Introduction
There is a strong base of evidence suggesting that mental health in the members of the lesbian, gay, and bisexual (LGB) community may be significantly affected by numerous factors. According to the article written by Taylor et al. (2019), for example, suggest that heterosexual individuals are not as prone to mental health issues because they do not represent a minority that may be deprived in terms of certain other resources or services. This differentiation contributes to an even bigger gap between the members of LGB and their heterosexual counterparts. A specific place in this discussion is taken by people with the bisexual identity because their exposure to mental health issues may be strengthened by their inability to find the balance between their sexualities. The current research views the mental health of bisexuals from several different perspectives in order to evaluate all the possible mechanisms that could have contributed to mental health issues in bisexual individuals over the course of the past two decades.
Theories of Mental Health in Bisexual Subpopulation
One of the most important ideas that have to be covered when dwelling on the theory of mental health in bisexuals is the presence of specific systems of values that guide their worldviews. There is a common understanding that the culture of collectivism may have affected bisexual individuals, causing them to search for bonding and interdependence (Randolph et al., 2020). Nevertheless, not all needs of bisexual people can be or will be satisfied with the help of collectivism because their social identity is most likely to differ from what the majority of community members think about mental health issues. Despite same-sex behaviors being decriminalized, the stigma is still affecting bisexual individuals to an increasingly great extent because of the lack of empathy and understanding coming from others (Escobar-Viera et al., 2018). Mental health could also deteriorate from the constant discriminatory practices that became embedded in the general human values.
There is also a strict need to look at the issue of mental health in bisexual people through the prism of social disapproval and their fear of opening about sexual orientation because of further stigmatization. This also contributes to the intersection (will be discussed in detail in the next subsection) of culture and bias, causing minorities to experience exceptional levels of stress when interacting with other community members (Salim et al., 2019). From the theoretical point of view, bisexual individuals have to meet numerous negative connotations due to the low level of recognition displayed by the remaining society. With a decreased visibility, the bisexual community cannot change the existing stigma or contribute to an altered culture (Pakula et al., 2016). The increasing amount of stress experienced by bisexual individuals may also be subject to external pressures forcing them to engage in opposite-sex relationships and resolve their sexual identity in a pro-social manner.
Intersection of Differences
Combined, the disparities described above lay the foundation for the biggest challenges that bisexuals have to go through when establishing their identity. In a sense, the intersection of differences for them relates to all the disparities that minorities have to cope with when interacting with the community (Escobar-Viera et al., 2018). In other words, members of the LGB community may be affected by the lack of information related to mental health prevention. Without a sense of belonging and relation to a collectivist society, bisexual individuals will be most likely to lose access to any kind of coping resources (Taylor et al., 2019). The differences in bisexuals are so strong that some of the individuals may be affected by the lack of connection to the sexual minority community. They also lose their identified roles and fail to acquire all the necessary resources.
According to Salim et al. (2019), the intersection of differences may be rendered tangible because bisexuals are practically invisible to policymaking and other initiatives intended to help improve the conspicuousness of minority populations. Knowing that bisexuals are largely deprived of any kind of support or connection, they fail to acquire any kind of identification and cannot cope with not being included in the LGBT community properly. The negative influence of the intersection of differences may be explained through the interface of the so-called bi-negativity that leaves bisexual individuals prone to marginalization even within the community that was intended to protect and support them in the first place (Randolph et al., 2020). Such inherent susceptibility develops into a lower sense of connection and the advent of disparities that revolve around mental health, too. The problem is that a detailed mental health assessment would not be enough to cover the needs of the bisexual community.
Biopsychosocial Assessment
In terms of biological factors, the bisexual community does not differ significantly from any of its counterparts representing different sexuality. The presence of mental disorder in a bisexual individual does not represent anything specific from the point of a biological assessment because there are no dimensions related to how distinct satisfaction or dissatisfaction could eventually translate an individual from one health state into another (Salim et al., 2019). The variations in biological conditions contribute to the operationalization of mental health and its further diversification intended to respond to the dynamics of human sexuality.
From the psychological point of view, the mental health of bisexual individuals could be affected by constant concealment and the inability to reveal the true sexual orientation. This is why many bisexuals have trouble experimenting with their sexuality due to being unable to fall under any of the valid identity categories established by society (Pakula et al., 2016). The unreasonable hostility coming from other people sets bisexual people under pressure because they cannot overcome the stigma and have to cope with depressive episodes, anxiety, or even paranoia.
As for the social construct of bisexuality, it may be safe to say that marginalization based on identity struggle is the biggest issue that bisexuals have to cope with when interacting with the world. The majority of societies around the world are monosexist, forcefully exerting attempts to erase bisexuality or display it as something negative since it does not go in line with the dichotomy of sexual orientation (Pakula et al., 2016). Culturally prescribed labels are not challenged in any way at the moment, causing bisexuals to deal with exposure to beliefs that are obsolete and do not reflect the dynamics of sexuality.
Gay-Affirmative Practice
Another iteration of mental health challenges for the bisexual population would be the application of gay-affirmative practice. The first essential value that has to be covered when implementing this method is interpersonal closeness (Randolph et al., 2020). It has to be cultivated in order to improve the relationship between the client and the counselor and ensure that every participant is going to adapt positive behaviors. Practitioners should be as open-minded as possible in order to enhance the correlation between encouragement and positive mental health outcomes in bisexual individuals (Taylor et al., 2019). Either way, gay-affirmative practice will be most likely to force practitioners to step out of their comfort zone to establish a connection to the required client.
