Jerel Armstrong, Jonathan Preiss, and Carmen Wolf
BisexualityBisexuality refers to the “human capacity for loving,valuing, and sexually desiring other people in ways thatare not limited by gender. (Firestein, 2007).Third and often forgotten or dismissed variation of sexualorientation.Bisexuality and pansexuality might be considered to beon opposing ends of a spectrum regarding theimportance of gender. Strict bisexuality gives strongerconsideration of the gender of the person with whomthey are attracted. Pansexual individuals may not giveany consideration to gender and most likely reject abisexual identity.
Models of Bisexual identity developmentD’Augelli (1994) model of developmentencompasses both gay/lesbian identitydevelopment as well as bisexual development.D’Augelli’s theory consists of an interactivemodel of development. This is in contrast to thestage model developed by Cass (1979).Cass does assert that bisexual, heterosexualand homosexual can be taken as separateidentities with similarities and differences intheir developmental process.
D’Augelli (1994) modelExiting heterosexual identity• Recognition that one’s feelings and attractions are notheterosexual as well as telling others that one is lesbian, gay, orbisexual.Developing a personal lesbian/gay/bisexual identity status• A “sense of personal socio-affectional stability that effectivelysummarizes thoughts, feelings, and desires” (D’Augelli 1994).• One must also challenge internalized myths about what it meansto be gay, lesbian, or bisexual.• Developing a personal identity status must be done inrelationship with others who can confirm ideas about what itmeans to be nonheterosexual. Adopted from: Bowling Green State University
D’Augelli Model continuedDeveloping a lesbian/gay/bisexual social identity• Creating a support network of people who know and accept one’ssexual orientation.• Realizing people’s true reactions can take time.• Reactions may also change over time and with changingcircumstances.Becoming a lesbian/gay/bisexual offspring• Disclosing one’s identity to parents and redefining one’srelationship after suchdisclosure.• D’Augelli noted that establishing a positive relationship with one’sparents can take timebut is possible with education and patience.• This developmental process is particularly troublesome for manycollege students whodepend on their parents for financial as well as emotional support.
D’Augelli Model continuedDeveloping a lesbian/gay/bisexual intimacy status• This is a more complex process than achieving an intimateheterosexual relationshipbecause of the invisibility of lesbian and gay couples in our society.• “The lack of cultural scripts directly applicable tolesbian/gay/bisexual people leads toambiguity and uncertainty, but it also forces the emergence ofpersonal, couple-specific,and community norms, which should be more personally adaptive”(D’Augelli, 1994).Entering a lesbian/gay/bisexual community• Making varying degrees of commitment to social and politicalaction.• Some individuals never take this step; others do so only at greatpersonal risk, such aslosing their jobs or housing.
Weinberg et al. (1994)4 stage model of bisexual development•Initial Confusion •People feel confused because their attractions for members of both sexes are strong and anxiety provoking •One’s self-labeling options include only “heterosexual” or “homosexual” •Difficulty acknowledging one’s same-sex attraction, a phenomenon more common in men than women.•Finding and Applying the Label •Having enjoyable sex with members of both sexes after becoming aware of the “bisexual” label. •Negative attitudes about bisexual behavior, and stereotypes about bisexuals added to their intermittent self-doubt or confusion (Weinberg et al., 1994). As cited in Brown (2002)
Weinberg et al. (1994)Settling into the Identity •More comfortable with their sexuality, often through social support. •Acceptance of bisexual feelings rather than to sexual or emotional involvement with members of both sexesContinued uncertainty •After self-label as bisexual, it was common to experience periodic confusion about sexuality •Insufficient social validation and a lack of bisexual role models and communities thought to contribute
Layercake Model of Bisexual Identity DevelopmentBleiberg et al. (2005)Based on a sample of college age self identified bisexuals.1. Socializes into a Heterosexual world; Develops Heterosexual identity •From birth to first encounter with homosexuality2. Experiences Homosexual feelings, thoughts, and/or behaviors •Begin to question heterosexual identity1. Accepts homosexual attraction while maintaining heterosexual identity •Conscious of being rejected by homosexual and heterosexual communities if they come out.
Layercake continued4. Integrates and assimilates heterosexual and homosexualidentities •Identify as neither gay or straight, but attracted to both genders •Sexuality as a continuum •Anger and Frustration common as a reaction against being invisible as a separate and legitimate sexual identity •May start coming out process5. Identifies as bisexual •Develops own definition of bisexuality or self label
Models of Bisexual Identity DevelopmentThese models are of course broad and overly simplified frommultiple people’s experiences of developing their identity. Everypersons experience will be different but we can use these genericmodels to help guide our conceptualization and understandingabout a client’s particular place on the development journey.Ethnicity, gender, religion, age, culture will all contribute to anindividuals identity development process. The intersectionality ofall these components will present varied challenges anddifficulties that will need to be navigated in the clinical setting.Research is sorely lacking regarding the influence of thesefactors on bisexual identity development. Research into gay andlesbian development can provide useful information, keeping inmind that bisexual identity development is unique and may notfollow the same course as homosexual development.
