groups than is currently available for bisexual people.

A recent report on bisexual health by The National Gay and Lesbian Task Force identified the following top ten health issues for the bisexual community. Click on the heading for a discussion of these issues.

  1. Substance use

  2. Alcohol use

  3. Sexual health

  4. Tobacco use

  5. Cancer

  6. Nutrition, fitness and weight

  7. Heart health

  8. Depression and anxiety

  9. Social support and emotional well being

  10. Self harm 

Health Concerns for Bisexuals

A recent report on bisexual health by The National Gay and Lesbian Task Force identified the following top ten health issues for the bisexual community. This list may or may not include the health issues that are particularly relevant for you. Your own specific behaviors and concerns determine which health issues will be most important for you to research and address.  

1. Substance use

Research shows that bisexual women have higher rates of drug use than heterosexual women. Some studies indicate that the rates are similar to those of lesbians and some suggest that they are slightly higher.

Research has not tended to look at bisexual men separately from gay men for this topic. Men who have sex with men report higher rates of substance use than the general population, but differences between gay and bisexual men are not known.

2. Alcohol use

In several studies, bisexual women report the highest rates of alcohol use, heavy drinking and alcohol related problems when compared to heterosexual and lesbian women.

With bisexual men, the picture is less clear. In one study, bisexual men did not report more alcohol problems or use than men of other sexual orientations. In another, bisexual men did show higher rates of alcohol misuse.

3. Sexual Health

Bisexual women report higher risk sexual behavior than heterosexual women. Compared to heterosexual women and lesbians, bisexual women have the highest rates of combining substance/alcohol use and sex, which can be associated with higher risk sexual behaviors.

For bisexual men who have sex with men, there is an increased risk of HIV infection.Sexually transmitted infections such as syphilis, gonorrhea and Hepatitis A and B also occur in higher rates in men who have sex with men. Bisexual and gay men are more likely to report having an STI. On the other hand, one study shows that bisexual men report less risky sexual behavior with males than gay men.

4. Tobacco use

Bisexual women smoke at higher rates than heterosexual women, and at about the same rates as lesbians.

Less is known about bisexual men’s smoking habits. In one study, bisexual men’s rates of smoking were similar to heterosexual men. Gay men smoke at higher rates than bisexual men or heterosexual men.

5. Cancer

A large U.S. study of women ages 50-79 indicates that bisexual women have higher rates of breast cancer, and bisexual women reported having any type of cancer in higher rates. Breast cancer risk factors that are higher among lesbian and bisexual women include not having given birth, being more likely than heterosexual women to give birth after age 30, and alcohol consumption. Bisexual women are less likely to have had a mammogram or to have appropriate levels of mammography. Bisexual women also have the highest rate of never having a pap test. It is important to remember that all females, including women who only have sex with other women, need regular pap tests to screen for cervical cancer. Brown students can make an appointment for a pap test at Health Services by calling 863-3953.

Men or women who have receptive anal sex with men are at higher risk for anal cancer due to an increased rate of HPV infection, the virus that causes genital and anal warts. Smoking is also a risk factor for anal cancer

6. Nutrition, Fitness & Weight

Bisexual women may be more likely to struggle with healthy eating. Lesbian and bisexual women have higher rates of obesity when compared with heterosexual women, with lesbians most at risk. It has also been found that more bisexual women are underweight than heterosexual or lesbian women. Studies also suggest that lesbian and bisexual women eat fewer fruits and vegetables than heterosexual women. For some gay and bisexual men, the pressure to achieve the perfect body has resulted in compulsive exercising, steroid use, poor body image and eating disorders. While regular exercise is very good for cardiovascular health, too much of a good thing can be harmful. The use of substances such as anabolic steroids and certain supplements can adversely affect health.

7. Heart Health

This health concern impacts bisexual women, but does not seem to be a particular risk factor for bisexual men as compared to men of other sexual orientations. In one study, bisexual women reported higher rates of heart disease than heterosexual women, but lower than lesbians.

Risk factors for heart disease:

  • Smoking

  • High blood pressure

  • BMI

  • High cholesterol

  • Not getting regular cholesterol screenings

  • Alcohol use

8. Depression and anxiety

Bisexual men and women report consistently higher levels of depression and anxiety than heterosexuals, in some studies similar to lesbians and gay men, and in other studies higher. The likelihood of depression or anxiety may be greater, and the problem may be more severe for those men and women who remain in the closet or who do not have adequate social supports. Adolescents and young adults may be at particularly high risk of suicide because of these concerns. Culturally sensitive mental health services can be effective in the prevention, early detection, and treatment of these conditions. At Brown, Counseling and Psychological Services can help with these problems.

