what is one strategy that some gay men, lesbians, and bisexuals adopt to resist homophobia?
Am J Public Health. 2010 March; 100(iii): 496–502.
Perceived Determinants of Mental Health for Bisexual People: A Qualitative Examination
Abstruse
Objectives. We examined the determinants of mental wellness, every bit perceived by bisexual people, in club to brainstorm understanding the disparities in the rates of mental health problems reported past bisexual people versus those reported by heterosexual people, and, in many studies, gay men and lesbians.
Methods. Our customs-based participatory activity research project comprised focus groups and semistructured interviews with 55 bisexual people beyond the province of Ontario, Canada.
Results. Perceived determinants of emotional well-being identified by participants could be classified every bit macrolevel (social structure), mesolevel (interpersonal), or microlevel (individual). In the context of this framework, monosexism and biphobia were perceived to exert a broad-reaching impact on participants' mental health.
Conclusions. Similar other marginalized populations, bisexual people perceive experiences of discrimination as important determinants of mental health problems. Additional research is required to examine the relationships between these perceived determinants of emotional well-being and specific mental health outcomes and to guide interventions, advancement, and back up for bisexual people.
A growing body of epidemiological bear witness shows that sexual minorities, including gay men, lesbians, and bisexual people, written report poorer concrete and mental health outcomes than do heterosexuals.1–5 Experiences of discrimination—that is, exposure to unpredictable, episodic, or daily stress resulting from the social stigmatization of 1's identityhalf-dozen—are of import contributors to wellness disparities associated with minority sexual orientations.6,7
The health status of bisexual people has received little contained report, in part because the small sample sizes in many studies have led researchers to group bisexual people with gay men and lesbians.half-dozen,8 However, in studies that take examined bisexual people separately, they written report poorer mental health and college rates of mental wellness service utilization than do heterosexuals1,9–14 and, in some studies, than do lesbians and gay men.x–14
Various factors have been proposed to explain the association of bisexuality with these poor mental wellness outcomes, including the relative invisibility of bisexual people and a resulting lack of in-grouping customs support.13 The specific bigotry experiences of bisexual people may also be important contributors to these mental wellness disparities. Bisexual people tin experience biphobia, which is analogous to homophobia in that it describes negativity, prejudice, or bigotry against bisexual people. Similarly, monosexism is analogous to heterosexism: some people view only single-gender sexual orientations (heterosexuality and homosexuality) to be legitimate, and at the structural level, bisexuality is dismissed or disallowed.15 Finally, bisexual people may also experience internalized oppression7 in the class of internalized biphobia and internalized monosexism. These terms refer to an unconscious credence by bisexual people of negative or inaccurate social messages well-nigh bisexuality, potentially leading to identity conflict and self-esteem difficulties.
To our knowledge, no research to date has examined the relationships between these or other factors and mental health or emotional well-existence equally perceived by bisexual people. We therefore conducted a community-based participatory action research projection to answer the following question: what factors, both positive and negative, do bisexual people perceive to be significantly associated with their mental health? Our goal was to draw upon the principles of grounded theory methodology to develop a conceptual framework to describe the perceived determinants of mental health for bisexual people in Ontario. We used participants' own qualitative descriptions of the factors that they perceived to affect their mental health to develop a framework that would enable us to begin to empathize mental health disparities associated with bisexual identity.
METHODS
Inquiry on mental health in sexual minority communities must exist sensitively approached because historically their sexual orientations were treated past mental health professions, particularly psychiatry, as pathological.16 To address this challenge, we designed a customs-based participatory action research project17,18 in which members of the bisexual customs, representatives of partner organizations, and academic researchers were equally involved in every aspect of the inquiry process.17 We developed the project in partnership with the Sherbourne Health Centre, Toronto, Canada, which serves sexual minority communities, and nosotros hired bisexual community educators and activists as research staff.
