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.

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