Biphobia, Bierasure, and Bimisogyny: A Qualitative Exploration into the Contemporary Experiences of Bisexual Women Aged in Their 20’s

Current research and theory regarding women's experience of sexuality depict more flexibility and variability in sexual identity development and self-labeling than generally accounted for in traditional sexual identity models. The present study examined lesbian and bisexual women's use of sexual identity labels, attitudes about sexual fluidity and self-labeling, and patterns associated with sexual identity processes. Two hundred nineteen women with same-sex attractions or experiences participated in the study, completing an anonymous online survey. The majority of participants (85.4%) identified as White, with ages ranging from 18 to 69. One hundred eighteen women identified as lesbian, 59 as bisexual, 5 as heterosexual, and 34 chose not to label their sexual orientation (termed "unlabeled women"). In addition to choosing one traditional category designation, participants rated the frequency and context of their use of 10 sexual identity labels (e.g., lesbian, dyke, queer). They then completed measures of sexual attractions and behaviors, importance of sexual group identity, beliefs about sexual orientation, and identity history and change. Finally, participants were asked to react to a news story about fluidity of sexual identity and hesitance to use sexual identity labels among young women. Overall, participants reported using a wider range of labels when thinking about themselves than when talking to others, and unlabeled women used a wider range of labels with themselves than did self-identified lesbians or bisexual women. Comparisons between self-identified lesbian, bisexual, and unlabeled women's experiences of sexual identity and fluidity yielded numerous differences. Lesbians had a more exclusive sexual and emotional orientation to women, a stronger sexual group identity, more essentialist sexual orientation beliefs, and less focus on the person (not the gender) than bisexual or unlabeled women. Unlabeled women reported greater future likelihood of sexual identity change than lesbians or bisexual women. Analysis of the open-ended items revealed that participants supported young women's explorations of sexuality on their own terms, but also felt a hesitancy to abandon sexual identity labels because of their utility in catalyzing collective identity and combating heterosexism. Results are discussed in relation to a social constructionist framework for sexual identity.

Using a multi-method qualitative design and analytic approaches derived from grounded theory, the current study examined the appearance standards within lesbian and bisexual communities and how these norms relate to lesbian and bisexual women's psychological experiences with physical appearance. The study investigated how the women's diverse social identities relate to these experiences. Participants consisted of a relatively diverse sample of 24 bisexual (n = 10) and lesbian (n = 14) women who took part in 1 of 4 focus groups. From this sample, 4 bisexual women and 6 lesbians were recruited to participate in in-depth interviews. Participants represented a broad age range (18--62; M = 36.2). Participants discussed their experiences with the internalization of appearance standards within both mainstream and lesbian subculture and how this related to their sexual identity and body image. Both lesbian and bisexual women repeatedly discussed two conflicting concepts: (1) having freedom from and resistance to traditional and oppressive norms of appearance (e.g., celebration of all kinds of women, body sizes, beauty in curvaceousness, non-traditional gender norms); and (2) pressure to conform to strict standards within lesbian communities (e.g., dress code, butch/femme identities). The latter serves primarily as a "survival" tool or a way through which they can signify their membership in the lesbian community. Within the interviews, participants discussed their experiences of objectification and its subsequent effects of body consciousness and self-objectification. The act of self-objectification served as a strategy to cope with and anticipate others' reaction to their bodies. By viewing themselves from an outsider's perspective, several women experienced negative psychological consequences such as anxiety, body dissatisfaction, and disruption in "flow." Finally, a small sample of participants (n = 4) discussed specific mental health outcomes as a result of their anxiety and body dissatisfaction. Suggestions for future research to explore these strategies and the more specific ways lesbian and bisexual women experience objectification, body consciousness and the negative outcomes of self-objectification are provided.

Current Challenges in the Management of LGBT Suicide

While prior studies have shown LGB individuals have elevated risk of poor mental health, poor physical health, and substance use, existing study designs may be improved by using representative samples, wider ranges of health outcomes, heterosexual comparison groups, and disaggregated data. The goal of this study is to provide estimates of multiple health disparities across sexual orientations in Canada based on these principles. Using data from 2009-2014 Canadian Community Health Surveys, a sample of 19,980,000 weighted individuals was created. Outcomes included mental health, physical health, binge drinking, illicit drug use, and cannabis use. The study used logistic regression models adjusted by covariates, stratified by sex, to estimate health disparities across sexual orientations over time. Among LGB individuals, there was evidence for elevated risk of poor mental health (i.e. gay men, bisexual men, bisexual women), poor physical health (i.e. bisexual men, bisexual women), binge drinking (i.e. lesbians, bisexual women), illicit drug use (i.e. lesbians, bisexual women), and cannabis use (i.e. lesbians, bisexual women) relative to their heterosexual counterparts. Those identifying as 'don't know' or 'refuse' showed reduced odds of substance use. Bisexual women exhibited highest disparities in health outcomes, e.g. OR=3.3, 95% 2.58 to 4.22 for poor mental health. Trends over time showed worsening mental health among bisexual women (relative to changes in heterosexual women), and decreasing substance use in gay and bisexual men, and lesbians. This study highlights health disparities across sexual orientations in Canada, especially bisexual women, calling for targeted interventions (e.g. increased training of service providers in working with bisexual women and community outreach against biphobia). Future research should aim to explore these disparities longitudinally while also including the use of administrative-linked health data to reduce potential bias in self-reported data.