Data Drove
We conducted eight focus groups of three to 9 participants each and interviewed 9 additional participants who either lived in more than remote settings or could non be included in focus groups for other reasons. Six focus groups met in Toronto: ii with women, 3 with men, and 1 with transgender and transsexual people. A mixed-gender focus grouping convened in Ottawa, Canada'due south uppercase city (eastern Ontario), and another in a small-scale community in southwestern Ontario. Nosotros interviewed seven individuals by telephone and 2 at locations requested by the participants. Data drove began in December 2006 and was completed in Oct 2007.
We used the aforementioned semistructured guide for both interviews and focus groups. Our analysis focused on answers to the post-obit questions:
-
What are some of the unique issues, experiences, and challenges you face every bit a bisexual person (or a person who is attracted to or sexually agile with men and women)?
-
What are the principal issues, experiences, and concerns you have faced over the course of your life as a bisexual person?
-
What practice you feel has a positive impact on your mental health and emotional well-beingness as a bisexual person?
-
What do you feel has a negative touch on your mental health and emotional well-being equally a bisexual person?
Prior to the focus grouping or interview, each participant provided written informed consent and completed a demographic questionnaire. Focus groups lasted approximately 2 hours and interviews ane hour. At the close of each focus group or interview, participants received a bundle of resources on bisexual health.
Participants
Participants were identified through convenience sampling of customs wellness and social service agencies; local bisexual or lesbian, gay, bisexual, and transgender organizations; online support and discussion groups; and advertisements in local newspapers. We advertised the study every bit "a customs-based research project to improve empathize the factors that affect mental health and emotional well-being amidst bisexual people" and invited individuals who identified as bisexual or were attracted to or sexually agile with both men and women to participate.
A total of 125 people expressed interest in the study. Of these, more than twoscore% reported learning well-nigh the study via e-mail or an online give-and-take grouping. Eligibility criteria, ascertained by a brief screening questionnaire completed by 99 (79%) of those who contacted united states, included being aged 16 years or older, residence in Ontario, and self-identification as bisexual or as attracted to or sexually active with both men and women. Of those screened, 10 (x%) were ineligible: ix participants lived outside of Ontario, and 1 did not run across our definition of bisexual.
We used purposive sampling to identify a terminal sample of 55 participants with multifariousness in gender, ethnicity, and geographic location. Selected demographic characteristics of participants are provided in Table 1.
Tabular array 1
Selected Demographic Characteristics of Participants (North = 55) in Written report of Bisexuals and Mental Health: Ontario, Canada, 2006–2007
| Characteristics | No. (%) or Mean (Range) | |
| Gender identificationa | ||
| Male | xxx (55) | |
| Female | 25 (45) | |
| Sexual orientation | ||
| Bisexualb | 41 (75) | |
| Queer | 8 (fifteen) | |
| Omnisexual | 1 (2) | |
| No identity label | five (9) | |
| Ethnocultural background | ||
| White/Caucasian | 38 (69) | |
| Person of color | 17 (31) | |
| Relationship statusc | ||
| Single | 18 (33) | |
| Married/mutual law/living with partner | 16 (29) | |
| Partnered/dating | xviii (33) | |
| Divorced/separated | 14 (25) | |
| Multiple partners | four (7) | |
| Geographic location | ||
| Greater Toronto area | thirty (55) | |
| Ottawa area | 10 (18) | |
| Southwestern Ontario | 9 (xvi) | |
| Northern Ontario | 6 (11) | |
| Instruction | ||
| Completed college/university | 36 (65) | |
| Completed high school | 17 (31) | |
| Did non complete high school | ii (4) | |
| Private income,d $ | ||
| < ten 000 | half-dozen (eleven) | |
| 10 000–29 999 | 25 (45) | |
| 30 000–59 999 | thirteen (24) | |
| 60 000–100 000 | 10 (xviii) | |
| > 100 000 | 1 (two) | |
| Age, y | 35 (18–66) | |
| Mental health historye | ||
| Experience with mental wellness problem reported | 38 (69) | |
| No mental health problem reported | 17 (31) | |
Data Analysis
Focus groups and interviews were digitally recorded and later transcribed verbatim. We analyzed anonymized transcripts with a grounded-theory approach; this method of qualitative data analysis derives a conceptual framework or theory from the data.19,twenty We used QSR N6 software to generate reports from the coded transcripts for each of the main categories and subcategories.21 Nosotros then applied selective coding procedures20 to these reports to identify the linkages between the primary categories and construct a conceptual framework to elucidate the relationships between these categories and mental health or emotional well-being.
