What about the “B” in LGBT+?

This article originally appeared in BU Today. Viewpoint articles are written by members of the SPH community from a wide diversity of perspectives. The views expressed are solely those of the author and are not intended to represent the views of Boston University or the School of Public Health. We aspire to a culture where all can express views in a context of civility and respect. Our guidance on the values that guide our commitment can be found at Revisiting the Principles of Free and Inclusive Academic Speech.

This weekend marks the city of Boston’s 49th annual Pride celebration, when members of the LGBT+ community and their allies will march, dance, sing, and honor their own identities and those of other queer folks in Boston and all over the world. Throughout Pride Week (May 31 to June 9), some have likely referred to the celebration as “gay pride.” The term “gay” is often used as a shorthand that is supposed to capture everyone who isn’t straight or cisgender. Focusing solely on sexuality, referring to the community as “gay” typically includes only those who experience attraction to people of their same gender.

Who is forgotten? What about the “B” in LGBT+, who make up 40 percent of the queer population? Bisexual people, who may be attracted to other people of their own gender as well as those of any and all other genders, are often misunderstood and may experience prejudice based on their sexuality. Like homophobia (discrimination against gay and lesbian people), the term biphobia refers to the discrimination, oppression, and trauma many bisexual people face, and it can contribute to multiple negative health effects.

As a whole, queer people who come out to their medical providers are able to get care that reflects their specific needs, but this can potentially lead to homophobia if the medical provider or their team are not supportive. This is especially true for bisexual people; almost half of bisexual people report experiencing biphobia in a medical setting. As a result, only about two-thirds of bisexual people come out to their doctor, compared to nearly 90 percent of gay men and lesbians. For some people, the stress isn’t worth it, so they stop seeking preventive medical care. Bisexual people are more likely to have high cholesterol, asthma, cancer, heart disease, and obesity, all health effects that may be helped by seeing a doctor regularly.

Bisexual people are also more likely to have poorer sexual health, often stemming from a lack of resources and education that is specific to their needs. Compared to heterosexual and gay/lesbian people, bisexual people are more likely to engage in risky sexual behavior, including lack of condom use, substance use with sexual activity, and not getting tested for STI/HIV. Bisexual women are also at greater risk for intimate partner and sexual violence. A staggering three out of four bisexual women in the United States have experienced sexual violence in their lifetime; less than half of heterosexual women and lesbians have had such violence enacted upon them. Research indicates that this may be due to male partners fetishizing their female partner’s attraction to women, thereby dehumanizing her and making it easier to justify violence.

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Danielle McPeak is an MPH candidate.