By Lila Hartelius
Let me take you on a boat ride through the landscape of my ruminations on a question that’s been simmering in my mind since I first discovered published research suggesting bi+ women’s health outcomes are poorer than those of heterosexual women and lesbians respectively: “why?” This landscape’s been shaped by my experiences and observations and others’ anecdotes. I should say “waterscape,” because I’ll invite you to peer into a vast ocean and a few boats we’ll pass. I’ll try to keep this conversational, but my intellect will undoubtedly interject. Please bear with us.
1. Steeped in the “ocean” of society
First stop: a few unsettling “swells” which have led me to some “aha”s.
Swell #1: Chatting with a friend. Topic of bisexuality arises. Friend makes biphobic comment. I’m confused: should I call them my friend? I speak up. It was an innocent oops. I should be happy, but something’s missing. I don’t know what.
Swell #2: Chatting with another friend. Topic of bisexuality arises. Friend makes biphobic comment. I’m baffled: this is happening again? I speak up. They argue the comment’s not offensive. I explain my point. Useless. I give up, hurt, exhausted.
Swell #3: Chatting with a third friend. Topic of bisexuality arises. Friend makes biphobic comment. This is getting old. I speak up. They reply, “Oh, I didn’t know that. Huh.” Life goes on, but my mind’s stuck at swell #1. Now I know what was missing. Do they understand this isn’t just about the comment? Do they know about health risks specific to bi+ women? Are they ever going to connect the dots?
“Aha” #1: All three scenarios reflect the biphobia and bi-invisibilization polluting the societal “ocean” we’re steeped in. With so much material to convince people that detrimental bi+ stereotypes are truer than they are, and so few widely-visible examples to the contrary being taken seriously, it’s understandable someone who knows little about bi+ identities and experiences might unknowingly say something biphobic, not recognize health risks specific to bi+ women or how biphobic comments might contribute to those, or be hesitant to accept one bi+ woman’s words against society’s.
“Aha” #2: These comments, innocent as they may have been, could be considered microaggressions. Added up over time, they could favor development of chronic stress in bi+ women exposed repeatedly to them—which wouldn’t bode well for health outcomes in bi+ women. Personally, I do feel that encountering biphobia—and the emotional labor of educating others on bi+ topics—has adversely impacted my self-image as a bi+ woman and my mental health.
Bi+ women are incredibly diverse. Many factors—intersecting identities, variations in personal resilience—undoubtedly influence a bi+ woman’s susceptibility to developing chronic stress from repeated exposure to microaggressions. But harmful bi+ stereotypes and bi-invisibilization may be negatively affecting bi+ women’s health outcomes. This should be investigated further.
2. A “boat” to call home
Now that we’ve explored some of what’s percolating in the water, I’d like to show you a couple of must-see boats I’ve been pondering.
Boat #1: Someone on a podium speaks to people dressed in rainbows: “I was afraid, ashamed. But when I finally understood and accepted myself, I felt liberated from a weight I didn’t know I was carrying.” Listeners murmur in recognition. The speaker continues: “I had to tell someone. I couldn’t live alone with this truth anymore. The isolation was killing me. The first time I came out, I was so relieved. The more people I came out to, the more I started finding people like me. One thing led to another, and now that I’ve found this beautiful community, I feel like I’ve found my family, my home. We’re all still sailing rough seas, but having you here makes the sailing smoother.” The crowd breaks into applause, hoots, and whistles.
We’ve just seen the boat many call the LGBTQ+ community. Like any good boat, it protects its passengers from the potentially dangerous force of ocean waves. Well, some of its passengers. Bi+ women are often among the exceptions to this rule. You know that story the person at the podium told? OK, nobody’s story is perfect, but hear me out. Where bi+ women seem to diverge from this narrative is at the part about community. Pretty important, right? Finding support and experiencing psychological safety among safety among people who just “get” you might help buffer effects of minority stress. Community. Yeah, pretty elusive to some of us bi+ women—or at least, that’s an idea I’ve been pondering.
