This comprehensive report from the National Gay and Lesbian Task Force Policy Institute, the Fenway Institute at Fenway Community Health, and BiNet USA documents the unique health issues for bisexual individuals. The report includes historical background, definitions and a literature review. Two useful appendices list the top health issues for bisexuals and tips for health care providers when working with bisexual clients.
TIPS FOR HEALTH CARE PROVIDERS WHEN WORKING WITH BISEXUAL CLIENTS
by Marshall Miller and Dorian Solot
There are three golden principles:
1. Don’t make assumptions
2. Support and validate people’s diverse experiences and identities.
3. A person’s sexual behavior and a person’s sexual orientation are two different things.
Definition of terms:
Bisexual: This is a term some people use to describe their sexual orientation. In a health care setting, these are people who will come to your office and if asked about their sexual orientation, will say they are “bi” or “bisexual.” There are many ways to make people who identify as bi feel comfortable in your office, including having bisexual brochures available, using the word bisexual in addition to gay and lesbian when talking about sexual orientation and being willing to ask about and discuss the client’s sexual experience with men, women, and transgender people.
Men who have sex with men and women (MSMW)/women who have sex with men and women (WSMW): These are terms that accurately describe behavior. These terms recognize that people have sex with more than one gender, but may or may not identify as bisexual. They may identify as questioning, bi-curious, heteroflex- ible, gay, lesbian, heterosexual, some other term or they may not identify as anything at all.
1. The fact that someone is sexually active with someone of a different sex does not automatically make that person heterosexual. The fact that someone is sexually active with someone of the same sex does not automatically make that person gay or lesbian.
2. Because of negative experiences and lack of understanding they may have encountered in the past, bisexual people may not “volunteer” their sexual orientation. They may look to you for clues about whether you want or need the information and how you will respond if they come out to you. You can make your office more welcoming of bisexuals by:
• Visibly displaying pamphlets about bisexuality. See http://www.biresource.org/ category/publications to read and order pamphlets that you wish to photocopy and make available.
• Adding the word “bisexual” some or all of the time when you talk about “gay and lesbian” issues with clients communicates to them that you are comfortable discussing bi issues.
• Adding the word “bisexual” to your written materials in order to communicate your comfort.
3. Whether or not you know you have bisexual clients, you almost certainly already do. It’s impossible for you to guess accurately which of your clients are bisexual or MSMW/ WSMW based on their age, marital status, political beliefs or the way they dress or behave.
4. Health care providers should think carefully about what you need to know and what questions you want to ask. For example, HIV is spread through bodily fluids, therefore whether or not people are at risk for HIV depends on their behavior, not their identity. You cannot determine someone’s HIV risk by asking about her or his sexual orientation. You can learn more by asking about her or his sexual behavior.
5. Bisexuals can be monogamous or non-monogamous. Bisexuality is a sexual orientation; it is independent of the decisions about monogamy. It is a mistake to assume that because someone has the potential to be attracted to men and women they must have (or desire) twice as many sex partners.