Therapy for bisexual people: Barriers to care
Quality healthcare is hard to find for people who are bisexual. It’s difficult to navigate the barriers alone. This blog will explore one researcher’s findings to shed some light on finding therapy for bisexual people, and what stands in the way of that.
Robyn Ochs’ Research on Bisexual Health Care
The central hub of the Chicago Public Library system is the Harold Washington Library on State Street. Like many public libraries they had a display out for Pride Month containing a smorgasbord of delectable queer literature, both fictional and nonfictional. I gravitated right to the cover of Bodies and Barriers: Queer Activists on Health the moment I saw it on the Pride table. Who should I see on the table of contents list but Robyn Ochs herself!
The rundown on Robyn Ochs is that she is a cis bisexual woman who spent 40 years as an out bisexual, health researcher, and advocate doing the work in the queer community. Her academic publishings are impressive, as is her spot on Teen Vogue’s “9 Bisexual Women Who Are Making History.”
I think all I’ll need to convince the uninitiated of this women’s credentials is the title of her article in Bodies and Barriers. It reads “Without Wincing or Clenching: Bisexual People’s Experiences with Healthcare Professionals.” I want to note that this article is not the result of academic research. This is not a double-blind research study and there is no control group. That’s a part of what makes it widely applicable to bi+ people; the article is an exploration of the central themes that came up over and over again in a set of responses Robyn Ochs received on a social media post. She asked for bi+ people to detail their experiences, positive and negative, with healthcare providers, and this article compiles their responses.
Does therapy need to be all about bisexuality?
The first theme I’d like to highlight is therapists only wanting to make the therapy session about bisexuality, regardless of what the person actually wants to focus on. I have heard from clients that this has happened to them too. One responder commented “My coming out is a part of my struggles with mental illness, I can’t deny that, but it’s not all of it. I often find that entire sessions are focused on my bisexuality rather than what I’m actually there for.” Their full, human complexity can get lost when providers only focus on this one facet of their personhood.
Backing up to the start of the article, Robyn Ochs opens the writing by describing her personal experiences of anxiety with coming out to her various therapists as bisexual. She details what those providers met her with, in one case sharing that she was unable to come out at all, and ended up terminating the therapy feeling that she had wasted her time. Eventually she found her way to a self-proclaimed out and proud bisexual therapist; picture me cheering her on as she writes this part! “By choosing her,” she writes, “I could be certain that my bisexuality would be seen as simply one aspect of my identity.”
Not sure about whether to come out to your therapist? Read more about the pros and cons of coming out as bisexual to your therapist here. Or, read more about the benefits of LGBTQ+ friendly therapy here.
Harmful assumptions are another barrier to finding quality health care that bisexual people face.
Another theme: assumptions made in every direction about what a bisexual person wants or needs! “Bi folks share the challenge of holding a nonbinary identity in a culture that leans heavily on binary assumptions.” From queer therapists: the idea that identifying as bisexual must be a pitstop on their clients’ journey of coming out as “fully gay” or “fully lesbian,” rather than seeing bisexual as an identity in its own right, worthy of respect. From heterosexual therapists: the idea that regardless of sexual activity, the mere fact of identifying as bi+ automatically places you in a higher risk category, regardless of whether there was any “higher-risk” sexual behavior.
The reality that you could be on the receiving end of any of these biphobic responses can be enough to keep bisexual people from sharing relevant information with their doctors. One respondent shared “I would not dream of letting them know!” That’s one of the biggest risks of being bisexual and getting healthcare: avoiding giving your doctors information that could be relevant or even medically necessary for them to have, because of how they are likely to respond. In anxiety treatment, we take great care to separate out which fears are rational, i.e. which are fears of things that could reasonably happen to you according to the laws of physics, or irrational, i.e. which fears are not as likely to happen to you. Where do we place getting misgendered or getting your experiences invalidated or even, as one respondent shared happened to them, getting told that “I was bisexual simply because I craved attention and needed to feel like a victim?”
Clearly, facing biphobic responses from your doctor is a rational fear, with its roots in a true lived experience that happens to many bisexual people. In fact, one study conducted by an official journal of the National Sexuality Resource Center found that bisexual people are even more likely to not share information on their sexual orientation than their gay or lesbian peers. That study, “Patterns and Predictors of Disclosure of Sexual Orientation to Healthcare Providers among Lesbians, Gay Men, and Bisexuals,” found that “39% of bisexual men and 33% of bisexual women hadn’t told their doctor about their sexual orientation, compared to 10% of gay men and 13% of lesbians.”
Choosing What to Disclose to Healthcare Providers
This article did not provide a single tip for how to change your behavior or what you say in order to better navigate the healthcare system- I assert that it is not on you to change the way the system handles your concerns. This is very much a problem on the provider’s side. That is not on you, or any client, to fix. Also, advice on how to navigate the healthcare system when it comes to which information to provide to whom, is generally unhelpful when it is vague enough to be widely applicable. It is up to each of us to try and make a judgment call on which providers to share which pieces of information with. And that brings us back to Robyn Ochs’ joy in finding a fellow bisexual provider. Having to run the equation in your head of “can I trust this person” is done for you.
If that sounds intriguing to you, I will point you to this link to find out more about therapy services with a bisexual provider at Full Focus Therapy.