I’ve witnessed many women apparently experiencing restorative, soothing effects from enjoying camaraderie with other women. Heteronormativity and biphobia have made this sense of ease and warmth in socially bonding with other women harder for me to access. I’m often more comfortable in women’s spaces and more at home with the idea of queer women’s spaces than generic ones. My attempts at finding community with other queer women—in person and online—have often been in spaces dominantly referred to as lesbian, where most of the participants have been lesbians. It’s in these spaces that I’ve experienced the most frequent biphobia within the LGBTQ+ community. I’ve found truly bi-inclusive spaces for queer women and spaces specifically for bi+ women to be comparatively rare.
Encountering biphobia in the LGBTQ+ community—including from other queer women—may add to stress many bi+ women experience from biphobia in heteronormative society. The internet is a breeding ground for some particularly toxic biphobia, notably within lesbian culture. Greater anonymity online can make it easier to voice feelings one wouldn’t normally express in person. While venting in itself may be healthy, when it contains biphobic remarks accessible to a wide public which may include bi+ women seeking support or community, the results can be harmful. A need for spaces specifically for lesbian community is valid. It’s also important to recognize the diversity of the bi+ spectrum. There are myriad reasons a bi+ woman might gravitate toward lesbian spaces or content creators.
Bi+ women’s experiences around finding community certainly vary. However, because identity, love, sexuality, and intimate partnerships are so important for so many people, feeling a sense of belonging within social spheres where it’s safe to talk about these could have a significant impact on one’s stress levels and stress regulation capacities.
Yeah, and I’d be surprised if I were the only bi+ woman asking, “Where’s my boat?”
Boat #2: People dressed in white lab coats encircle an ordinarily-clothed person. They palpate, stethoscope, check charts and screens, ask questions, nod, type, scribble.
We’re in luck today; this is a rare sighting. You could call this boat the health care community of the patient. Who’s the patient? Probably not a bi+ woman.
In the presence of a risk factor as potentially significant as a dearth of a sense of supportive community, access to relevant health care that includes trusting relationships with competent health care professionals would be highly important for bi+ women.
Agreed. My experiences, and anecdotes I’ve heard from other bi+ women, suggest this is another “boat” that seems to elude many of us. For some, it’s feeling unsafe coming out as bi+ to a doctor. For others, it’s a practitioner making inappropriate or offensive comments or never mentioning health risks specific to bi+ women.
Bi-invisibilization and a perpetuation of harmful bi+ stereotypes at a societal level surely contribute to an apparent lack of bi-specific competence even in health care professionals who’ve undergone LGBTQ+ competence training. A trusting relationship with even one health care professional is arguably an important factor in positive health outcomes, perhaps due to possible stress-buffering effects of the trusting relationship.
We’ve reached the end of our boat ride. I guess this means I need to anchor—I mean, summarize. Um, intellect, can you come back for a sec?
In summary, potential development of chronic stress from experiencing repeated biphobic microaggressions, plus possible stress from difficulties finding community, may contribute to poorer health outcomes among bi+ women.
Whew! Back on dry land. After you.
Now that you’ve had a tour of my musings about bi+ women’s health, let me leave you with four elements I consider important in improving bi+ women’s health outcomes:
—More research to better understand relationships between risk factors and health outcomes for bi+ women
—More visibility and awareness-raising—within the LGBTQ+ community and in society generally—regarding bi+ women’s identities, experiences, and struggles
—More funding of projects and organizations offering relevant support, resources, and community-building opportunities to bi+ women (e.g. the Boston Bisexual Women’s Network)
—More widespread training, within LGBTQ+ competence training for health professionals, on health risks specific to bi+ women.
Sustainable, collective, strategic actions working to foster beneficial change at systemic levels can positively impact bi+ women’s health outcomes. As individuals, we can each participate in such actions in ways aligned with our personal strengths, values, and interests.
Together we can build “boats” of community to help bi+ women sail the “ocean” of society more smoothly and in better health.
Lila Hartelius is a neurodiverse, bilingual (English & French), multidisciplinary queer artist and writer who is honored to have had the opportunity to be a EuroBiCon workshop leader. She loves cats, creative and expressive arts, ecological intelligence, and brain-friendly approaches to anything from folding laundry to becoming an Olympic ice skater.