Improving the Field of LGBTQ Psychology: Strategies for Amplifying Bisexuality Research

Abstract

Bisexuality has been critically understudied despite decades of research demonstrating pronounced disparities among bisexual populations. To better understand the state of bisexual research in the field of LGBTQ psychology, we conducted a content analysis of abstracts published in the Psychology of Sexual Orientation and Gender Diversity (PSOGD). Of 223 articles published in PSOGD, less than 1% were focused on bisexual populations. Many studies used “bisexuality” in their titles or as a keyword even when they contained little to no focus on bisexuality. Results from the content analysis are consistent with content analyses on medical and sexualities literatures. We highlight important strategies for improving the quantity and quality of bisexual research in LGBTQ psychology, including but limited to careful attention to bisexuality from study development to dissemination.

People who identify as bisexual are the largest, and fastest growing, portion of the lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) community (Copen, Chandra, & Febo-Vazquez, 2016). Nearly two decades of literature on sexual minority health disparities demonstrates evidence for poorer health and wellbeing among bisexual people compared to heterosexual and, often, lesbian and gay people (IOM, 2011; Marshal et al., 2013; Pompili et al., 2014); these health disparities are widening, not narrowing (Fish et al., 2017). Thus, research on the specific experiences of bisexual people is critical to addressing vulnerabilities and emphasizing resiliency.

However, there is considerably less research on bisexuality and the psychology of bisexual people, though the field has grown in recent years. Systematic reviews and content analyses of medical and sexuality research show consistently less attention on bisexuality than lesbian/gay issues (Kaestle & Ivory, 2012; Monro, Hines, & Osborne, 2017; Ross et al., 2017). Illustratively, a recent systematic review on bisexual mental health outcomes excluded over 75% of articles on lesbian, gay, and bisexual health outcomes because authors did not report bisexual specific results (Ross et al., 2017). Has bisexuality fared better, by comparison, in the field of LGBTQ psychology?

In an effort to further understand the landscape of articles about bisexuality in LGBTQ psychology, we conducted a content analysis of all titles and abstracts of articles, including book and film reviews and commentaries, published in Psychology of Sexual Orientation and Gender Diversity. Since its inception, PSOGD has been “dedicated to the dissemination of top quality psychological scholarship on sexual orientation and gender diversity” (Gonsiorek, 2013, p. 1). Considering the journal’s focus on sexual orientation, broad reach to both researchers and clinicians as an American Psychological Association (APA) journal, and commitment to high quality scholarship, the articles contained within this journal serve as a barometer that reflect the highest quality research in the field of LGBTQ psychology.

Between the dates October 16-17, 2017, we examined titles and abstracts of articles, including book and film reviews and commentaries, in all issues of the journal, including the supplemental issue in 2013. We double reviewed each abstract to categorize it into four groups based on the amount of focus it had on bisexuality. We operationalized bisexual content as whether the abstract contained information on nonmonosexual (i.e., oriented toward more than one sex or gender) identities, attractions, or behaviors. We coded abstracts as bisexual-focused content when the abstract or article specifically addressed bisexual or nonmonosexual issues through theoretical framework, sample population, or content area. Abstracts coded as some bisexual content did not specifically focus on bisexual issues but discussed results or implications of their study for bisexual people. Studies with abstracts that only briefly mentioned bisexuality, or stated that they were unable to address bisexual issues in their study, were coded as minimal bisexual content. Finally, we coded studies with abstracts that contained no information on bisexuality as no bisexual content.

At the time of review, there had been 223 articles published in the journal. Twenty-nine (13%) articles in total were categorized as either bisexual-focused, some bisexual content, or minimal bisexual content. Of these, twelve articles (0.5%) fell into the bisexual-focused content category. There were ten articles (0.4%) with abstracts categorized as some bisexual content while seven articles (0.3%) were categorized as minimal bisexual content. The most common domains studied in articles with any bisexual content—domains were not mutually exclusive—were minority stress (14; 48.28%), psychological functioning such as self-esteem or suicide (8; 27.59%), romantic relationships (8; 27.59%), and women (7; 24.14%). There were many studies that included the phrase “lesbian, gay, and bisexual” in their titles or abstracts that did not have disaggregated samples, had only lesbian/gay samples, or combined sexual minority subgroups. Many studies included “bisexuality” as a keyword despite a lack of bisexual focus, data, analyses, or discussion.

