By Jennifer Taub
Do non-heterosexual women have fewer or more mental health problems than heterosexual women? Do lesbians and bisexual women have different mental health issues? This “Research Corner” takes a look at what the small body of research differentiating bisexual women and lesbians has to say about mental health.
It is safe to say that, in general, individuals with a sexual minority status have been subjected to greater stress in their lives than heterosexuals. Such stresses include being closeted, being harassed or attacked, being subjected to threats or hate crimes, the challenges of coping with internalized homophobia, or being rejected by friends and family. In fact, research has shown that lesbian and bisexual women reported higher frequencies of discrimination than heterosexual women, which in turn, is associated with psychiatric morbidity. (1)
Most research, however, has lumped bisexual and lesbian women into one group, which obscures differences between the groups. In addition, most research in this area has used samples of convenience (e.g. from GLBT events, clinical samples) rather than random samples, limiting conclusions that can be made.
Lesbians who make their sexual orientation known to family, friends and/or coworkers (i.e., those who are “out of the closet”) have better mental health than lesbians who are closeted. Disclosure of lesbian identity has been associated with less anxiety, more positive affectivity and higher self-esteem. (2) Further, lesbians who are out are more likely to align with peer groups and receive social support, which can diminish the likelihood of mental disorders. (3-4) Thus, being out can be associated with positive mental health. There is very limited data on bisexual women and outness. A recent study (5) found bisexual women are more likely than heterosexuals or lesbians to have used an illicit drug in the past 12 months and to have a history of an eating disorder. They were more likely than heterosexual women (but not more than lesbians) to have felt stress as a teenager, been treated for depression (ever) or had a suicide attempt (ever). Lesbians who were not out had a 90% higher rate of suicide attempt than heterosexual women, while bisexual women who were not out had a 300% higher rate than heterosexual women. Lesbians who were not out and bisexual women who were out were 2-2.5 times more likely to experience suicidal ideation in the past 12 months. This study found that protective factors include being in a relationship, and being out to more people in one’s life.
In a study titled “Lesbians and Their Sisters as a Control Group: Demographic and Mental Health Factors,” (6) researchers Esther Rothblum and Rhonda Factor created matched controls by recruiting sexual minority women with heterosexual sisters. In this way, they had groups of women with similar demographics and backgrounds. They had 184 pairs of lesbian-heterosexual sisters, 44 pairs of bisexual-heterosexual sisters, and 29 pairs of bisexual-lesbian sisters who completed standardized questionnaires of mental health symptoms. They conducted analyses controlling for age, education level, and income. Surprisingly, they did not find any differences in mental health symptoms between the lesbians and the heterosexuals in the study. However, they did find that bisexual women reported more mental health symptoms than either the lesbians or the heterosexual women. In particular, depression, anxiety and overall mental health symptoms were greater for bisexual women. This was not a finding the researchers anticipated. Possibilities posited for this finding by the researchers included bisexual women being discriminated against by both heterosexual and lesbian communities, perhaps resulting in greater stress and being less out (outness has shown a positive relationship to mental health). These were just suggestions, however, and have not been tested empirically.
Very little research has been done in these areas, but what we do know so far shows some disturbing Research Corner, continued from previous page trends for bisexual women. Why do you think research has shown bisexual women to have higher rates of mental health problems, eating disorders, and a history of suicidal ideation and suicide attempts than heterosexual women or lesbians? Why is outness less of a protective factor for bisexual women than lesbians? I welcome your comments via email at dr.jennifer. firstname.lastname@example.org
Jennifer Taub, PhD, is a licensed clinical psychologist who lives in Boston. She has conducted research about bi women and is a proud member of BBWN
- Mays, V.M. and Cochran, S.D. (2001). Mental Health Correlates of Perceived Discrimination Among Lesbian, Gay, and Bisexual Adults in the United States. American Journal of Public Health, 91(11), 1869-1876.
- Jordan K.M., Deluty R.H. (1988). Coming out for Lesbian Women: Its Relation to Anxiety, Positive Affectivity, Self-Esteem and Social Support. Journal of Homosexuality, 35. 41-63. 3
- Morris, J.F., Waldo, C.R., and Rothblum, E.D. (2001). A model of predictors and outcomes of outness among lesbian and bisexual women. Am Journal of Orthopsychiatry, 71, 61-71.
- Oetjen, H., Rothblum, E.D. (2000). When Lesbians aren’t Gay: Factors Affecting Depression Among Lesbians. Journal of Homosexuality, 39, 49- 73. 5 Koh,
- A.S. & Ross, L.K. (2008). Mental Health Issues: A Comparison of Lesbian, Bisexual and Heterosexual Women. Journal of Homosexuality, 51(1), 33-57.
- Rothblum, E. D. and Factor, R. (2001) “Lesbians and Their Sisters as a Control Group: Demographic and Mental Health Factors. Psychological Science, 12(1), 63-69.