S8E5: Bi+ Mental Health Is a Crisis. Why Is No One Talking About It?

Rachel Chickerella [00:00 – 00:17] – A lot of Bi+ folks in this data that we’re coding are not going to the doctor. This data also shows that if Bi+ people are going to the doctor, they’re not really discussing their sexual orientation because sometimes when people do, they do experience those microaggressions. 

Jasper Nighthawk [00:22 – 03:44] – This is the Seed Field Podcast, the show where Antiochians share their knowledge, tell their stories, and come together to win victories for humanity. I’m your host, Jasper Nighthawk, and today we’re joined by Rachel Chickerella for a conversation about mental health in bisexual populations and the crisis there that most people simply don’t know about. I, for one, didn’t know that bisexual-identifying folks experience serious psychological distress at rates that are roughly double that of both straight-identifying people and gay and lesbian populations. That’s a kind of stunning figure, and surveys show that almost half of Bi+ folks report experiencing moderate to severe psychological distress in the last year. I want to stop for just a second and explain that Bi+ is an umbrella term that includes bisexual folks, but also pansexual and other people who are attracted both to their own gender and to other ones. So just to be personal to myself, when I learned these figures that across our society, Bi+ folks are experiencing mental health distress in really extreme numbers, I had the experience of realizing that I kind of felt seen in a way that I hadn’t before. It’s generally not something that I lead with in my professional life, but I myself am bisexual. And I have also experienced a lot of psychological distress in my own life. But I never really thought to connect those two things until I found these statistics. And at that point, I reflected back and thought, wow, yeah, there has been a lot of challenge around my sexuality. It’s hard to live in a society where your sexuality is often being policed. You’re maybe being told that you don’t exist. And there’s not necessarily an easy lane for expressing all of who you are as a sexual person. So I want to talk more about these figures, about this crisis, and about what mental health professionals and everyone can do to alleviate it. And I thought the perfect person to have this conversation with would be one of the authors of this paper that I read that revealed to me that there is this hidden mental health crisis. So that’s why Rachel Chickerella is here in the studios with us today. Rachel is a psychologist. Here at Antioch, she serves as core faculty in clinical psychology. That mostly means teaching in our Doctor of Psychology program on our New England campus. In that program, she teaches a lot of different introductory and also high-level classes. But as a researcher, Rachel’s practice largely centers around Bi+ mental health. She’s done studies on how Bi+ mental health intersected with the great stress of the COVID-19 pandemic. She’s looked into how depictions of bi identities in popular media can stigmatize or affirm Bi+ identity and more. As part of her professional service, she’s also the program coordinator for the Bisexual Issues Committee of the American Psychological Association’s Division 44. In that role, she promotes visibility and research on Bi+ communities. And she’s also a podcaster. She co-hosts the podcast Reality Test, where with each episode, they take feminist and psychological lenses to reality TV. So truly, Rachel is the perfect person to have this conversation with. And with all that wind up, Rachel, welcome to the Seed Field Podcast. 

Rachel [03:45 – 04:13] – Oh, thank you, Jasper. Thank you so much for having me and for your intro about your own reflection on Bi+ identity, because I think you highlighted a really common set of experiences for folks of kind of not even maybe taking space to reflect on their sexual orientation, because perhaps they’ve internalized the message from society that it’s not something they should talk about. So I’m just very grateful for you sharing all that and so glad you wanted to talk to me. Oh, 

Jasper [04:14 – 05:20] – Thank you so much, Rachel. And thanks for reflecting that back at me. Thank you for your work. It has affected me personally. But before we like go down that whole lane, I want to start off by asking you to disclose your positionality and I’ll disclose my own. We’ve found that this is really useful for people who are just listening. They can’t see us. They don’t know exactly who we are. And just to think where we’re coming at this from, because I know I’ll just disclose myself as a white man, you know, my own bisexuality is not intersecting with other avenues of oppression the way other people might be experiencing. So I think it’s useful for, on my end for people to know that I’m white, I’m a cisgendered man. I usually identify as queer, but I am also bisexual. I’m not living with a physical disability, but I do experience anxiety and depression and have since I was a kid. I have a college degree and a master’s and I currently have steady housing and steady income. And I’m also the parent of a two-year-old. Okay, I’ll toss it over to you, Rachel. As much as you’re comfortable, can you share your position? 

