New research from UMD’s Prevention Research Center found that bisexual women had the worst self-reported mental health and the greatest number of barriers to accessing mental health care compared to other groups.
The study measured mental and behavioral health outcomes and barriers to care for lesbian, gay, bisexual, heterosexual, and "other" identified men and women. Heterosexual men were used as the reference group.
According to lead author Natasha D. Williams, a fourth year PhD candidate in Family Science and a licensed marriage and family therapist, possible reasons for the particularly averse outcomes for bisexual women include bi-erasure and bi-phobia. Jessica Fish, Deputy Director for Research and Evaluation at the PRC, recently published research that corroborates this idea.
“A lot of people, whether they’re in the queer community or not, invalidate bisexuality as a legitimate identity,” Williams said. “People will say, ‘it’s just a phase,’ or ‘you’re just experimenting,’ when it’s a bona fide sexual identity with its own sources of resilience and stress. Over and over again, it’s not uncommon to see bisexual groups have some of the more pronounced disparities or worse outcomes because of this marginalization.”
It’s not totally clear what’s going on with bisexual women in particular in terms of worse mental health and access to care. Williams said this is in part because there has been relatively little research on women in the LGBTQ+ community.
“A lot of LGBTQ+ health research started from the AIDS crisis, which was certainly necssary but tended to focus on gay white men,” she said. “The field is quite young; we've been trying to play catch-up and broaden the focus of LGBTQ+ health research.
The PRC’s research is particularly pertinent to this moment, Williams said. Since the country is more than a decade removed from the passage of the Affordable Care Act—the biggest piece of health care legislation since the 1960s—it is an ideal time for researchers to start to examine the effects of the policy. Is access to mental health care improving? If it is, is it improving for everyone?
A shift in the national social discourse is also permitting a more nuanced understanding of mental health in the LGBTQ+ community, Williams said.
“The lived experience of LGBTQ+ folks is talked about more now than ever,” she said. “People are waking up to the experiences of stigma, discrimination and marginalization they face. I think it’s easy for people to make the connection between those experiences and mental health, but it’s more difficult to think about those experiences in terms of access to care.”