Mignon R. Moore Lipstick or Timberlands? Meanings of Gender Presentation in Black Lesbian Communities C onsider the ways in which the following women explain gender pre- sentation in one black lesbian community: Asa Bambir (age 34, executive assistant): 1 In New York I saw more of this butch-femme thing and I was a little floored by it, a little shocked, like why do people have to play these roles? . . . But at the same time I looked at it in awe because there was a part of my childhood when I really liked wearing boyish clothes, but I never did. . . . So, I was very intrigued by it, and I think over the years I’ve just been allowing that to surface. I really do like wearing boyish clothes. Were you drawn to women who were more feminine looking or less feminine looking? I was definitely drawn to women who were feminine looking, very feminine looking. Lynn Witherspoon (age 33, corporate attorney): When I first started to come out . . . it was interesting because I had this type that I was attracted to, and yet when I was going out I was always attracting the more butch looking women. And I was like, “Oh, I’m carrying this purse,” and all of these other things, you know, all these things you do in the straight community. So I had to change the way I dressed, and I stopped carrying a purse, and I was able to find women who I was more attracted to, to go out with. When I first came out I was wearing makeup; I stopped wearing makeup. Data collection was supported by the Woodrow Wilson Junior Faculty Career Enhance- ment Fellowship, the Andrew W. Mellon Foundation, the Institute for Social and Economic Research and Policy, and the Institute for Research in African-American Studies at Columbia University. The Russell Sage Foundation generously supported the writing of this manuscript. I thank Karolyn Tyson, Elaine Harley, Laurie Essig, two anonymous reviewers, and the current and former editors of Signs for their helpful comments. Pseudonyms are used to protect respondents’ anonymity. Following Kath Weston’s (2004) model, I assign surnames to this study’s participants to convey a sense of respect and adult status not always afforded sexual or racial minority group members. [Signs: Journal of Women in Culture and Society 2006, vol. 32, no. 1] ᭧ 2006 by The University of Chicago. All rights reserved. 0097-9740/2006/3201-0009$10.00

LGBTQ cultural competence for pharmacists

Gay and bisexual men might face unique, status-based competitive pressures given that their social and sexual relationships often occur with other men, who are known to compete for social and sexual gain. In a multistage study, we delineated intraminority gay community stress theory-that status-focused elements of the gay community challenge the mental health of gay and bisexual men. We first created a measure of gay community stress with items derived from qualitative interviewing (n = 49); calculated its psychometric properties, including 1-year temporal stability (n = 937); and confirmed its structural stability in distinct samples (n = 96; n = 1,413). Being stressed by perceiving the gay community's focus on sex, focus on status, focus on competition, and exclusion of diversity predicted gay and bisexual men's mental health over-and-above a comprehensive battery of traditional minority stressors (β = .17, p < .01) and mediated the association between one's gay community status and mental health. To examine the impact of individual differences in status concerns (i.e., about masculinity, attractiveness, and wealth) on gay and bisexual men's feelings of within-community exclusion, a series of experiments manipulated (a) the sexual orientation (gay vs. heterosexual) of rejecters (n = 103), (b) the social status of gay rejecters (n = 83), and (c) whether rejection from gay and bisexual rejecters was status-based or nonstatus-based (n = 252). Overall, these experiments provide partial support for the possibility that gay and bisexual men's status concerns underlie their experience of gay community stress. Together, these studies advance psychological and sociological accounts of gay and bisexual men's mental health beyond minority stress theory, with implications for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background: Little research has focused specifically on alcohol, tobacco, and other drug (ATOD) use of lesbian and bisexual women in general or the college subgroup specifically. Previous research shows sexual minority women at increased risk when compared to their heterosexual counterparts. Objectives: The purpose of the current study was to compare ATOD use of lesbian, bisexual, and heterosexual undergraduate college women. Methods: A secondary analysis of three fall semesters (2009–2011) of American College Health Association-National College Health Assessment (ACHA-NCHA-II) data was conducted. Women who self-identified as gay/lesbian (N = 538), bisexual (N = 1579), and heterosexual (N = 40,869) were compared on ATOD use. Chi-square Tests were used to analyze differences between the groups and logistic regression determined odds ratios of ATOD use. Results: Bisexual women had greater odds of using alcohol, tobacco, and marijuana than heterosexual women and lesbians. They also had greater odds of using all illicit drugs (except steroids) and misusing prescription drugs than heterosexual women and greater odds of using amphetamines other than meth, sedatives, and ecstasy when compared to lesbians. Lesbians had greater odds of using tobacco, marijuana, sedatives, hallucinogens, other illegal drugs and misusing prescription drugs than heterosexual women. Conclusions/Importance: The study confirms increased ATOD use among sexual minority women as compared to their heterosexual counterparts with bisexual women having the highest use. This is the first study to examine misuse of prescription drugs among a large number of lesbian and bisexual college women, and contributes to the scant literature addressing college women's ATOD use by sexual orientation.