Rachel [05:20 – 05:44] – I am a white, cisgender, mostly able-bodied, bisexual woman. I’m neurodivergent. I have obsessive compulsive disorder. I have a stable income as well and have relative financial privilege in that regard. I have a two-year-old pup and a nine-year-old kitty that I love to the moon and back. 

Jasper [05:44 – 06:15] – That’s sweet. Thank you. I also have a 12-year-old cat who I love very dearly. Okay, so let’s talk about the mental health crisis here. I think this is a good place to start and to ground our conversation. I found those numbers really shocking that it’s almost half of people with this identity are experiencing moderate to severe psychological distress. And yeah, I wanted to ask you, like, how widely known are these numbers? How well confirmed are they? And can you talk a little bit about this crisis? 

Rachel [06:15 – 07:18] – They are incredibly well-confirmed numbers. The study or these findings that Bi+ people have higher rates of mental health concerns, both, this is a little binary, and I think research could do a better job not being so binary, but both folks identify, who identify as bi-men and folks who identify as bi-women. Also tends to be increased substance use concerns and increased sexual health concerns in particular for Bi+ men. So the statistics are pretty staggering. And unfortunately, the funding and interventions to better support Bi+ people aren’t really aligning with I love that you use the word crisis, because I truly think it is a crisis as well. I mean, I think that’s a really apt way to describe it. The numbers, I think, tell a really important story. I should also note that more than half of the LGBTQ plus community is Bi+ people. So we’re actually the biggest proportion of that community. And yet I think people often ignore our needs and our experiences. 

Jasper [07:19 – 07:41] – Yeah. And I think about what the factors are that contribute to this, because I do think it’s a crisis where it’s not like a total mystery or like a black box of like, why is this the case? When you think about it, I think most people have experienced the way that sexuality can be policed and gatekept. Can you tell us a little bit about some of the stresses that Bi+ people face? 

Rachel [07:41 – 09:32] – There are plenty. And by the way, having this conversation is not, from my perspective, the oppression Olympics, right? I’m not saying that other communities do not also experience their own set of distressors. What I am saying is the stressors that Bi+ people experience often aren’t validated. This includes a lot of people saying, oh, you know, your identity doesn’t count. That’s a really common one. If men identify as bi, folks are more likely to say, oh, you’re just gay. You’re still figuring it out. However, when women identify as bi+, people tend to fetishize that orientation and kind of center the male gaze on Bi+ identity for women. And the intersection of being like, for example, non-binary and Bi+ is not really discussed. And yet there are a lot of non-binary folks who identify as Bi+. So that’s another kind of intersection of invisibility that we see. I think also, you know, LGBTQ communities might kind of police based on, you know, your bi resume, if you will, like who you’ve been in relationships with in the past. For example, if you are a Bi+ woman who’s only been with cis men, I think that folks in the queer community might kind of poo-poo your sexual orientation, which can feel so invalidating. However, then there’s also the flip side of that, where if you are in a relationship with someone of a similar gender to you, there’s often still erasure. Like people will assume you’re lesbian or gay, right? So it kind of happens on both sides. And it can be really hard for Bi+ people to find a home to talk about their sexual orientation. I think it creates this space where they don’t quite know where they fit in a lot of the time. I know I’ve certainly experienced that in my own life. 

Jasper [09:33 – 10:48] – Yeah. Well, I think we sometimes forget that being closeted can actually be a comfortable place where it’s like, oh, I don’t have to trumpet my own sexuality to the rafters. For myself, I know I’ve been heavily policed by largely like gay men to not identify as gay because this is not 100% of gay men. I’ve also had a lot of people who are like embrace me as who I am. But having people say like, well, you’re with a woman because I’m married to a woman now and the major relationships I’ve had in my life have been with women. And I have always felt like I had to kind of prove it. I felt so policed when I was preparing for this interview. I was thinking about this document that I made about a year ago where I went back through the transcripts for every episode of the Seedfield podcast. And I took the part of my positionality statement where I say, I’m white, I’m a cisgendered man, I’m this. And four years ago when I was starting the show, I always said, I’m not straight, but I live with straight privilege because I’m married to a woman. Or I was like very coy about it. And like over the years, it finally evolved to me just saying like, I’m queer. 

