What Is Bisexual Erasure-and How Does It Affect Health?

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- Bisexual erasure ignores bisexuality, which leads to negative mental and physical health outcomes.
- You can support bisexual community organizations to increase visibility and prevent bisexual erasure.

"They're just confused. They're gay or lesbian. It's a transitional phase until they fully come out. They're actually straight, but they want the attention. It's not even real." These are examples of bisexual erasure, or disregarding bisexuality as an identity. Bisexual erasure, or bisexual invisibility, can negatively affect physical and mental health.
- More people identify as bisexual, but many still question or deny it as a legitimate identity.

Despite the many stereotypes surrounding bisexuality, it's a legitimate sexual orientation. Younger adults are even more likely to identify as such. A Gallup poll released in 2021 showed that 3.1% of adults in the United States identify as bisexual. About 5.1% of millennials and 11.5% of Gen Z adults report that they're bisexual.

Others continue to play down, ignore, and essentially erase bisexuality, even as the number of people who identify as bisexual increases.

What Is Bisexuality?

Bisexuality refers to a person who's emotionally, romantically, or sexually attracted to more than one gender or sex. You may not be equally attracted to all genders if you're bisexual.

Research has found that people who identify as bisexual face more negative health outcomes. These complications include adverse mental health outcomes, like depression and anxiety, and substance use disorder (SUD).

Defining Bisexual Erasure

Bisexual erasure happens when people question or deny the legitimacy of bisexuality as an identity. A person or a society can perpetuate bisexual erasure.

Bisexual erasure is reinforced anytime someone leans beliefs like:

- Asking a partner who is bisexual to label their sexual identity in a way that "reflects" your relationship
- Assuming a man and a woman who are in a relationship together are both straight
- Assuming two women who are in a relationship together must be lesbians
- Downplaying bisexuality as a phase
- Leaving out the bisexual community in LGBTQ+ advocacy

Bisexuality vs. Pansexuality

Pansexuality refers to people who have an emotional, romantic, or sexual attraction to people of any gender. You might be attracted to different genders at varying times or degrees of attraction.

This term has gained visibility, especially as more celebrities, like singers Janelle Monáe and Miley Cyrus, have come out as pansexual. "I think for a lot of people, it can be affirming, comforting, and validating to know that there is a word for what you're feeling and experiencing. I think that's part of why we see the emergence of new labels as time goes on, like pansexual," Brian Feinstein, PhD, an associate professor of psychology at Rosalind Franklin University of Medicine and Science, told Health.

"Because for some people who don't feel that any of the existing labels really fit what they're experiencing, there is this pull to find language to better convey what they're experiencing," said Feinstein.

Does pansexuality become a form of bisexuality erasure? The identities might share similarities, but they're two distinct labels. "I think there's space for both of [the labels] to exist without necessarily one invalidating or erasing the other," said Feinstein.

Acknowledging both identities gives people a way to understand who they are and identify themselves. These labels can also help in-person and digital communities form.

"These communities are really important for people to get the support they need to navigate what it's like in the world as a person who is multigender attracted," Lauren Beach, PhD, a faculty member at Northwestern University's Institute for Sexual and Gender Minority Health and Wellbeing, told Health. "It's important that people use labels that make them happy to be who they are."

Why It Happens

Bisexual erasure can stem from what Beach referred to as "a Westernized social obsession with binary." People might erase bisexuality because many think in stark, black-and-white terms. Rigid ways of thinking lead many to assume that someone is straight, gay, or lesbian, disregarding gray space between those identities.

"I think, for some people, it's hard to get their heads around this idea that sexual orientation doesn't have to be either-or," said Feinstein. "That it's not only being attracted to people of the same gender or people of another gender but that you could be attracted to more than one different type of person."

Sexuality Is Not Always Black and White

"There is this idea that you must either be gay or straight," said Beach. "That, therefore, eliminates the possibility of being bisexual. If you do allow for an ability to be identified as bisexual, the way that the dominant cultures talk about it is that bisexuality is a little bit of this or a little bit of that. That 50/50 stereotype because you're part gay and part straight."

Beach disagreed with this definition: "A lot of people, including myself, say, 'I'm not part of this and not part of that identity.' I'm neither of those. I have a distinct identity as bisexual."

