Bisexuality, poverty and mental health: A mixed methods analysis

Abstract

Bisexuality is consistently associated with poor mental health outcomes. In population-based data, this is partially explained by income differences between bisexual people and lesbian, gay, and/or heterosexual individuals. However, the interrelationships between bisexuality, poverty, and mental health are poorly understood. In this paper, we examine the relationships between these variables using a mixed methods study of 302 adult bisexuals from Ontario, Canada. Participants were recruited using respondent-driven sampling to complete an internet-based survey including measures of psychological distress and minority stress. A subset of participants completed a semi-structured qualitative interview to contextualize their mental health experiences. Using information regarding household income, number of individuals supported by the income and geographic location, participants were categorized as living below or above the Canadian Low Income Cut Off (LICO). Accounting for the networked nature of the sample, participants living below the LICO had significantly higher mean scores for depression and posttraumatic stress disorder symptoms and reported significantly more perceived discrimination compared to individuals living above the LICO. Grounded theory analysis of the qualitative interviews suggested four pathways through which bisexuality and poverty may intersect to impact mental health: through early life experiences linked to bisexuality or poverty that impacted future financial stability; through effects of bisexual identity on employment and earning potential; through the impact of class and sexual orientation discrimination on access to communities of support; and through lack of access to mental health services that could provide culturally competent care. These mixed methods data help us understand the income disparities associated with bisexual identity in population-based data, and suggest points of intervention to address their impact on bisexual mental health.

Under the Bisexual Umbrella: Diversity of Identity and Experience

“…Research has consistently identified higher levels of poverty among bisexual and other non-monosexual groups in contrast to their monosexual peers (Gorman, Denney, Dowdy, & Medeiros, 2015;Ross et al, 2016). Poverty and income inequality may then be considered a social justice issue for individuals under the umbrella, and the greater number of people advocating for income equality, the more likely our voices are to be heard.…”

“…Another uniting factor among the wide range of people included under the umbrella is the higher vulnerability for negative health outcomes (Schick & Dodge, 2012), which is also related to income inequality (Braveman, Egerter, & Williams, 2011;Ross et al, 2016). Whether nonmonosexuality is categorized by identity or behavior, researchers consistently report higher rates of negative mental and physical health outcomes among nonmonosexual people in contrast to our monosexual peers, though how nonmonosexuality is conceptualized within research affects the overall outcomes (Bauer & Brennan, 2013).…”

Epistemic Injustice: Towards Uncovering Knowledge of Bisexual Realities in Social Work Research

“…In such a context, the gay subject cannot make proper sense of his sexuality, owing to the fact that gay people as such were prevented from making a full contribution to collective resources for social meaning, with the result that the forms of understanding available for making sense of homosexuality were crucially uninformed and distorted. (p. 70) Similarly, bisexuals can experience testimonial and hermeneutical injustice in society (e.g., Bostwick & Hequembourg, 2014;Ross et al, 2010;2016;Sarno & Wright, 2013, which may be addressed through various methods in social work research and practice).…”

“…These epistemic injustices vis-a`-vis microagressions may help explain why bisexuals have the highest rates of mental health issues among sexual minorities (King & McKeown, 2003;Jorm et al, 2002) and why they have uniquely negative experiences within the healthcare system (Dobinson et al, 2005). For instance, because of bisexual invisibility, many healthcare providers, including LGBTQ-friendly providers, are not always competent regarding bisexuality and are perceived by bisexuals as not inclusive of their identity and reality (Dobinson et al, 2005;Ross et al, 2010;2016). Bisexuals can also experience judgment or dismissiveness about their sexual identity from health care providers and social workers, as well as inappropriate questions about their sexual practices (Eady, Dobinson, & Ross, 2011).…”

Estigmatização de pessoas que vivem com HIV/aids e sua relação com suporte social e qualidade de vida

“…Em relação à baixa percepção de suporte social em relação aos bissexuais, esta pode estar relacionada ao baixo nível socioeconômico desta população, o que, para Ross et al (2016), está fortemente ligado aos maus resultados de saúde mental e ao estresse pós-traumático, os quais são agravados pela discriminação, pela falta de apoio social e pela inacessibilidade financeira aos serviços de apoio (GORMAN et al, 2015).…”