The percentage of abstracts with any bisexual content in PSOGD was similar to the percentage of studies in PubMed that contained the term “bisexual” or “bisexuality” and reported separate data for bisexual people (Kaestle & Ivory, 2012). The findings of our content analysis are striking because PSOGD is a subspecialty journal for LGBTQ psychology, of which bisexuality is a crucial component, rather than a broad psychology journal in which we might expect low amounts of bisexual content. Our analysis indicates that there is a lack of focus on bisexuality in LGBTQ psychology, which not only limits the field’s ability to address large and widening bisexual health disparities (Fish et al., 2017), it also has the potential to contribute to these health disparities by perpetuating bisexual minority stressors for bisexual laypeople and bisexual researchers.

We offer some recommendations here to increase visibility of bisexuality and improve rigor and clarity in articles written for, submitted to, and published in PSOGD and beyond. We also acknowledge that we are not the first to offer these recommendations (for example, see Barker, 2012; Bostwick & Hequembourg, 2013) but, based on the results from our content analysis, believe these recommendations bear repeating.

• The first step to a more robust literature on bisexuality is data. Authors should consider the unique experiences of bisexual people when framing their studies and when collecting and analyzing data. For example, authors should not simply ask whether or to whom their participants have disclosed their sexual identity, but also which sexual identity they disclosed because research shows bisexual people can disclose as bisexual, lesbian/gay, or not at all, depending on the context (Scherrer, Kazyak, & Schmitz, 2015).

• Authors should be accurate about their focus and/or samples in their titles, abstracts, and keywords and avoid using the phrase “lesbian, gay, and bisexual” when they instead mean sexual minority or exclusively same-gender attracted.

• Reviewers for the journal should pay careful attention to these issues. Ask authors to engage with bisexual-specific literature when discussing results with bisexual samples (or subsamples) rather than only contextualizing findings within broader sexual minority populations. If the authors did not or could not disaggregate by sexual identity, reviewers can ask them to be explicit that this is a limitation and, where possible, consider how their results could apply to sexual minority subgroups, including bisexual people.

• Scholars and clinicians can join the listserv for the Committee on Bisexual Issues in Psychology, whose members have worked diligently to meet the committee’s goal “to foster discussion, scholarship, and advocacy related to bisexual issues in psychology within Division 44 and within the American Psychology Association more broadly” (Committee on Bisexual Issues, 2014). Each year the committee sponsors content at the APA convention, including symposia and discussions on bisexuality, which all are welcome to attend.

• It is also critical that the field’s leadership, including editors, address inclusion and visibility of bisexuality in journals, conference proceedings, and funding through a number of means. Workshops or information sessions on issues related to bisexual research, such as measurement or sampling issues, can enable scholars to conduct rigorous, inclusive studies on bisexuality. Editors can increase bisexual content by prioritizing space in journals for high quality manuscripts on bisexuality and through special sections on bisexuality and bisexual issues, which signal to authors that these topics are important and submissions are welcomed.

Indeed, visibility was our goal in soliciting manuscripts for the special section on bisexuality in the current issue of PSOGD, which, in a single issue, nearly doubles the number of bisexual-focused content in the journal. We are calling on scholars, clinicians, and activists in the field of LGBTQ psychology to show allyship to bisexual people by including them thoughtfully in research and practice rather than simply considering them another letter in the identity acronym. By following these recommendations, there is an opportunity for the field of LGBTQ psychology to show leadership in ways that other fields have struggled (Kaestle & Ivory, 2012; Monro et al., 2017; Ross et al., 2017) with enormous potential ramifications for the psychological health and wellbeing of bisexual people, a group that has often felt left behind.

Public significance statement.

We found few articles in Psychology of Sexual Orientation and Gender Diversity with abstracts that contained discussion of bisexuality, suggesting a lack of attention on bisexuality in the field of lesbian, gay, bisexual, transgender, and queer/questioning psychology. We offer recommendations to improve the visibility and rigor of bisexual research with the goal of addressing elevated risk for poor health among this understudied, but largest and fastest growing, group of sexual minority people.