Bisexual people have been present in the LGBTQ+ movement since its beginning. The bisexual community has talked about erasure for decades, and the concept is spreading to mainstream culture.

Beach liked that people were paying more attention to bisexuality. "If you go through the history of depictions of bisexuality in the press and the media, the themes that come over and over and over is that bisexuality is a new sexual orientation when it is not," said Beach.

"I'm glad that the media are shifting away from newness and shifting toward the erasure because that is a much more accurate portrayal of the reality of bisexual people and community," added Beach.

How Does Bisexual Erasure Affect Health?

"Bisexual erasure is a form of stigma. Stigma is bad for health, just to put it in a nutshell," said Beach. This goes for both mental and physical health. Some evidence suggests that bisexual people have higher rates of anxiety and depression than straight, lesbian, or gay people. Bisexual erasure is a critical potential contributor to these mental health disparities.

Getting rid of bisexual erasure may help many bisexual people experience less isolation, lowering the incidence of mental health issues. "[Bisexual people] are not coming out. They're not getting support for the stigma they face every day," said Beach.

"There's been associations of some of [those mental health diagnoses] with poverty and other structural level social determinants of health. It's important to help to fight back against bisexual erasure," added Beach.

Bisexual people and others in the LGBTQ+ community are more likely to experience:

- Increased heart disease risk factors due to stress
- Overweight or obesity
Smoking

Bisexual people may face these disparities because of a lack of quality preventative care. This care includes breast, colorectal, and cervical cancer screening tests. Bisexual women, for example, receive routine health care less frequently than straight women.

The disparities become increasingly layered for transgender people and people of color who identify as bisexual. These groups of people potentially have to navigate transphobia or racism.

Obstacles in Healthcare Settings

A lack of access to proper health care might be because sexual orientation isn't a topic a healthcare provider brings up. It might also be a topic people don't feel comfortable bringing up themselves.

"One of the biggest challenges is the assumptions that [healthcare providers] make," said Feinstein. A healthcare provider might discuss sexual behavior and screening for sexually transmitted infections (STIs), for example, with a woman in a relationship with a man. The healthcare provider may assume the woman is straight and make recommendations based on this assumption.

What if the woman is bisexual and has relationships with people of other genders? "People might not get treated [as they should] if they're not recognized as a member of a certain group," said Feinstein.

Bisexual people may also be afraid to bring up their sexual identity if a healthcare provider doesn't inquire about it. "I think part of it is just expecting that [healthcare providers] will have some of the same negative attitudes and make the same sort of comments that they're used to," said Feinstein.

Bring up your bisexuality when you are most comfortable, maybe before entering the exam room. "You can start to kind of shape the conversation, even if you don't want to tell your [healthcare provider] that you're bisexual, to make sure you're getting the care you need," said Beach.

How To Be an Ally

Increased visibility, especially in pop culture and media, helps end bisexual erasure. "I think [the media] puts it out there that bisexuality is a sexual orientation, gets it into the discourse, and sort of get people seeing it more," said Feinstein.

Supporting bisexual community organizations can also help promote bisexual visibility and, in turn, end bisexual erasure. Make sure to include the bisexual community in your work if you're already involved in LGBTQ+ allyship or advocacy.

Other steps you can take to become an ally for the bisexual community include:

- Acknowledge the person-including cisgender, transgender, and non-binary people who identify as bisexual.
- Use inclusive language when talking about the LGBTQ+ community-for example, saying "LGBTQ+" instead of "gay and lesbian."
- Call out others when they make biphobic statements.
- Avoid stereotyping bisexual people-for example, don't hypersexualize bisexual people.
- Don't question a bisexual person's identity when they tell you they're bisexual.

"If you say things like [bisexuality isn't real], chances are that people who identify that way are listening to you," said Beach. "That's a really important thing to keep in mind because you're only letting people know who you are, and people don't forget that. If you're judgmental on that front, what else are you judging on?"

Wellness
Mental Health
Social and Public Health


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Gallup. LGBT identification in U.S. ticks up to 7.1%.

Human Rights Campaign. HRC's brief guide to getting bisexual coverage right.

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