The first study of bi+ Australians has revealed that the community comprising bisexual, pansexual, queer and fluid people experience significantly poorer sexual health and safety outcomes than the general population.
The survey of 2100 bi+ people was conducted by the Kirby Institute at UNSW Sydney to paint a detailed portrait of their health, relationships, and experiences with sexual health care.
The report published earlier this month revealed critical gaps in bi+ sexual health and care, with evidence suggesting that the community is educated and engaged, but doesn’t feel supported. 36 per cent of participants reported having been diagnosed with an STI in the past, a statistic that’s more than double that of the general population. That means the community arguably has a greater need for appropriate sexual health care — but all too often, biphobia or ignorance towards bi-specific concerns mean they’re left without adequate support.
“Bi+ Australians are the largest population group in the LGBTQ+ community, yet their experiences have been consistently overlooked,” UNSW Associate Professor Benjamin Bavinton, chief investigator of the Bi+ Sexual Health and HIV (BiSHH) study, said. “Our findings reflect a diverse and engaged population. However, across many measures, bi+ people experience poorer sexual health and wellbeing outcomes compared to the general population.”
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Bi+ people feel invisible in health services
Major findings from the survey revolved around bi+ attitudes towards and experiences of accessing sexual health care, revealing a population who want to access sexual health care but don’t feel very understood by it.
Nearly 90 per cent of bi+ people in Australia have accessed sexual health care at least once, but only half felt comfortable discussing sexual health with care providers, and one in six felt like they received bi-relevant information. Less than half felt that clinics were inclusive or knowledgeable about bi+ people — and that even extends to LGBTQ+ clinics, with half of the respondents saying these seemingly inclusive clinics could be more bi+ inclusive specifically.
Bi+ woman, PhD candidate and project coordinator of the study, Bella Bushby, said the findings demonstrate “that bi+ people are engaging with health care, but systems are not meeting them where they are”.
“Health care services tend to assume you are either gay or straight by default which can make many bi+ people feel invisible in these services,” she continued.
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The ongoing effects of biphobia
In addition to feeling unwelcome or unsupported even in LGBTQ+ clinics, the survey revealed the biphobia at play in many respondent’s lives.
Only half reported that they were out to their families, and just 15 per cent were out at work. They reported feeling most comfortable being out to other bi+ people and most included in bi-specific spaces, followed by LGBTQ+ people and mixed LGBTQ+ spaces.
Bushby explains that feeling seen and understood plays a role in accessing relevant sexual health information — so it’s vital to ensure biphobia doesn’t seep into health services.
“We know that connection and belonging increases the likelihood of bi+ people seeking and receiving relevant sexual health information, so it is essential to increase the visibility of safe spaces and networks for this community. As it stands, there is a significant gap in bi+ inclusion within sexual health services including LGBTQ+ focused ones. The results from this survey show a need for greater understanding and inclusion of bi+ communities within these settings,” she said.
Cis bi+ men experience consistently poorer outcomes
The historical stigmatisation and biphobia experienced by cis bi+ men was also revealed to negatively impact on how they engage with sexual health care.
While this group report higher rates of casual partners, group sex, and condomless anal sex, they’re also the least comfortable talking about sexual health and the least likely to even access sexual health care at all. Plus, they’re the least likely to feel comfortable in LGBTQ+ and bi+ spaces, and less likely to disclose their sexuality to health professionals.
Vice-president of the National Association of People with HIV Australia Steven Spencer, who is a bi+ man and co-investigator on the study, says more needs to be done on the inclusivity front, given bi+ men’s high needs for inclusive sexual health care.
“This is particularly concerning because bi+ cis men face historical stigmatisation as being a bridge for HIV transmission from gay to heterosexual communities. It’s essential that services do a better job to create non-stigmatising healthcare access for bi+ men,” he said.
Stigma against cis bi+ men affects their accessing of healthcare / Charlie PixSignificantly higher experiences of sexual violence
Concerningly, 63 per cent of respondents reported having experienced sexual violence since age 18 — a rate that’s more than four times that of the general Australian population. Additionally, about half reported that the perpetrator knew about their bi+ attraction, identity or sexual history at the time of the violence.
Cis bi+ women reported the highest rates, and were three times as likely as women in the general population to have experienced sexual violence. They were closely followed by trans and non-binary and gender-diverse bi+ people, who were more than 4.5 times as likely as the general population.
While cis bi+ men were half as likely to have experienced sexual violence compared to other bi+ gender identities in the study, their experiences were still more than five times higher than the general male population.
‘Urgent need to recognise bi+ Australians’
Overwhelmingly, the study revealed a distinct need for bi+ Australians to be better recognised and supported in sexual health care — with the community actively seeking care but rarely finding it in an affirming way. Biphobia continues to affect the way bi+ people access and experience sexual health care, and more needs to be done to strengthen bi-specific inclusion and visibility.
“The findings from this survey reflect both shared experiences and diversity among bi+ people in Australia and point to an urgent need to recognise bi+ Australians as a distinct population with specific health needs,” Associate Professor Bavinton said. “The more we understand about people with bi+ identities, the better equipped we are to challenge historical and harmful stereotypes, combat stigma, and design better health services.”
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