The Urgent Need for Bisexual Health Research: Q&A with Dr. Brian Feinstein

Recently, the Institute for Sexual and Gender Minority Health and Wellbeing designated bisexuality as one of its priority research areas of growth. This #BiHealthMonth, we caught up with the ISGMH’s Dr. Brian Feinstein to learn more about why this research is so important, and his work promoting bisexual visibility.

How did you end up doing bisexual health research at ISGMH?

Picture of Dr. Brian Feintein

 I’m a clinical psychologist by training, and I’ve always had a deep personal interest in sexual minority mental health. Something I noticed early on in my graduate work was that, even in casual conversations, people spoke about bisexual people differently from how they would talk about gay and lesbian people. For example, they’d say that, after seeing that someone identified as bisexual on their online dating profile, they’d choose not to date them because of that.

This piqued my interest in why bisexual people may experience stress and discrimination differently from gay and lesbian people. Since then, understanding these differences has become more and more of a focus in my work.

 

While all sexual and gender minorities face different types of stress, bisexual people face unique stressors that largely come down to biphobia.

ISGMH recently designated bisexual health as an area of growth. What led to that decision?

I was really excited by ISGMH’s decision to prioritize bisexual health research. LGBTQ populations have long been underrepresented in medical and scientific research. And, when they are included, they’ve been generally treated as one monolithic group.

Recently, researchers have been teasing these groups apart in their studies, revealing striking health disparities among bisexual people – including depression, anxiety, suicidal ideation, and substance use – compared to straight, gay and lesbian people.

 

Unless a bisexual person tells you they’re bisexual, there’s really no good way of knowing that.

Why do you think those disparities exist?

While all sexual and gender minorities face different types of stress, bisexual people face unique stressors that largely come down to biphobia. For example, some people don’t even believe that bisexuality is a real or a valid sexual orientation. There’s also the stereotype that bisexual people are just “confused” about who they are, or that they’re just waiting to come out as gay or lesbian once they feel more comfortable doing so. For bisexual men in particular, there’s also the stereotype that they act as a bridge for HIV transmission between men and women – a belief that has no basis in empirical research.

We’ve also seen a sizeable proportion of bisexual people say they’ve had partners who pressured them into changing how they label themselves. For example, once a bisexual man is in a relationship with another man, their partner may push them to say they’re not bisexual anymore.

I think that a lot of this stems from a general binary way of thinking. And there are so many assumptions made about someone’s sexual identity, based on who they’re in a relationship or having sex with at the time. Unless a bisexual person tells you they’re bisexual, there’s really no good way of knowing that.

Can you tell us more about the Bi+ Visibility Project?

Generally, we assume that being open about your sexual orientation is healthy. But, in a couple of studies I’ve done, I’ve seen the reverse is true for bisexual people – and that being more open about their sexuality is associated with depression and substance use.

The goal of the Bi+ Visibility Project is to understand how bi+ individuals make their sexual identity visible to others, and the impact that has on them. The project is a collaboration between myself, ISGMH’s Dr. Christina Dyar, and Stony Brook University’s Dr. Joanne Davila.

We included the “+” because we wanted to recognize that there are many different labels people use to reflect attraction to more than one gender or sex – people may identify as bisexual, pansexual, queer, or fluid, or they may not use a label at all.

A handful of members of the Chicago Bisexual Health Task Force, from left to right: Lauren Beach, Mike Oboza, Jim Pickett, Adrienne McCue, Brian Feinstein, and Ashley Walker.

A handful of members of the Chicago Bisexual Health Task Force, from left to right: Lauren Beach, Mike Oboza, Jim Pickett, Adrienne McCue, Brian Feinstein, and Ashley Walker.

What about the Chicago Bisexual Health Task Force?

 A group of community members, healthcare providers, and researchers – including ISGMH’s Dr. Lauren Beach and I – co-founded the Chicago Bisexual Health Task Force in April 2018. At the start, our purpose was to bring together all of these different groups of people to really think about how we can all work together to improve the health of bisexual people here in Chicagoland. When thinking about the composition of the task force, it was important to us to have diverse representation of the many stakeholders invested in the health of Chicago’s bi+ community.

One of our major milestones so far was that we were instrumental to Mayor Emanuel’s recognition of September 23 as Chicago’s “International Day of Bisexual Visibility,” which is essentially the bi+ version of Pride day. This was a huge step toward showing that the city has a vested interest in improving bisexual health specifically.

Did any surprising needs come up during the task force’s discussions?

I’ll start with what was less surprising – a clear need for better access to affirming, inclusive health care services. One thing that came up that was outside of our primary focus on health, though, was a common desire for more social and community spaces designated for bisexual people, where they could be themselves and be open about their sexual identity. This is really important because social relationships are so important to our health and wellbeing. So, a priority of the task force is to create community-building events. For example, on July 9, we’re hosting the Bisexual Health Summit, which will focus on the latest bisexual health research but will also create a space for networking and socialization.

Learn more about ISGMH’s designated areas of growth, including women’s health, transgender health, and stigma, structural inequality, and intersections of race and SGMH identities, here.