Bisexual women report worse mental health outcomes compared to heterosexual and lesbian women. To explore potential factors related to bisexual women's mental health and wellbeing, we examined bisexual women's daily experiences with sexual identity microaggressions and microaffirmations as they relate to depression, suicidality, and happiness. We used a 5-day online daily diary study design. The first day participants completed a survey with information on demographics, sexual identity, social support, depression, and self-esteem. For Days 2 through 5 participants completed daily diary entries consisting of the Bisexual Microaggression and Microaffirmation Scales, measures of depression, suicidality, and happiness. Data were analyzed using a multilevel model with two levels-repeated daily diary measures nested within each participant. We assessed the relationship between daily microaggressions and microaffirmations and mental health within individuals, and how mental health may differ between individuals based on social support, connectedness to LGBTQ community, self-esteem, and internalized binegativity (negative feelings about one's bisexual identity). There was a significant relationship between daily microaggressions and depression, suicidality, and happiness within individuals. Between individuals, there was a relationship between some of the mental health outcomes and Day 1 depression, self-esteem, trans identity, and racialized identity. Public Significance StatementWe found that the small, commonplace negative experiences that bisexual women encounter are associated with increased depression, increased consideration of suicide, and decreased happiness. These findings identify the important role of anti-bisexual microaggressions in taxing the mental resources of bisexual women, contributing to their mental health disparities. These findings highlight the need to reduce anti-bisexual stigma in order to improve bisexual women's mental wellbeing.

In the current study, we examined how bisexual women’s unique experiences of sexual identity stigma might elevate their risk for verbal sexual coercion. Online survey data were collected from 350 self-identified bisexual women. Hayes PROCESS macro was used to test moderated-mediation and mediation analyses. Results indicated that anti-bisexual experiences (from both heterosexual and lesbian/gay individuals) were associated with greater internalized heterosexism (i.e., internalization of negative societal attitudes and stereotypes about one’s minority sexual orientation), which in turn was associated with increased odds of experiencing verbal sexual coercion. We did not find moderating effects of outness, such that internalized heterosexism mediated the relation between anti-bisexual experiences and verbal sexual coercion regardless of bisexual women’s levels of outness. Findings suggest that anti-bisexual experiences and internalized heterosexism are associated with bisexual women’s elevated risk for experiencing verbal sexual coercion. There is a need for targeted sexual violence prevention and risk reduction efforts that take into account the unique experiences and vulnerabilities of bisexual women in victimization risk. Results also highlight the need for campaigns that reduce sexual orientation-related stigma at the population level in order to prevent negative health outcomes among bisexual women.

Bisexual women experience worse mental health outcomes than lesbian and heterosexual women, which may be explained by greater rates of sexual violence among bisexual women. The current comprehensive literature review aimed to synthesize research on mental health and substance use outcomes related to lifetime sexual violence among bisexual women. A comprehensive literature search was conducted within the PsycINFO and Medline databases (final search conducted in August, 2021). Inclusion criteria required articles to examine a mental health or substance use correlate/outcome of lifetime sexual victimization experiences among bisexual women. Fifteen studies met inclusion criteria and were reviewed. Results indicate that there are significant gaps in this literature, including limited research on psychological distress outcomes. Most notably, there is a limited focus on the experiences of bisexual women specifically and the role of bisexual minority stress. Findings indicate that lifetime sexual victimization experiences are linked with increased posttraumatic stress, depression, and alcohol (and other substance) use and consequences. It appears that bisexual women are vulnerable to cumulative victimization, which may further exacerbate outcomes. Clinicians working with bisexual women should provide bisexual-affirmative care, help bisexual women access positive social supports, and build more effective coping strategies for managing post-trauma distress. Future research on outcomes of violence among bisexual women would benefit from contextualizing adjustment following sexual assault within a bisexual minority stress-informed approach for a more comprehensive understanding of this process.

Bisexual women experience high rates of sexual victimization, receive more negative social reactions from others upon disclosing experiences of sexual assault, and report greater hazardous alcohol use compared to heterosexual and lesbian women. The current study examined how experienced and internalized binegativity and bisexual identity affirmation relate to these disparities among a sample of 130 bisexual women who disclosed their sexual assault experience to at least 1 person. A moderated-mediation model was tested, which specified that experienced binegativity would indirectly relate to increased alcohol use via the impact of negative social reactions to assault disclosure, and that this indirect effect would be moderated by internalized binegativity and identity affirmation. Results indicated greater experienced binegativity predicted greater negative reactions to sexual assault disclosure, which predicted increased hazardous alcohol use. This indirect effect was qualified by internalized binegativity, such that negative social reactions to disclosure predicted hazardous alcohol use only in the context of higher internalized binegativity. Bisexual identity affirmation did not moderate the link between reactions to disclosure and drinking. Findings identify experienced and internalized antibisexual stigma as important targets for intervention efforts and highlight the need for campaigns that reduce binegativity at the individual and population level. Public Significance StatementBisexual women with histories of sexual assault who encounter negative stereotypes of bisexuality may be more likely to receive unsupportive responses from others when they disclose sexual assault. These unsupportive responses in turn may contribute to increased risk for hazardous alcohol use especially for women who have internalized negative attitudes toward bisexuality to a greater extent. Results highlight the need to reduce antibisexual stereotypes and attitudes in efforts to prevent the detrimental impact of unsupportive responses on alcohol use and to improve bisexual women's wellbeing.

Bisexual women experience higher rates of sexual victimization and mental health problems compared to heterosexual and lesbian women. Bisexual women also receive more unsupportive or overtly negative reactions when they disclose experiences of sexual victimization. The current study aimed to examine the interaction of negative social reactions and binegativity (i.e., experiences of stigma due to bisexual identity) in predicting posttraumatic stress, depression, and hazardous drinking among bisexual women. The sample consisted of 161 young adult bisexual women (ages 18–35) who disclosed a sexual victimization experience to at least one person. Moderation analyses were conducted via the PROCESS macro for SPSS. “Turning against” reactions to disclosure (e.g., victim blame and avoidance of the victim) predicted increased posttraumatic stress and hazardous drinking in the presence of binegativity. In addition, reactions to disclosure that acknowledged the experience but were unsupportive predicted increased drinking in the context of binegativity. Depression was not associated with either type of negative reactions, regardless of binegativity. Thus, findings suggest that binegativity in combination with negative responses to disclosure of sexual victimization are important factors in specific types of distress related to sexual violence among bisexual women. Implications for research, clinical intervention, and policy are discussed.