Rachel [10:48 – 10:49] – Yeah.

Jasper [10:49 – 10:57] – I can own that without having to like prove it or like have a dossier where it’s like, this is how queer I am. 

Rachel [10:58 – 11:30] – Absolutely. The co-author who was first author on this paper, Sophie Schuyler, we wrote about, I think we titled it, Is It Worth It? The Pros and Cons of Coming Out as Bisexual. And the reason we talked about this is because it’s not a simple decision. And I think a lot of therapists and people are trained like, you know, coming out is the final the final step of LGBTQ plus development, which is, I think, kind of a silly way to think we’re much more fluid and complicated than that as human beings. 

Jasper [11:30 – 11:45] – Also, we’ve talked on this show about how you can come out in different contexts and people can be like totally out with one friend group. And maybe there’s a different friend group who they’re their rec league basketball team. And they’re like, you know, they don’t need to know. I don’t have to trumpet it. 

Rachel [11:46 – 12:55] – Exactly. And I think for by people that feels specifically true, depending on kind of where they feel comfortable and whether or not it feels worth it to them. So it’s kind of a constant pro-con decision-making sort of schema that people have to sit with to make these decisions about whether they want to disclose this part of themselves. And what we found that the reason people do disclose is because it helps them to feel more authentic and more aligned with who they are, which feels really true to what you described. And I know for me in my own life, that’s what keeps me disclosing because it helps me feel seen and then to see others better in return and to feel more authentic in who I am, which I think is a really pivotal part of just being a human being. And sometimes, depending on intersecting identities that people hold or family dynamics or whatever it may be, it just doesn’t feel safe in all situations. And that’s okay, too. So while I think the authenticity of coming out in spaces can be great, it’s certainly not for everyone and certainly not for every space. I love how you described that. 

Jasper [12:55 – 13:48] – Yeah. I think for a long time when I was closeted about my bisexuality, I thought that I was being an ally. Like I identified really strongly as an ally and was like, of course I have that little side of myself. But because it’s not like something that I’m acting on this month or I mean, whatever acting on is, because I’m in a relationship with somebody of the opposite gender, it actually is better for me just to like leave that part and not talk about it. Or if I talk about it, just talk about it vaguely. But instead, just show up, just be a really great ally. And I think when I realized that it doesn’t necessarily help people to like vocally support them while also denying your own self and that there wasn’t any gain there in hiding that part of myself. And instead, by being open about it, I could actually make space for other people to be open about that. 

Rachel [13:48 – 14:25] – It’s a form of activism to be open. And of course, to be mindful of like, I think the fear is like taking up too much space in the LGBTQ plus community, right? If you feel like you have privilege based on the relationship you’re in, which is totally a valid thing. And I think right now, a lot of Bi+ people are taking up no space. So there is a bit of an overcorrection, in my opinion, that needs to occur. And I’m glad you’ve come to that space as well. Because, yeah, I think it’s incredibly complicated. And I think you’re right. You’re not doing anyone any favors by denying that part of yourself. 

Jasper [14:25 – 14:40] – Well, I also I’ve heard the way that these things get policed are so subtle. I’ve been in conversations before where people are like, oh, did you hear she came out as like bi and now she’s queer? But she’s like lives with this man. So, like, what does that even mean? 

Rachel [14:40 – 15:37] – It’s a really common thing. And it’ll be like, oh, yeah, they’re queer, but they’re like with a man now. And even I remember when I was in a relationship with a woman, I was like the cool bi, right? And I feel like I got a lot of like secret cred that I didn’t even realize I was accumulating. And when I started dating a man more recently, well, not really recently anymore, but I guess relatively recently in the span of my life, I noticed a huge shift in it. And it was subtle, I think because I’m a sensitive person, I picked up on it. And so then I kind of like apologized for who I was dating. I could feel myself being like a walking apology a little bit with, oh, this is the person I’m with. I know he’s a man, blah, blah, blah. And it’s like, and this is a person I love. It didn’t feel right. Yeah, it’s all so complicated and so messy and stressful and can feel really scary and vulnerable. 