Clinical ApplicationFirestein (2007) explains that changes in identity constitute aprocess of construction and reconstruction of the self. In order todevelop new ways of thinking about sexuality to make room for theauthentic sexual self, aspects of the self must be reconstructed.This involves the reconstruction of the self, one’s ownpsychosexual world, and sociocultural sexual world.The therapeutic container can be a safe place for a persondeveloping their bisexual identity to “test” or “practice” their newway of being. Also, therapy can help clients distinguish thefundamental elements of their attraction to another person. Forinstance is the client attracted to another person because of theirgender or is gender only secondary to their attraction. Thisseparation of attraction being tied to sex/gender can help a clientdevelop their own personal way of understanding and expressingtheir developing identity.
Clinical Application ContinuedA therapist can also help clients understand the nature of theirattraction to another person. Is their attraction, sexual, sensual,friendship, platonic affection, admiration, or many other types offeelings?Firestein (2007) provides clinical tips for working with bisexualclients:“Assure Clients that attraction to men and attractions to women arenot mutually exclusive or contrary types of attraction” p. 24“Give clients permission to see their sexuality as changing over thelife course” p.24“Give clients permission to embrace identities within their ownunique narrative” (culturally sensitive)
Clinical Application Continued“Provide outside resources” Resources for bisexual clients may not be as available ashomosexual resources. Do not wait to find resources until you have a client that needsthem. Find them now!!Affirmative practice is ethical practiceBecome adequately informedBisexual specific education is often lackingFirestein (2002) recommends reviewing APA/Division 44Guidelines for Psychotherapy with Lesbian, Gay, and BisexualClients (2000) as an adequate starting place for becominginformed.http://www.apa.org/practice/guidelines/glbt.pdf
“There is really no such thing as beingbisexual.” -Dr. Ruth (2005) Societal influence on Bisexuality
Lack of Acknowledgement Western perspective on sexual orientation views the construct as Binary (Bradford, 2004). For individuals who identify as bisexual this means they are forced to choose a label that isn’t fitting OR be invisible (Bradford, 2004). The above pressure to choose not only comes from the dominant culture but also from others in the LGBT community (Obradors-Campos, M. (2011).
Acknowledgement Cont’DCapulet (2010) declared that activism by LGBT organizations often fails to “address bi-sexual specific problems (p 294).Obradors-Campos (2011) notes that the confusion around how bisexuality is defined leads to misconstruing what it means to be bisexual.
Risk Factors – Challenges for bisexuals Discrimination from dominant culture because of being sexual minority Non-bisexuals, including other sexual minority groups, view bisexuality as a transient phase rather than a third sexual orientation Popular media portrayals often depict bisexuals as wild and promiscuous.Capulet, I. (2010). With reps like these: bisexuality and celebrity status. Journal ofBisexuality, 10, 294-308. doi: 10.1080/15299716.2010.500962.
Impact on the Bisexual SelfBisexual individuals are at risk of internalizing the aforementioned stereotypes and instances of discrimination and oppression (Calzo, Antonuuci, Mays, &Cochran, 2011).Bisexuals are left with little room to assert the identity and be validated (Bradford, 2004)
Variability and Development The age at which an individual comes out and acknowledges their bisexuality will have influence on career development and sexual identity development E.g. For those who acknowledge their bisexuality later in life their sexuality is a more salient and significant part of their life, whereas those who are younger tend to view it as another aspect of their identityCalzo et al. (2011)
Variability and DevelopmentCont’d For clients who begin to identify as bisexual later in the developmental process coming out is often associated with loss (i.e. of privilege and social status). For individuals who begin to identify as bisexual at an earlier stage of development other areas (i.e. career development ) are arrested while sexuality and sexual orientation are explored.
Clinical IssuesAffirming the client - Ask about orientation rather than assuming to avoid marginalizing the client. - Working from a strength based approach will help to counteract the propensity to pathologize this population.Making sure the therapy space is also affirming to the client (i.e. explicit symbols of acceptance)Bradford, M. (2004)
Clinical Issues Cont’d Externalizing society’s discrimination and oppression as a problem that lies with them rather than something faulty within the client. Exploring issues of homophobia, biphobia and how it affects the client. Being familiar with the community in order to connect or refer clients to appropriate resourcesBradford, M. (2004)
Invisibility in researchBarely any research on the B in LGBT (Ross, Siegel, Dobinson, Epstein, and Steele, 2012). Instead bisexuality is generally clustered in with the gay and lesbian populations.
