Bisexual women are more likely than their male counterparts to suffer from depression and stress and to binge-drink, according to a new national study led by George Mason University researcher Lisa Lindley.
Bisexual women also are at greater risk to smoke and be victimized, the research finds.
"Why?" Lindley wonders. "That's what we keep asking."
She has some theories. "Bisexuals are often invisible," she says of bisexual women. "There's a lot of prejudice against them. They're told 'You're confused -- pick one.' There tends to be this expectation or standard that a person picks one sexual identity and sticks with it. I think there's a lot of misunderstanding about bisexuals. I think their risk has a lot more to do with stigma."
The study, published in the American Journal of Public Health, uses three different dimensions of sexuality -- identity, behavior and attraction -- and links them to a variety of health outcomes, says Lindley, an associate professor in Mason's Department of Global and Community Health within the College of Health and Human Services.
Looking closely at the survey data, Lindley notes, both bisexual girls and boys were more likely to be high-risk for depression, stress and alcohol abuse when they were teenagers. She found that the odds dropped for men as they got older, but not so for women.
In addition, women who were strictly identified as straight or gay didn't have the same risk factors that bisexual women had, Lindley says. More studies are needed to understand what is going on with these young women, she adds.
Lindley's research builds on new information. Until now, few national studies have asked about sexual attraction, behavior and identity, Lindley says. Some think bisexuals are increasing the risk level reported among the overall lesbian, gay, bisexual and transgender community, she says. Researchers need to learn more about the individual communities.
"They're not all troubled," she says of the lesbian, gay, bisexual and transgender community. "They're not all high risk."
Discordance could be at the heart of the issue for bisexual women, Lindley says. "They're saying, 'I identify one way, but I behave in a different way and am attracted in another way,' " she says.
They may be more isolated and may not feel as if they have someone to talk with who understands what they are going through, she adds.
More young women than men reported that they were attracted to both sexes and that they were "mostly" straight or bisexual.
"Women are more likely to have sexual identities that fluctuate over time," Lindley says. "Whereas with men, it tends to be either 'I'm straight' or 'I'm gay.'"
Men didn't report feeling as depressed or stressed as women did. They also didn't binge-drink or smoke as much as bisexual women.
So why are men better off?
"I don't know is the honest answer," Lindley says. "Perhaps it's because men, if gay or straight, have a stronger connection to their community. Bisexual women may not feel as if there is a community for them."
Lindley and her co-authors Katrina M. Walsemann and Jarvis W. Carter Jr. of the University of South Carolina used a nationally representative sample of 14,412 people -- 7,696 women and 6,716 men -- in the survey. The survey first was given in 1994-95 when the respondents were enrolled in grades 7-12 and given again in 2007-08 when they were 24 to 32 years old.
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