We validated the framework at a community launch of the enquiry findings in September 2008. No substantive changes to the framework were required following this validation with participants and other community members.
RESULTS
Our information indicated that the established sociological framework of intersecting macrolevel (social structure), mesolevel (interpersonal), and microlevel (individual) determinants of health22,23 agreed with our participants' descriptions of potential risk and protective factors for mental health problems (Effigy one). All the same, within this framework, specific factors at each level were unique to or operated in a unique context for bisexual people. Quotes that illustrate these factors are provided in Table ii.
Potential risk and protective factors for mental health problems for participants in report of bisexuals and mental health: Toronto, Ontario, 2006–2007.
Table 2
Quotations From Participants in Study of Bisexuals and Mental Health: Ontario, Canada, 2006–2007
| Factors Affecting Mental Health | Participant Comments |
| Macrolevel (social structure) | |
| Experiences of biphobia and monosexism | "I just don't tell anybody [that I'm bisexual], because I hear all the jokes … my historic period being as it is that I never felt comfy actually telling anybody how I felt" (Rebecca, an older participant). |
| Common social attitudes and beliefs about bisexuality | "The stereotype is that bisexuals are confused, because they don't know who they are, and what I've actually realized is that guild is confused, because they don't know who nosotros are." (Owen) |
| Media representation of bisexuality | "I think I've e'er feared being visible as a bisexual adult female. Mainly because what's been portrayed to me in media or anywhere on the dance floor are girls who acted out to get male attending, and I was always afraid that people would recall that that's what I'1000 doing." (Kate) |
| Invisibility every bit a bisexual person | "I didn't even know bisexuality existed until I was in my early twenties… . It didn't occur to me that there was something other than straight or gay, that was what I was taught." (Sharon) |
| Experiences of homophobia | "I was walking on Yonge Street [in Toronto] with my friend and some guys yelled out of a car, 'you fuckin' faggots.' We were doing null. We were walking on Yonge Street on the sidewalk, and, and we're non partners." (Miguel) |
| Mesolevel (interpersonal) | |
| Partner and intimate relationships | "One of my showtime actually serious relationships with a male, he was quite homophobic, and I told him nearly a past lover of mine who was female. And he was incredibly immature most it. And he would make fun of me … anyways, it was pretty traumatic, and it took me years to overcome, and fully step into who I actually am." (Donna) |
| Family members | "My father'due south from [an African country], and at that place people still kind of believe that homosexuality isn't even African at all. Like, information technology'southward like this affair that white men brought." (Owen) |
| Friends | "I have two very close friends that also identify every bit bisexual and nosotros are like this [crosses fingers]. Very tight, very shut, they've been really supportive. They understand what I'm going through. They're very accepting. So I call up that that has been extremely—I feel very lucky." (Nicole) |
| Colleagues | "When I got a new dominate, I contemplated for a long time whether I should say 'Hey, I'm living with a woman' and 'I take bipolar disorder.' Those are two sort of big bombs, I was trying to effigy out which one to drop commencement. I felt, for me, in terms of taking care of my mental health, it was important to take been open near both." (Diana) |
| LGBT community | "It'southward actually fun to feel role of the LGBT customs. I think all 4 are very dissimilar, and it shouldn't necessarily ever be lumped together, merely at the aforementioned time it's fun to sort of say, I'm part of this community… . I come across myself perhaps wanting to go a chip of an advocate for all 4 [communities] and, similar, that could be something I could feel proud of." (Chris) |
