What’s harming the health of bisexual people?

"If bisexuals are minorities within the minority and experience unique and more extreme forms of discrimination, this might contribute to disparities in things like earnings, educational attainment, the propensity to smoke cigarettes and other factors that affect well-being," says Justin Denney. (Credit: boldly wanderlust/Flickr)

Bisexual men and women report poorer health than gay, lesbian, and heterosexual people, according to a new study.

The study examined the self-rated health of 10,128 sexual minorities (gay, lesbian, and bisexual adults) and 405,145 heterosexual adults to see how it differed across sexual orientation. The findings appear in the journal Demography.

“According to the Institute of Medicine, existing health research on the sexual minority population is sparse and typically does not make distinctions between the different types of sexual minorities,” says lead author Bridget Gorman, a professor of sociology at Rice University. “We developed this study both to examine the health of these different sexual minority groups and to assess how risk factors for poor health contribute to their overall health.”

In addition to recording self-rated health information, the researchers analyzed the participants’ lifestyle according to a number of factors that traditionally impact health, including socio-economic status (including education level, employment status, household income, and access to health insurance), health behaviors (smoker or nonsmoker, drinking habits, body mass index, and access to health care) and social support and well-being.

Key disadvantages

The study found that 19.5 percent of bisexual men and 18.5 percent of bisexual women rated their health as “poor or fair,” the highest proportion among the groups surveyed. In contrast, only 11.9 percent of men identifying as gay and 10.6 percent of women identifying as lesbian rated their health as “poor or fair,” the lowest proportion of those surveyed.

Health was also rated poor by 14.5 percent of heterosexual men and 15.6 percent of heterosexual women.

Across the groups surveyed, the researchers also found that bisexual men and women are disproportionately disadvantaged on important social, economic, and behavioral factors strongly associated with health and well-being.

For example, bisexual men and women were the least likely of the three groups to be college-educated. (Only 26.5 percent of bisexual men and 32.1 percent of bisexual women were college graduates, compared with 55.7 percent of gay men and 57 percent of lesbian women and 37.9 percent of heterosexual men and 37.5 percent of heterosexual women).

Bisexual men and women were more likely to smoke (23.8 percent and 21.9 percent, respectively), compared with 14.9 percent of gay men, 16.6 percent of lesbian women, 11.1 percent of heterosexual men, and 8.3 percent of heterosexual women.

Bisexual men and women were the most likely of the three groups to have an annual household income of less than $25,000; 39.5 percent of bisexual men and 42.1 percent of bisexual women fell into this category, compared with 22.9 percent of gay men, 25.4 percent of lesbian women, 24.8 percent of heterosexual men, and 29.5 percent of heterosexual women.

‘Minorities within the minority’

“If bisexuals are minorities within the minority and experience unique and more extreme forms of discrimination, this might contribute to disparities in things like earnings, educational attainment, the propensity to smoke cigarettes and other factors that affect well-being,” says Justin Denney, director of the Kinder Institute for Urban Research’s Urban Health Program and an assistant professor of sociology at Rice.

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Both Gorman and Denney say that the study has important implications for the study of the health of sexual minorities.

“Our study illustrates the importance of examining health status among specific sexual minority groups, and not among ‘sexual minorities’ in the aggregate, since the health profile of bisexual adults differs substantially from that of gay and lesbian adults,” Gorman says.

Hilary Dowdy, a graduate of Rice, and Rose Medeiros, a senior statistician at StataCorp, are coauthors the study. The National Institute on Minority Health and Health Disparities (part of the National Institutes of Health) supported the research.

Source: Rice University