9. Social support and emotional well-being

According to studies, bisexual women have the lowest levels of social support. Bisexual and gay men have lower social support levels when compared with heterosexual men. In studies, bisexual women and men have the lowest emotional well-being of any sexual orientation group. At Brown, Counseling and Psychological Services, the LGBTQ Resource Center, and the Queer Alliance are resources for students struggling with these issues.

10. Self-harm and suicide attempts

Bisexual men and women report higher levels of self-harm, suicide attempts and thoughts of suicide than heterosexuals, and in many studies, higher than gay men and lesbians as well. At Brown, Counseling and Psychological Services can help.

On-Campus Resources

Brown LGBTQ Resource Center   401.863-6062          
The LGBTQ Resource Center is a safe space for all students, staff, and faculty dealing with questions of sexual orientation and gender identity. The Center offers confidential support, information, and referrals for LGBTQ individuals and the people in their lives. Additionally, it offers fellowship advising and assistance with academic projects, as well as educational workshops.

BWell Health Promotion 401.863-2794
Health Promotion is available for individual appointments and group education on a variety of health issues, including LGBT health, alcohol, other drugs, nutrition and safer sex. We have condoms, lube, and dental dams available at rock-bottom prices. Come visit us, we are located on the 3rd floor of Health Services.

Health Services 401.863-3593  
Health Services provides a range of services including general health care, STI testing, inpatient services and emergency medical care. You can request a specific medical provider by gender or by name. We are located at 13 Brown Street on the corner of Brown and Charlesfield Streets. Call 401.863-3953 to make an appointment.

Counseling and Psychological Services 401.863-3476
Counseling and Psychological Services provides individual appointments, referrals, and groups on a variety of issues, including SORT (Sexual Orientation Reflection Time).

Chaplain's Office 401.863-2344 
The Chaplains are available for personal counseling about religious and social issues, parental and peer difficulties, career choices, interpersonal relationships and sexuality. A number of programs are offered during the year that include ecumenical discussion groups, innovative worship experience, ecumenical services, and dramatic and artistic events.

Queer Alliance 
The Queer Alliance serves as an umbrella organization for a number of groups on campus. Its mission is to be a multifaceted service to the LGBT community by offering resources through subgroups, community discussions, and events. The LGBTQ Resource Center (Faunce House, Room 321) has a wide array of queer-related books, movies, literature and resources. You can e-mail queer@brown.edu for more information or to get involved.

Student Groups

The Queer Alliance serves as an umbrella organization for a number of groups on campus. Its mission is to be a multifaceted service to the LGBT community by offering resources through subgroups, community discussions, and events. The LGBTQ Resource Center (Faunce House, Room 321) has a wide array of queer-related books, movies, literature and resources. You can get contact information under the leadership section of the Queer Alliance Website. 

BiTE (Bisexuals Talk and Eat) is a biweekly safe and confidential discussion group and social space where bisexuals, pansexuals, their allies/friends/partners, or those who choose not to self-identify under any of these categories can chat and eat. The group welcomes persons of all genders and sexualities.

Related Links

The American Institute of Bisexuality 
The American Institute of Bisexuality encourages, supports and assists research and education about bisexuality, through programs to enhance public knowledge, awareness and understanding about bisexuality.

The Task Force 
The National Gay and Lesbian Task Force’s Policy Institute has published studies addressing issues specifically related to the bisexual community. The most recent (March 2005) study is Bisexual Health: An introduction and model practices for HIV/STI prevention programming.

Go Ask Alice 
This is an LGBTq-friendly question-and-answer web site where you can anonymously email any health questions you have. This site has a huge archive that you can read through or search before posing your own question. Check out this in-depth web site for information about relationships, sexuality, emotional health, alcohol and other drugs, and nutrition. This site is provided by Columbia University's Health Education Program.

Gay and Lesbian Medical Association 
This site provides LGBT-friendly health care referrals, medical information, publications, news and links. GLMA works to ensure that LGBT people are treated competently and not discriminated against when they access health care. GLMA also works to ensure that LGBT healthcare providers do not experience discrimination in their training and at work.

Fenway Community Health
Fenway Community Health is a Boston based clinic that serves LGBTQ patients. Their webpage offers a variety of health information, as well as links to research and resources.

Bisexual Resource Center
The Bisexual Resource Center is a Boston based organization founded in 1985. The BRC provides support and resources to the bi community and raises public awareness about bisexuality. 

PHONE NUMBERS
  • 401.863-2794
    Health Promotion
  • 401.863-3953
    Health Services
  • 401.863-6000
    Sexual Assault Response Line
  • 401.863-4111
    EMS
  • 401.863-3476
    Counseling & Psychological Services
  • 401.863-4111
    DPS