| Bisexual community | "It was nifty for my mental wellness [to go to meetings of a bisexual support group] … just to sort of look around the room and become, oh my god, maybe I'1000 not equally lonely as I think I am." (Diana) |
| Microlevel (individual) | |
| Struggles with identity | "My idea process was, at least if I was gay I have no choice, I have to find a woman to be with for the remainder of my life. But in this guild, I'1000 supposed to be with a man, simply what if I autumn in love with a woman? And it was only constant anxiety well-nigh that. Too many choices, you know?" (Leslie) |
| Cocky-acceptance | "I think the fact that I've been able to come to a position of peace and exist a Christian and a bisexual and polyamorous all at the same time, and brand those pieces of the puzzle fit together. I think that, that'south been good for you for me." (James) |
| Self-care | "At that place's a lot of things that have a positive touch on on my health, things that have nothing to practise with existence a bi person. Things like do, and schoolwork, and socializing, finding a bodyguard on occasion and getting out of the house." (Robyn) |
| Empowerment and education | "I was maybe in my early on teens when I began to have regular Internet access at habitation, and it gave me an opportunity to find other bisexual people, to learn about unlike sexual identities in general, and sympathize that I wasn't alone." (Jane) |
| Advocacy and activism | "[Speaking to others about bisexuality] helped me immensely. Only being able to tell my story to other people was really beneficial, I think. Considering after every lecture that I did, at that place was always a couple people in the grouping that come up and talk to me and say, 'I've never heard a bisexual person speak before, that was really powerful.'" (Aaron) |
Macrolevel Factors
The critical roles of biphobia and monosexism in participants' mental health experiences were apparent in their responses. Bisexuality is oftentimes dismissed or disallowed at a structural level, to the extent that participants felt they were constantly required to justify or explicate their sexual identity: "[Y]ou're either straight or yous're gay/lesbian. [People] don't run across that there are other possibilities" (James [All names used here have been inverse.]). Bisexual identity was structurally disallowed for transgender and transsexual participants in detail, as in the example of gatekeepers to gender identity services: "The general stereotype is that if you lot're bisexual, you're probably not transsexual, you lot're just confused. And that if you really are a transsexual and you really are a woman, then you should merely exist attracted to men, otherwise this is all bullshit" (Chris).
Participants described the invisibility of their bisexuality and expressed frustration at being labeled with either a gay or heterosexual identity tied to the gender of their current partner. They noted the added burden of constantly or repeatedly disclosing their bisexual identity, by contrast with the feel of gay men and lesbians, whose sexual identity is implicit in the disclosure of the gender of a current or past partner. Similarly, participants who were in long-term, monogamous relationships felt that others questioned the legitimacy of their bisexual identities, because they were not shortly sexually active with both men and women. Bisexuality'due south lack of social legitimacy, several participants reported, meant that they were unaware that bisexuality existed during their teenage years and young adulthood.
Bisexuality is also explicitly degraded or demeaned in ordinarily held behavior and attitudes about bisexuality, particularly every bit they are perpetuated through the media: "People assume y'all're promiscuous. People presume you have threesomes. People assume a lot about beingness bisexual that, for me, none of it is true" (Evelyn). In addition to existence portrayed equally hypersexual, bisexuals are commonly understood to be gay or lesbian people who are confused about their sexual orientation or in transition to coming out equally gay or lesbian. Some common social beliefs and attitudes about bisexual people are gender specific; for example, bisexual men are viewed equally carriers of disease to the heterosexual population, and bisexual women are seen as willing objects of sexual pleasure for heterosexual men.