Knowing that most of the discrimination targets are members of the LGB community, practitioners should engage in special training programs to develop their critical thinking and gain a better understanding of how they could address the mental health issues of bisexual clients in a reverential manner. One way to implement gay-affirmative practice would be to maintain a safe counseling environment and promote role-playing exercises to help clients develop an objective view of the world (Escobar-Viera et al., 2018). Additional partnerships with community organizations may be required to establish a correlation between self-efficacy and competency in bisexual individuals. Through the gay-affirmative practice, members of minority communities, such as LGB, might get a chance to voice their concerns and dwell on how their experiences changed their lives. The practitioner will be responsible for active listening and an unbiased review of all input information.
Areas of Advocacy
Speaking of advocacy actions, the first possible strategy would be to instill a safe care environment and educate bisexual clients on how they could resolve the issue of their sexual identity while externalizing ambivalence and self-doubt. Responsible practitioners will be required to reduce the occurrence of conflicts in bisexuals and promote a view of sexual orientations that is not based on the feeling of shame (Escobar-Viera et al., 2018). Practitioners should also advocate for bisexual clients being able to escape self-devaluation and focus on their identity instead. Despite the lack of resources available to minority populations, practitioners could make it possible that bisexuals would gain the feeling of certainty and escape the vicious circle of victimization and comparisons (Salim et al., 2019). Knowing that there is a gap between mental health resources available to gays/lesbians and bisexuals, it should be noted that the essential area of advocacy should be the improved visibility of LGB.
On the other hand, practitioners should carefully advocate for bisexual individuals replacing their concealment behaviors with proper attraction behaviors to certain genders. This proposition is based on the idea that bisexuals could be blamed by their own community for heterosexual attractions, with heterosexuals also expressing aggression when facing same-sex attraction (Escobar-Viera et al., 2018). Therefore, practitioners will have to set up educational programs for community members to help the latter realize the dilemma that bisexuals have to cope with on a daily basis. This approach may be intended to aid the community in becoming more open-minded and engaging in more interpersonal interactions that are not deceiving in any way (Pakula et al., 2016). In the future, the problem of poor mental health in bisexuals may be ultimately resolved by a complete replacement of concealment with clearly displayed behaviors and values.
Best Practices for the Population
The biggest problem that practitioners could encounter when communicating with bisexual individuals is the presence of stressors that would affect clients at multiple levels at once. Instead of generic therapies, practitioners could significantly benefit from custom experiences shared by bisexual clients and validate most of their efforts by instilling a sense of acceptance in the clients (Salim et al., 2019). Sexuality is a concept that is dynamic by nature, which also means that bisexual clients could validate their condition without experiencing any external bias or blame. There should be a strong inclination toward adaptive coping strategies in order to affect the interpersonal context and help bisexual clients overcome emotional distress (Randolph et al., 2020). Another possible solution for practitioners would be to develop a closer connection to clients through peer-based interventions and strengthened social support. By doing this, counselors will make the members of the LGB community more visible.
The need for social media campaigns and community-wide initiatives is also evident since bi-negativity has to be challenged and replaced with healthier outlooks on the dynamics of a person’s sexuality. The existing monosexist view should be confronted as well in order to reduce the negative effect of peer pressure and have bisexual individuals refine their values and approaches to interpersonal communication (Randolph et al., 2020). The lack of community support makes it essential to implement long-term strategies aimed at the transformation of the existing culture and the mitigation of mental health disparities affecting both minorities and the general population (Taylor et al., 2019). Without similar approaches, there will be no opportunity for the government to overcome sexually-based disparities of mental health.
Conclusion
With the evidence on the subject in mind, it may be safe to say that a person’s sexual orientation may be a serious predictor of mental health issues. Sexual minorities tend to be significantly more prone to problems with identity and interpersonal communication because their experiences are affected by the trifold psychological burden of intrapersonal, interpersonal, and community-level difficulties. Concealment behaviors and the lack of empowerment pave the way for the need to challenge the existing state of affairs and motivate the members of the LGB community to display more affirmation. The presence of stress in bisexual individuals should be addressed with the help of targeted advocacy and safe therapeutic interventions, which should be culture- and location-specific. Therefore, mental health vulnerabilities represent an issue that can be and should be overcome in the future, especially with an evidence-based backbone in the form of therapies and community-wide nurturing of mitigation strategies.
References
Escobar-Viera, C. G., Whitfield, D. L., Wessel, C. B., Shensa, A., Sidani, J. E., Brown, A. L., Chandler, C. J., Hoffman, B. L., Marshal, M. P., & Primack, B. A. (2018). For better or for worse? A systematic review of the evidence on social media use and depression among lesbian, gay, and bisexual minorities. JMIR Mental Health, 5(3).
Pakula, B., Shoveller, J., Ratner, P. A., & Carpiano, R. (2016). Prevalence and co-occurrence of heavy drinking and anxiety and mood disorders among gay, lesbian, bisexual, and heterosexual Canadians. American Journal of Public Health, 106(6), 1042-1048. Web.
Randolph, C.H. Chan, Operario, D., & Mak, W. W. S. (2020). Bisexual individuals are at greater risk of poor mental health than lesbians and gay men: The mediating role of sexual identity stress at multiple levels. Journal of Affective Disorders, 260, 292-301. Web.
Salim, S., Robinson, M., & Flanders, C. E. (2019). Bisexual women’s experiences of microaggressions and microaffirmations and their relation to mental health. Psychology of Sexual Orientation and Gender Diversity, 6(3), 336–346. Web.
Taylor, J., Power, J., Smith., E., & Rathbone, M. (2019). Bisexual mental health: Findings from the ‘Who I Am’ study. Australian Journal of General Practice, 48(3).