Bisexual people are at increased risk for anxiety and depression compared with heterosexual and gay/ lesbian people, but little is known about people who use other labels to describe attractions to more than one gender (e.g., pansexual, queer; collectively biþ). In addition, some people use more than one label to describe their sexual orientation, but research has yet to examine whether using one versus multiple labels is associated with identity-related experiences or mental health. To address these gaps, we explored potential differences in disclosure, minority stress, and mental health among biþ adults based on primary sexual identity and multiple label use. As part of a larger project, 669 biþ adults completed an online survey. Primary sexual identities included bisexual (53.2%), pansexual (26.3%), and queer (20.5%), and 55.2% used multiple labels. Compared with bisexual participants, pansexual participants reported higher disclosure, discrimination from heterosexual people, and depression. Pansexual participants also reported higher anxiety and lower internalized binegativity, but these associations became nonsignificant after adjusting for demographics. Queer participants reported higher disclosure, discrimination from heterosexual people, and anxiety, but only the difference in disclosure remained significant in adjusted analyses. Finally, participants who used multiple labels reported higher disclosure and discrimination from heterosexual and gay/lesbian people, but only the difference in discrimination from gay/lesbian people remained significant in adjusted analyses. Findings highlight the heterogeneity of biþ individuals and the importance of considering bisexual, pansexual, and queer individuals as unique groups as well as considering whether biþ individuals use one or multiple sexual identity labels.
Public Significance StatementThis study suggests that there may be important differences among subgroups of biþ individuals based on their primary sexual identity (bisexual, pansexual, or queer) and whether they use one or multiple sexual identity labels. Pansexual individuals appear to be at particular risk for discrimination and depression, and biþ individuals who use multiple sexual identity labels may also be at risk for discrimination. These findings highlight the importance of assessing sexual identity in ways that attend to the diverse range of biþ identities as well as the use of multiple labels.