Participants as well described experiences of homophobia, specially from people who causeless them to be gay or lesbian. In a peculiarly hitting business relationship, a respondent described the homophobic violence she and her girlfriend experienced in their isolated northern Ontario customs: "My girlfriend came downwards to see me, and she got beaten, almost to expiry, for beingness a bisexual" (Carol). In this instance, simply being visibly in a same-sexual practice relationship resulted in an incident of homophobic violence; the actual sexual orientation of the victim was irrelevant to her attacker.
Common social beliefs and attitudes well-nigh bisexuality, also every bit other manifestations of monosexism, biphobia, and homophobia experienced by participants, were perceived to affect emotional well-being in diverse ways. Of particular importance to participants was the effect of internalization of these social perceptions, both by important people in their lives (family, friends, partners, and potential partners) and by the participants themselves.
Mesolevel Factors
Although participants noted the benign furnishings of a supportive partner on their emotional well-being, they as well provided examples of relationship problems associated with partners and potential partners internalizing mutual social beliefs about bisexuality.
"I had the unfortunate experience of going on a date with this lesbian … she was very anti-bisexual. She said, 'You lot're sitting on the fence. Make a choice, either you're gay or directly'" (Shaiva).
Polyamory, which can be broadly understood as a relationship construction in which individuals may take more than 1 romantic or sexual relationship, conducted openly with the consent of all involved, was a myth for some of our participants and a reality for others. Although simply 4 (seven%) respondents reported having multiple partners at the time of the study, others indicated openness to multiple relationships in the hereafter. Although some of these participants had embraced the integration of their bisexual and polyamorous identities, others noted challenges that polyamory introduced, particularly in the development and nurturing of long-term relationships. Still other participants were not interested in polyamorous relationships and preferred monogamy.
Participants similarly expressed both value and challenges associated with support from family members. Many participants spoke well-nigh the difficulties their family members had embracing a bisexual identity: "My sis said to me … I would prefer it if you were simply my gay brother, and not this slutty person who simply sleeps with everyone" (Jonathan). This claiming was multilayered for participants who identified with minority ethnoracial communities. Some of these participants perceived that within their communities, a bisexual identity was considered even more than pathological or more than incompatible with their ethnoracial identity than a lesbian or gay identity would exist.
Supportive friends, and peculiarly bisexual-identified friends, were described as beneficial for mental wellness. However, some participants expressed challenges in disclosing their bisexual identity to heterosexual friends: "Female person friends have found out afterward a while, and they're like, 'oh my god, why didn't you lot tell me? Ooh, then I don't feel comfortable effectually y'all'" (Anne). Conversely, some participants described anxiety nigh disclosing their bisexual identity to gay and lesbian friends, out of concern that they would exist seen to exist no longer legitimate members of the lesbian and gay community. Participants also expressed anxiety nearly disclosing their bisexuality in the workplace, while at the same fourth dimension noting the mental health benefits of existence out at work.
Participants described circuitous relationships with the larger lesbian, gay, bisexual, transgender, and transexual customs. Although some described positive interactions, others reported experiences of biphobia associated with involvement in predominantly gay and lesbian events:
"I call back being at a party and having a really expert fourth dimension, and then a bunch of people started talking about someone who wasn't at the party, and why wasn't she at that place, and she had 'turned straight' and was dating a man" (Emily).
By contrast, participants consistently expressed the value of access to a community of other bisexual people, although there was variability in the extent to which this desire was realized; geographic location was an important factor. For some, participation in our focus groups offered their starting time opportunity to meet and share experiences with other bisexuals: "I accept never been in a room total of this many bisexuals that I've known" (Leah). Level of involvement in a bisexual community was dependent on other identity variables likewise, peculiarly ethnicity and age, considering bisexual communities were perceived to exist primarily bachelor for Toronto-based, White, and young or middle-anile bisexual people.
Microlevel Factors
Many participants described by, and sometimes ongoing, struggles to empathize and accept their bisexuality:
"I ever knew I was attracted to both men and women, but coming from a pocket-sized boondocks you know you're supposed to hide those feelings … you want to fit into the norm of society" (Aaron).