Invisibility and how it is projectedon othersThings people say about bisexuality:It’s just a phaseYou are greedyIt’s not realIt’s a stop on the way to gay townBisexual individuals cannot be monogamous
Media It’s either about sex Or it’s a joke: http://www.youtube.com/watch? v=DamwesHr7pQ Here is a great video blog on bisexuality myths: http://www.youtube.com/watch? v=aGXCC9VCMF4 And here is a clip from one of my favorite shows unfortunately perpertrating those myths: http://www.youtube.com/watch? v=AEIWg6pV9g0
Objectification Pornography (lesbian & bisexual porn; generally unrealistic or involves a man in some manner) Music (I kissed a girl by Katy Perry, Nicki Minaj recruiting women for Ushers song Little Freaks, etc.) Video that shows the lack of healthy representation of bisexuality in the media: http://www.youtube.com/watch? v=b6myqGvifRk
Increased Health IssuesIncreased stress (low social support from both the gay and straight communities, judgment from both sides, invisibility, etc.)Increased substance abuse (cigarettes, alcohol, etc.)Increased chronic health issues (diabetes, heart disease, etc.)Increased mental health issues (depression, anxiety, etc.)
Health Issues cont’d• Increased sexual health issues (greater risk for STD’s and infections)• Less likely to have health insurance.Stole this one from the teacher: http://www.youtube.com/watch? feature=player_embedded&v=CohtBDd j66Ahttp://www.youtube.com/watch? v=aGXCC9VCMF4
Minority Status and Health• “Hispanic lesbians and bisexual women, compared with Hispanic heterosexual women, were at elevated risk for disparities in smoking, asthma, and disability. Hispanic bisexual women also showed higher odds of arthritis, acute drinking, poor general health, and frequent mental distress compared with Hispanic heterosexual women. In addition, Hispanic bisexual women were more likely to report frequent mental distress than were non- Hispanic White bisexual women” (Kim & Fredriksen-Goldsen, 2012, p e9).
Age and health• “Lesbian and bisexual women in the Womens Health Initiative, a national study of postmenopausal women over 50, were less likely than heterosexual women to have health insurance and more likely to be smokers, to use alcohol, to report other risk factors for reproductive cancer and cardiovascular disease, and to score lower on measures of mental health and social support” (Valanis et al., 2000; as cited in Ryan & Gruskin, 2006, p. 330).
Videos Several more videos I found informative (at least partially) and/or funny (but you may not agree): http://www.youtube.com/watch?v=t- 4w6NqfLAc http://www.youtube.com/watch?v=TIZ- 4CwWKVs
Implications for ConductingTherapy with Bisexual Women Keep in mind that sexuality is fluid. Bisexual individuals can change over time and now two people are identical. Some bisexual individuals may like men more, women more, or both equally…again sexuality can be fluid. Be aware of internalized homophobia. For example, a bisexual woman that is afraid of being friendly with other women because she fears they will think she is coming on to them. She has internalized societies negative views of the LGBT population and has fear while interacting with others.
Implications cont’d Be aware that they may not be out with their families and that this is there choice whether they come out or not. Let the client define their sexual orientation rather then making parameters for them. For example, having are you gay or straight on a form is not appropriate. A more appropriate question may be “how do you define your sexual orientation”, and then just let them write it out in their own words.
Male Bisexual Considerations Often not to be considered a legitimate sexual identity. Partly due to many now homosexual males having identified as bisexual during their gay identity development. Previous research was unable to identify bisexual genital arousal to both genders (Rosenthal, Sylva, Safron & Bailey, 2011).Bisexual men are rarelyobjectified in society to thedegree that femalebisexuals are.
Rosenthal, Sylva, Safron & Bailey, 2011 Found congruence between self identified bisexual males subjective and sexual arousal. This provided evidence that bisexuality actually exists.Sexual arousal as a function of self-reported sexual orientation (Kinsey score). For both graphs, thecurve labeled “1” represents arousal to the more arousing sex (Maximum Arousal), and the curvelabeled “2” represents arousal to the less arousing sex (Minimum Arousal). Dashed lines in the panelsrepresent 95% confidence intervals. Dependent variable units are within-subjects standard deviations.
Male Bisexual IdentityDevelopment Considerations Weinberg et al. (1994) Model as cited in Brown (2002). Stage differences for males development specifically Initial Confusion stage • experience conflict between their gender role and their sexual feelings. • Same-sex attractions provoke anxiety. • masculinity may be threatened • feel intimidated and fearful of rejection by heterosexuals, gay men, society, family members, and women.