Jasper [15:38 – 16:02] – I feel like this topic is one of these places where you can really see the way that gender and sexuality get policed in our culture. And of course, we’re in a time where like trans identity is being literally policed and denied at the highest levels of the U.S. government. And so there are like visible ways. But this is a way I think that you can really see into the ways that our society enforces norms around sexuality. 

Rachel [16:02 – 16:17] – And wouldn’t it be nice? I mean, isn’t the goal of queerness to be more inclusive? and yet sometimes it can feel like some of these high school politics still play out, right? Oh, you’re not queer in this way, so you can’t sit with us or whatever it may be. 

Jasper [16:18 – 16:23] – I think one lesson of adulthood is that it’s always going to still be high school. 

Rachel [16:24 – 16:29] – I keep thinking it’s going to stop and then I’m like, ah, damn, it’s still kind of this way. Shit. 

Jasper [16:31 – 16:52] – So, okay, I want to pivot and talk a little bit about, we’ve described this mental health crisis. And I want to talk about the addressing of it. So I wanted to ask, how do you approach Bi+ mental health as a mental health professional? And also, like, how do you equip your students who are going to head out into the world and work with undoubtedly some people who are Bi+? 

Rachel [16:52 – 19:46] – Likely many people who are Bi+. And that’s another great thing is the numbers of folks with this identity keeps increasing. And I think as mental health professionals, it’s always been important. And it becomes more and more important to be able to work with this identity. To me, it’s very important to be aggressively bisexual is what I call it. I’ve heard other people call it that. That’s not my original take. But I think because a lot of my students might have that identity and maybe don’t feel as comfortable sharing it, maybe just because they don’t want to, and maybe also because of their own internalized stuff. So for me, one way that I work to combat biphobia within Antioch is to just really be out and by and proud of that identity and hopefully to model that for others is my goal. So that’s something that I work towards. And I think it’s really important as a supervisor and in my own clinical work to never assume someone’s sexual orientation and to never assume just because someone doesn’t disclose it that they’re straight. I think the presumed heterosexuality is a huge problem, right? Because we don’t actually know how people identify. And so, you know, asking about their sexual orientation and also seeing if it’s something that they want to explore further, because you might see people or hear people be like, oh, yeah, I identify as bi, but it’s not really a big deal to me, or it’s not that important. I’ve heard that from clients. And I think because of my reaction, I’ll be like, oh, that’s interesting. The research does say that a lot of people feel that way. And I just want you to know that your sexual orientation is valid. And I also want to respect that if it’s not something that you want to talk about, I’m not going to make it the center of our work if it’s not the center for you. So I think putting that out there and putting it out in therapy early, even if they don’t return to it for a while, often it comes back around. Not always, but often. And it is something that people want to explore more. I think the research tells us that the constant concealment and monitoring and being unsure where we can fit in does impact mental health. And so I think it’s really important, like other identities, to validate this identity early and signal to your client that it’s a, I never like the word safe space because I don’t believe that in each space we can actually guarantee safety, safe enough space to talk about these sorts of things. I’ve also found, because I think I’m like publicly Bi+ and my work focuses on that area, that sometimes my clients will come in and they might identify as straight. And then like session three or four, I’ll hear this. So I’ve been thinking about something. And then I’ll hear maybe about their own sort of sexual fluidity, which has been cool. 

Jasper [19:47 – 20:07] – I really appreciate hearing how you think about that. and also that sort of bi-affirming. And I think that makes a ton of sense as an approach. And I wonder, are there ways that the field of mental health, which obviously includes the different disciplines, but are there ways that it has kind of let down Bi+ folks in the past? 