Participants demonstrated significant awareness of the extent to which they had internalized mutual social attitudes and beliefs about bisexuality:
"How did I become this idea that information technology isn't okay to exist who I am? … I look at my culture, I look at my parents, and I'thousand similar, okay, I get it, y'all didn't give me a space to come across that it was possible" (Sharon).
Some participants noted a close relationship between their mental health and their sexual identity struggles: "When I'm feeling kind of crazy, I think I'm a lesbian … when I'm feeling good, I kind of think I am a happy, normal, well-adapted bisexual" (Stephanie).
Many participants described the very positive mental health effects of cocky-credence, including acceptance of their bisexual (and sometimes other) identities: "I've plant that my biggest struggle over the years was accepting myself. And so once I did that, I experience a lot less weight on my shoulders" (Shaiva). Self-credence seemed to come with time and historic period for some participants; others achieved this with the help of supportive counselors or therapists, friends, and communities who were positive near bisexuality.
Many participants emphasized the importance of self-intendance activities, including practise, spiritual involvement, healthy support networks, and arts activities, in maintaining their emotional well-being. Participants noted that these self-care activities were benign for all people but that for bisexual people they served the additional purpose of providing a focus outside of the challenges and struggles related to their bisexual identities, as well equally being important sources of pride and self-esteem. Finally, many participants described feelings of self-fulfillment associated with involvement in advocacy, activism, and other activities intended to assist other bisexuals achieve self-credence and to challenge biphobia and monosexism in gild.
DISCUSSION
Our results illustrate the far-ranging mental health impact of biphobia and monosexism, in combination with homophobia and heterosexism, every bit perceived by bisexual people. Experiences of discrimination were perceived to affect mental wellness both directly (e.g., feet associated with fright of sexual orientation–based violence) and indirectly, through their furnishings on interpersonal relationships (e.g., distress associated with relationship problems) and on individuals' senses of self-worth and self-esteem.
Our conceptual framework is consequent with inquiry that has examined the various ways that homophobia and heterosexism tin influence the emotional well-beingness of gay and lesbian people, particularly as described past the Minority Stress Framework.7 Our data are consistent with this and other frameworks describing intersecting macro-, meso-, and microlevel determinants of health, lending credibility and transferability to our report. Yet, to our knowledge, ours is the start study to specifically examine the experiences of bisexual people, which can then exist compared with previous research on the touch on of discrimination on gay and lesbian people.7
We noted some unique experiences among bisexuals. For example, our participants described self-questioning of their bisexual identity, often in relation to a gay or lesbian identity—one that was perceived to be less stigmatized than a bisexual identity. That this questioning often occurred during times of mental health challenges demonstrates the strength required to continually resist social pressure to conform to a heterosexual–homosexual dichotomy.
Information technology is seldom acknowledged that bisexual people experience homophobia and heterosexism in improver to biphobia and monosexism. Participants in our study described experiencing rejection both from the heterosexual community (frequently in the form of homophobia) and from the gay and lesbian community (frequently in the grade of biphobia). Bisexual people may in fact experience more social discrimination than those who identify as gay or lesbian because of their doubly stigmatized identity. In addition, many bisexual people simultaneously negotiate other stigmatized identities (e.thousand., as people of colour or equally transgender and transexual people).24 The outcome of multiple oppressions on the well-being of bisexual people requires farther study, which may be informed past research examining the experiences of other doubly marginalized communities, such as biracial people.25,26
Our participants felt that the media and many social institutions failed to acknowledge bisexuality every bit a legitimate and salubrious sexual identity. When the media and other data sources refer to bisexuality or bisexual people, they often perpetuate negative, hurtful, or inaccurate images. For case, although it is true that some bisexual people are polyamorous, this relationship structure is not more common among bisexuals than among heterosexual, gay, or lesbian people.27,28 Furthermore, research on polyamory amongst bisexual people has differentiated this practice from promiscuity, describing it instead as a form of responsible nonmonogamy.29
In the context of the perceived multilevel significance of structural factors on the mental health of bisexual people, meaningful improvements might exist expected merely in one case issues in the surrounding society have been addressed. This raises the question of how, from a public wellness perspective, the development of a more than supportive social environment can be facilitated. Although addressing systemic bigotry is clearly a challenging undertaking, existing initiatives to address other forms of discrimination (including homophobia and heterosexism) could be expanded to accost issues specific to bisexual people. For example, to accost mutual beliefs about bisexuality (a macrolevel manifestation of biphobia and monosexism described by our participants), public health agencies could include healthy images of bisexuality in antidiscrimination public education campaigns.