SUMMARY This study examines mental health issues among women of different sexual orientations. An anonymous survey was administered at 33 health care sites across the United States; the sample (N = 1304) included lesbians (n = 524), bisexual (n = 143) and heterosexual women (n = 637). Not only did sexual orientation influence the probability of experiencing emotional stress, but also whether a bisexual woman or lesbian had disclosed her sexual orientation (was “out”) impacted the likelihood of having or having had mental health problems. Bisexual women and lesbians experienced more emotional stress as teenagers than did heterosexual women. Bisexual women were more than twice as likely to have had an eating disorder compared to lesbians. If a bisexual woman reported being out she was twice as likely to have had an eating disorder compared to a heterosexual woman. Lesbians who were not out and bisexual women who were out were 2-2.5 times more likely to experience suicidal ideation in the past 12 months. Lesbians and bisexual women who were not out were more likely to have had a suicide attempt compared to heterosexual women. Lesbians used psychotherapy for depression more commonly than did heterosexual or bisexual women. This is one of the few studies that compares lesbians, bisexual and heterosexual women. The implications of these findings are discussed.

ABSTRACTThis mixed methods study analyzed how bisexual (n = 241) and lesbian (n = 204) women qualitatively describe the settings in which they feel most positive and negative about their sexual identities. Secondly, the authors quantitatively assessed lesbian and bisexual women on identity-related processes (e.g., outness, negative feelings about identity) and standardized measures of acceptance and engagement with lesbian and bisexual communities and people. Compared to lesbian women, bisexual women were more likely to describe feeling most negative with family members and sexual minority peers, most positive when with allies, and were less likely to describe feeling positive “everywhere.” Bisexual women were less open and had more negative feelings about their sexual identity than lesbians but were accepting of and engaged with lesbian and bisexual communities. Lesbians were only accepting of and engaged with lesbian communities. The discussion focuses on the changing role of lesbian, gay, bisexual, transgender, queer contexts and the unique challenges faced by bisexual women.

In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies. Waves 2-12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations. Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with "other" orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures. The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations.

Although some bisexual men experience conventional sexual attraction to both males and females, others have less obvious sexual interests underlying their bisexual identity, attraction, or behavior (i.e., bisexual phenomena). Accordingly, it has been proposed that some men’s bisexual phenomena are motivated by autogynephilia, a male’s propensity to be sexually aroused by the thought or image of being a woman. For these men, sexual attraction to males is secondary to their autogynephilia, rather than a reflection of conventional attraction to males. The present study examined how common autogynephilia is among bisexual cisgender men, and how autogynephilic bisexual men may differ from non-autogynephilic bisexual men in their sexual interests and behavior, uncertainty about their sexual orientation, and gender-related experiences. We recruited a large sample of bisexual-identified men (n = 254) via Prolific to complete an online survey. Of the sample, 35% (n = 89) endorsed at least half of the items on a measure of core autogynephilia. Consistent with past research on autogynephilia, autogynephilic bisexual men reported more paraphilic sexual interests than non-autogynephilic bisexual men. Of clinical importance, autogynephilic bisexual men reported less certainty about their sexual orientation, elevated childhood and adult gender nonconformity, and elevated gender dysphoria relative to non-autogynephilic bisexuals. These findings suggest that a substantial minority of bisexual men experience autogynephilia, and that future research should consider the unique experiences and needs of autogynephilic bisexual men, including how else they might differ from other bisexual men.