Male Bisexual Identity DevelopmentConsiderations ContinuedFinding and Applying the Label “Once bisexual men find the label, they may not wish to applyit to themselves due to feelings of anxiety, stigma, ordemasculinization” (Brown, 2002, p. 83).Settling into the Identity Social support is crucial during this stage. Due the nature ofbisexuals often being disregarded support may be lacking. Thismay lead to a slower settling of their identity. Men may emphasize the sexual nature of the developingromantic relationships
Male Bisexual Identity DevelopmentConsiderations ContinuedIdentity Maintenance stage“affiliation with a bisexual community and/or serial or concomitantinvolvement with members of both sexes would be important formaintaining a bisexual identity” p. 83.Bisexual men may act upon their attractions towards members ofboth sexes before labeling as bisexual, but not all men act upon theirattractions to members of both sexes prior to self-labeling as“bisexual.”
Male Bisexual: Counseling ConcernsPage, E.H., in Firestein (2007) suggests therapists should:Be mindful to validate bisexual orientationEmphasize that bisexuality is a healthy sexual orientation identityUse good clinical skills including respect, empathy, positiveinquisitiveness, and a “bias” in favor of the client’s uniquely unfoldingdevelopment.Take an active stance on bisexuality issuesBe mindful of the degree to which bisexual clients have internalizedcultural bias deeply into their sense of self and well-being.Use creative approaches to to strengthen the client’s positive self-identity.Accrue bisexual resources and tools such as, the Bisexual ResourcesGuide (Ochs, 2001).
ReferencesBleiberg, S., Fertmann, A., Friedman, A., & Godino, C. (2005). The Layer Cake Model of Bisexual Identity Development: Clarifying Preconceived Notions. Campus Activities Programming, 37(8), 53-58.Bradford, M. (2004). The bisexual experience: living in a dichotomous culture. Journal of Bisexuality, 4 (1/2), 7-23.Brown, T. (2002). A Proposed Model of Bisexual Identity Development that Elaborates on Experiential Differences of Women and Men. Journal Of Bisexuality, 2(4), 67.Calzo, J. P., Antonuuci, T.C., Mays, V.M and Cochran, S.D. (2011). Retrospective recall of sexual orientation identity development among gay and bisexual adults. Journal of Developmental Psychology, 47(6) 1658-1673. doi: 10.1037/a0025508.Capulet, I. (2010). With reps like these: bisexuality and celebrity status. Journal of Bisexuality, 10, 294-308. doi: 10.1080/15299716.2010.500962.Cass, V. C. (1979). Homosexual identity formation: A theoretical model. Journal of Homosexuality, 4(3), 219-235.Weinberg, M. S., Williams, C. J., & Pryor, D. W. (1994). Dual attraction: Understanding bisexuality. New York: Oxford University Press.Firestein, B. A. (2007). Becoming visible: Counseling bisexuals across the lifespan. New York, NY US: Columbia University Press.
References cont’d.Kim, H., & Fredriksen-Goldsen, K. I. (2012). Hispanic lesbians and bisexual women at heightened risk or health disparities. American Journal Of Public Health, 102(1), e9- e15. doi:10.2105/AJPH.2011.300378Obradors-Campos, M. (2011). Cluster 2. Contests for bi phobia, bi negativity deconstructing biphobia. Journal of Bisexuality, 11, 207-226. doi: 10.1080/15299716.2011.571986Ochs, R. (Ed.) (2001). Bisexual Resource Guide (4th ed.). Cambridge: Bisexual Resource Center.Page, E. H., (2004) Mental health services expereinces or bisexual women and bisexual men: An empirical study. Journal of Bisexuality, 3(3/4), 137-160.Rosenthal, A.M, Sylva, D., Safron, A. & Bailey J.M. (2011). Sexual arousal patterns of bisexual men revisited, Biological Psychology, 88(1), 112-115, ISSN 0301-0511, 10.1016/j.biopsycho.2011.06.015.Ross, L. E., Siegel, A., Dobinson, C., Epstein, R., & Steele, L. S. (2012). I dont want to turn totally invisible: Mental health, stressors, and supports among bisexual women during the perinatal period. Journal Of GLBT Family Studies, 8(2), 137-154Ryan, C., & Gruskin, E. (2006). Chapter 14: Health concerns for lesbians, gay men, and bisexuals. Sexual Orientation & Gender Expression in Social Work Practice (pp. 305-342): Columbia University Press.Schmidt, C.K. & Nilsson, J.E. (2006). The Effects of simultaneous developmental processes: factors relating to the career development of lesbian, gay and bisexual youth. Career Development Quarterly, 55 22-37. doi: 10.1002/j.2161- 0045.2006.tb00002.x