Sexual health instruction presenting bisexuality every bit a legitimate and healthy identity would both address the invisibility of bisexuality (another macrolevel manifestation of biphobia and monosexism) and alleviate identity struggles at the intrapersonal level for bisexual youths. Support groups for partners of bisexual people could be established to deconstruct mutual social beliefs about bisexuality, particularly as they relate to bisexual people's capacity for healthy, stable relationships. This would not but address a manifestation of biphobia and monosexism at the structural level, but also accost biphobia and monosexism experienced in the context of bisexual people'southward relationships with partners and potential partners—a perceived interpersonal determinant of mental health problems described by our participants.
Limitations
Because nosotros conducted our study in one province of Canada, the extent to which our findings are reflective of the experiences of bisexual people in other settings is uncertain. Although Ontario is geographically diverse (information technology includes the largest urban center in Canada along with smaller towns and remote rural communities), a relatively progressive institutional environment exists throughout the province. Nevertheless, we would await that the negative effects of discrimination on emotional well-existence would be even more pronounced in less supportive jurisdictions. That is, in settings where bisexual people feel even greater levels of discrimination, the negative mental wellness impact may be more than meaning than our participants described.
Our convenience recruitment method likely resulted in a sample of bisexual people who were predominantly open nearly and comfortable with their sexual orientation. Furthermore, in acknowledgment of the fluidity of sexual identities,30,31 we opted to use a broad definition of bisexuality that included cocky-identification, sexual beliefs, and sexual attraction. Although the majority of our sample endorsed a bisexual identity, there may be differences between those who self-place as bisexual and those who do not. Finally, the bulk of our sample reported experience with a mental health problem. The extent to which our findings tin be generalized to a broader sample of bisexual people is therefore unknown.
Conclusions
Our employ of qualitative methods did not allow conclusions most causal relationships between the factors identified by our participants and mental health (and other health) outcomes. Our data suggesting an association between bigotry and mental health among bisexuals could serve as a starting point for future research. For example, quantitative studies could explore the relationships betwixt these perceived determinants and mental wellness outcomes. Respondent-driven sampling, a novel strategy for sampling of hard-to-accomplish populations,32 might be of value in this enquiry. Opinion polls could quantify social beliefs about bisexuality. Research is also needed to develop and test interventions and supports for bisexual people to ultimately improve the mental wellness status of this population.
Acknowledgments
This research was supported by a Community Research Chapters Enhancement grant from the Heart for Addiction and Mental Wellness (CAMH). Lori Eastward. Ross was supported past a New Investigator Award from the Canadian Institutes for Health Research and the Ontario Women's Health Quango (NOW-84656). Support to CAMH for salary of scientists and infrastructure was provided by the Ontario Ministry of Health and Long Term Care.
We thank Anna Travers, Ayden Scheim, Loralee Gillis, and our participants for their essential contributions to this research.
Note. The views expressed here do not necessarily reverberate those of the Ministry of Health and Long Term Care.
Human Participant Protection
This project was canonical past the research ethics board of the Middle for Addiction and Mental Health. Participants provided written consent.
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2820049/