Rachel [20:08 – 22:00] – Definitely. I would say that Bi+ research and research informs practice is still something that’s just not being centered nearly enough in the literature. For example, Division 44, the division that I’m a part of in APA that focuses on sexual and gender identity, had to create a specific bisexual issues committee because of activism that people did because that division in particular was run mostly by cisgender gay men. And me saying that is not me knocking the experience of being a cisgender gay man. That is a valid identity that should be celebrated, of course. And I think what Division 44 started to notice is that the ways in which, and of course, the ways in which sort of intersectionality plays out in society, it’s playing out in the APA. And so the concerns of Bi+ people, who, as we discussed, have pretty significant health disparities, were not really being talked about. And I think that trickles all the way down. And frankly, I still see it and hear it with colleagues where people, I think, erase their own identity or erase the identities of others for being Bi+. And it’s a shame. I even felt it in my research lab when I was a student. I sort of felt like I had to be a bit of, not a walking apology, but I felt that need to prove my queerness and that sense that maybe I didn’t cut the mustard or whatever. I had one supervisor tell me that I should watch the L word to enhance my queerness, which by the way, is a very biphobic show. So I think these sorts of things play out in APA. And I think it trickles all the way down to clients and how we see client care. 

Jasper [22:00 – 22:29] – Yeah, absolutely. And I wonder if there’s any advice that you could give to people who are wanting to explore their sexual fluidity, their Bi+ identity, that they’re making a connection now of like, I have experienced a lot of psychological distress. I am Bi+. Maybe these things go together. I mean, would you recommend that they be thoughtful in choosing a therapist? And how can therapy help people move through this kind of identity-instigated distress?

Rachel [22:29 – 23:46] – I would say to definitely make sure that your therapist is queer affirming and to test in those first few sessions how they respond to your Bi+ identity. Unfortunately, I don’t think you would mind me saying this. My current partner, when he came out as Bi+ to a prior therapist, what did they say to him? Well, everyone’s a little bisexual. Doesn’t really matter. Kind of like poo-pooing it, which I think was so invalidating to him in his own process. And so I think watching for things like that that are very quick to erase or diminish or fall into stereotypes, like if someone, for example, a doctor or a physical health sort of doctor or PCP, if you disclose your Bi+ identity and all they care about is your sexual health or assuming that you are promiscuous in some way or cheating on your partner, might not be the best fit in terms of understanding. that identity. So I think looking for those sort of cues to maybe that person’s own internalized biphobia and the ways in which that might not be the most helpful aspect for your journey if you are really committed to better understanding this identity. 

Jasper [23:46 – 24:21] – No, that seems like great advice. I think people don’t always know that you can just like fire a therapist after a session or two and or at 10 or whatever, but that is actually like a natural part of seeking mental health treatment. So I wanted to talk a little bit about your current research project where you’re looking into understanding why Bi+ folks report going to the doctor less than a lot of other populations, which isn’t a piece of data that I even knew. So can you talk a little bit about this phenomenon, maybe why it is, why it’s a problem and how it might be addressed? 

Rachel [24:22 – 25:50] – Yeah. So I want to give Bailey Merlin, who’s a Bi+ activist in Boston, a lot of credit for her work in this area and for bringing me into this project that she’s doing. And I’ve learned so much from doing this work. But essentially, a lot of Bi+ folks in this data that we’re coding are not going to the doctor, you know, maybe because of intersecting experiences of oppression, marginalization, or sort of that feeling that my experience isn’t valid, kind of trickling out to other aspects of their experience. This data also shows that if Bi+ people are going to the doctor, they’re not really discussing their sexual orientation, because sometimes when people do, they do experience those microaggressions. For example, getting assumed that they’re cheating on their partners or that they have STIs when that’s not someone’s focus. Not to shame anyone who that is something that they are interested in pursuing, But I think the assumption that, oh, they identify as bisexual, they must have told me this because they want to get a test for sexually transmitted infections is kind of a weird jump to make, but seems to be a common jump that happens when people do disclose that identity to their doctor or that someone’s cheating on their partner in some way. So I think biphobia is certainly trickling into people’s experience in the doctor’s office and therefore causing people not to disclose that aspect of their experience. 