The lack of recognition of the validity of a bisexual identity in society is mirrored by a paucity of research into the experiences of bisexual men and women. Despite the frequent use of the term “LGBT” (lesbian, gay, bisexual or transgender) and similar acronyms in gender identity and sexuality research, the majority of the work generated addresses the former two letters of the acronym, rather than the latter. After decades of research into gay and lesbian issues in psychology this remains true, even though it is likely the case that bisexual individuals (including those engaging in both same-sex and other-sex behavior as well as those who identify as bisexual) are at elevated risk for difficulties above and beyond those experienced by gay men and lesbians (Cochran et al. 2007; Moon et al. 2007). It is in this context that Ronald Fox’s edited compendium of articles addressing affirmative psychotherapy for bisexual men and bisexual women provides much-needed insight into these often overlooked groups. Mental health practitioners will find useful and timely information in this edited book. Those who are new to the field of LGBT studies generally, and to the study of bisexuality in particular, will benefit from explanations of theories related to bisexual identity formation and from overviews of terminology that clinicians are likely to encounter in their work with bisexual individuals (i.e., if you struggle to define terms such as “polyamorous,” this book is for you). The use of case examples in many of the chapters serves to bring the experiences of bisexual clients into more detail. For example, Mary Bradford’s chapter on working with bisexual women discusses the issues involved when a woman who has historically had same-sex relationships and identified as lesbian becomes involved in an intimate relationship with a man. The reader is likely to reference this volume frequently when encountering issues of sexuality in practice. This edited volume also has much to offer to the researcher interested in sexual orientation and identity. As with the practitioner, inquiring about sexual orientation in a categorical manner may obscure meaningful differences in the ways individuals describe their sexual attractions and behavior. Descriptions of the use of instruments to assess multiple aspects of sexuality (e.g., the Klein Sexual Orientation Grid, Klein 1993; and its later modification into the Sexual and Affectational Orientation and Identity Scale by Keppel and Hamilton 2000) will help researchers to ensure that they are inquiring about sexuality in an inclusive and comprehensive manner. Researchers will also receive an introduction to the research literature on bisexuality, which is woven throughout several of the chapters. For example, Geri Weitzman’s chapter regarding individuals who are both bisexual and polyamorous details her research findings, including data contradicting the myth that bisexual people tend to have both sameand differentgender partners simultaneously. Due to the historical omission of bisexuality from studies of sexual orientation, the empirically oriented reader is able to discern numerous areas of inquiry that could advance the field. Another theme of this volume is the intersection of multiple identities and how each identity (e.g., bisexual, transgender, African-American, older, person with HIV/ AIDS) provides additional insight into the experiences of bisexual clients. For example, Raymond L. Scott’s eloquently written chapter combines the underlying concepts Sex Roles (2008) 58:597–598 DOI 10.1007/s11199-007-9386-y

This article examines patterns of self-rated physical and mental health by sexual orientation among middle-aged and older adults in Canada, a rapidly growing subpopulation shown to be at risk of poor health. We use the Canadian Community Health Survey (CCHS 2015-2016) to estimate logit models predicting fair/poor self-rated physical and mental health by sexual orientation among middle-aged and older adults, stratifying by sex and age group. We find no differences in physical health for gay men and lesbian women compared with their heterosexual counterparts. However, middle-aged gay men are disadvantaged in terms of mental health, but not women. Bisexual women are disadvantaged in terms of physical health, and for mental health in some model specifications. Respondents who did not know their sexual orientation have poorer health across some measures of health and age groups. Our findings add to the paucity of research on older sexual minorities in Canada. They highlight the importance of separating out sexual minority groups because bisexual women have distinct health profiles. In addition, this is the first study to examine the health of respondents who "do not know" their sexual orientation, and future research should distinguish between different explanations for their poor health.

We identified health disparities for a statewide population of lesbian, gay, and bisexual (LGB) men and women compared with their heterosexual counterparts. We used data from the 2003-2006 Washington State Behavioral Risk Factor Surveillance System to examine associations between sexual orientation and chronic health conditions, health risk behaviors, access to care, and preventive services. Lesbian and bisexual women were more likely than were heterosexual women to have poor physical and mental health, asthma, and diabetes (bisexuals only), to be overweight, to smoke, and to drink excess alcohol. They were also less likely to have access to care and to use preventive services. Gay and bisexual men were more likely than were heterosexual men to have poor mental health, poor health-limited activities, and to smoke. Bisexuals of both genders had the greatest number and magnitude of disparities compared with heterosexuals. Important health disparities exist for LGB adults. Sexual orientation can be effectively included as a standard demographic variable in public health surveillance systems to provide data that support planning interventions and progress toward improving LGB health.