Jasper [25:50 – 26:39] – I certainly haven’t told my doctor. I don’t even know when it would come up, but I would expect that she would probably just be like, oh yeah, checklist says you’re now in part of a population that’s at heightened risk for STIs. Like, let’s get you a check. I could be like, you know, I have not been with anybody but my partner for many years now. And that’s kind of a rude assumption. Why would I even open that can of worms with that person? But they might be the person who should be giving a referral and saying, there’s a crisis in Bi+ mental health. I know you filled out your mental health screener. It seems like things are okay, but are they really okay? There’s a totally different approach you could take if you knew as a primary care physician that 50% of Bi+ folks or just under that are experiencing these symptoms. That could be a totally different approach than just being like, oh yeah, STIs, let’s get you checked. 

Rachel [26:40 – 27:13] – Exactly. That was so well said because knowing that data and knowing that perhaps Bi+ people might have a tendency to minimize aspects of their experience, maybe asking a few more follow-up questions could be really helpful and really important from a population health perspective, while also not assuming, right, what tests. And that’s, I think, the tension in any population you’re working with. You want to be as educated as you can, while also looking at the individual in front of you and recognizing their humanity and individual kind of experiences. 

Jasper [27:14 – 27:55] – That makes a ton of sense. I love that thought about the difference between population and individual. So we’re almost out of time, but I wanted to ask you for people who are listening to this and might be thinking, what ways am I affirming or maybe disaffirming, whatever the opposite of affirming is, the Bi+ people who without doubt are in my own life. And if they’re a mental health professional, whatever their lot in life is, even if they’re a Bi+ person themselves, What are some ways that you think people could change the usual way people act in our society just a little bit to be reducing stigma and helping mental health of Bi+ people in this time of crisis? 

Rachel [27:56 – 29:15] – One thing I want to say, and I think the research is starting to focus more on this, is like the really rad parts of being Bi+ and to celebrate what’s great about being Bi+. Because the research is focused so much on the disparities and what makes it really hard. This is a trend in sexual and gender diversity research in general, but I want to focus it on Bi+ folks. Like folks who are Bi+ often have an ability to see gray areas, to see nuance, to understand multiple perspectives and multiple ways of being in the world in a way that’s really beautiful. And so I also, I think Bi+ culture is becoming more and more of a thing. Like Bi+ people don’t know how to sit in chairs, right? They’re always kind of sitting funny in a chair. They’re cuffing their jeans. They might have color in their hair or wear a lot of flannels. There’s all these like sort of bi culture things that are really sort of fun that I just, you know, it’s small things. But I think it’s really important because it helps Bi+ people to have a sense of community and to start to feel that sort of kinship with each other, which can help us feel less alone. And hopefully will help our mental health to be a little better. But I really love the idea of bi joy, bi culture and celebrating what’s really cool about being bisexual, which I think there’s myriad things. 

Jasper [29:15 – 29:25] – I love that. Well, we’re out of time, but I want to thank you so much. It’s been such a pleasure to learn more about your work and get to talk about this subject with you today. 

Rachel [29:26 – 29:29] – Thank you so much, Jasper. And thank you for having me on. It’s been a pleasure. 

Jasper [29:38 – 30:47] – You can learn more about the PsyD program that Rachel teaches in on Antioch’s website. We’re including a link to the PsyD program page in our show notes and we’re also linking there to Rachel’s recent scholarship on Bi+ mental health which we discussed in the episode we’ll also link to Rachel’s podcast, Reality Test, which she co-hosts with her fellow PsyD faculty member, Kate Evarts. We post these show notes on our website, theseedfield.org, where you’ll also find full episode transcripts, prior episodes, and more. The Seed Field Podcast is produced by Antioch University. Our editor is Nastasia Green. I’m your host, Jasper Nighthawk. Our web team is made up of Jen Mont, Amelia Bryan, and Jonathan Hawkins. Our work-study assistants are Stefanie Paredes, Lauren Arienzale, Dani LaPointe, and Liza Wisner. We received additional production help from Karen Hamilton, Melinda Garland, and Laurien Alexandre. Thank you for spending your time with us today. That’s it for this episode. We hope to see you next time. And don’t forget to plant a seed, sow a cause, and win a victory for humanity. From Antioch University, this has been the Seed Field Podcast.