Bisexuality and Clinical Depression and Generalized Anxiety

A systematic review and meta-analysis by Ross and others[1] in 2017 examined 1,074 articles that reported bisexual-specific data on standardized measures of depression and/or anxiety. They looked at studies that reported mean scores and standard deviations for bisexual and comparison groups. They narrowed it down to 52 studies that passed stringent guidelines. Only eight of the 52 included studies that stated a bisexual-specific objective in their abstracts. Results indicated that bisexuals exhibited a consistent pattern of higher rates of depression and anxiety than heterosexuals and lesbian/gay people. They proposed that there were three interrelated contributors including sexual orientation- discrimination, bisexual invisibility, and lack of affirmative support. They argued that there was a lack of quality bisexual research despite evidence of greater mental health concerns.

Let’s first deal with the issue of invisibility of bisexual people. The answer is obvious, at least from the viewpoint of bisexuals. WE DO NOT WANT TO BE INVOLVED IN STUDIES. We prefer anonymity. Our sexual behaviors are private. We do not consider it a problem and certainly not cause for public concern. That would be true in most cases; however, we can’t ignore the number of us that are going through severe mental issues that seem to somehow be related to our bisexual nature. BISEXUALITY IS NOT A MENTAL CONDITION. Okay, that’s certainly true, but why are so many of us experiencing mental issues?

Secondly, let’s look at discrimination. Gay and Lesbian culture is now widely accepted by the general population but nonbinary, trans (especially men converting to women), and bisexuals are still facing a backlash. Transgender and conversion is a huge topic in itself so let’s leave that for another time. It is generally accepted that bisexuals face discrimination due to biphobia. It appears that the heterosexual community or the public at large seems to fear bisexuality as some kind of covert behavior that can lead to the weakening of the family and the general state of the community and country. It can be manifested as a disbelief in bisexuality as a valid identity – you are either a man or a woman and therefore should engage in sex as a heterosexual or as gay. The second issue is bi-erasure which refers to the tendency to deny or ignore our existence by both the general population and within the LGBTQ+ community. That would be good in itself; it is our own damn business. We want to be invisible so we can live our own lives and pursue sexual pleasures as our hearts so desire. But again, why the high incidence of clinical depression, generalized anxiety and suicide attempts. It is apparently an issue that cannot be ignored.

That brings us to the issue of lack of support. It would appear that the general population just want us to go away, or at least, just be quiet about our sexual tendencies. However, we may not have problems ourselves as individuals and we usually refuse to join groups of bisexuals for advocacy or just affirmation. I remember trying to start a meet-up group for bisexual people in Victoria BC. I immediately had close to fifty sign-ups. Another individual and I decided to have a meet-and-greet at our favorite breakfast venue. Nobody showed up except the two of us. However, the issue here is that as individuals we may be okay, but a very large number of us need to meet-up not for sex but just to talk about our issues and realize we are not alone. We also need to advocate for one another, not about our human rights, but about the unhealthy occurrence of mental issues among us.

                This brings us to the second major concern of this study – the lack of quality research with bisexuals as the major target population. We need to know a whole lot more about why so many of us are experiencing life-threatening mental health issues and then we have to start doing something about it.

Action Plan

  1. Many of us bisexuals need help and those of us who have gone trough our own Armageddon need to advocate for the help they need.
  2. We must work together to advocate for the meaningful inclusion of bisexual people in mental health research. We can advocate directly to our colleagues and acquaintances, and through our writing and involvement in professional associations.
  3.  There is certainly a need to address the mental health of individual bisexuals. We can advocate for affirmative support in the mental health sector. We can share information and resources about bisexual mental health. We can help people in decision making positions understand the need for intervention.
  4. We can be a voice in the LGBQR+ community to bring awareness of our specific gifts, talents and needs.
  5. There is no need for anonymity. There is nothing to be ashamed about. Like everyone else we are free to pursue sexual pleasures in our own unique way. Sex is meant to get the endorphins flowing for the establishment of meaningful relationships and creating a sense or well-being. If that is not happening, we may be in danger of becoming another statistic in mental health research.

[1] Lori E. Ross, Travis Salway, Lesley A. Tarasoff, Jenna M. MacKay, Blake W. Hawkins, and Charles P. Fehr. Prevalence of Depression and Anxiety Among Bisexual People Compared to Gay, Lesbian, and Heterosexual Individuals:A Systematic Review and Meta-Analysis. National Library of Medicine Published online: 03 Nov 2017. https://pubmed.ncbi.nlm.nih.gov/29099625/

Bisexual Men and Risk-Taking Behavior

  A study by Zhang (a geneticist at the University of Michigan) and Song found different genes drive bisexuality versus other same-sex sexual behavior. Zhang and Song mined a DNA database of some 450,000 people in the United Kingdom. They concluded that the genes underlying bisexual behavior are distinct from those driving exclusive same-sex behavior and may be intertwined with a propensity for taking risks.

Let’s first address the topic of risk-taking. Studies of twins have suggested that risk-taking traits may have a genetic component. The researchers found that bisexual and gay men may share some genetic variants, but the behaviors are genetically distinct from each other. They also found that bisexual behavior was genetically correlated with a propensity for taking risks in bisexual men, but not in bisexual women. Zhang and Song noted that about 23% of that behavior seemed to be related to genetics, and the environment (which seems to be missed in most studies) may play a bigger role in determining these kinds of traits. According to DSM 5, risk-taking describes a tendency to engage in reward-seeking actions despite the possibility of negative consequences. Research suggests that risk-taking in bisexual men may include unprotected sex (which we should always consider and respect) and promiscuity, which, in my opinion is a negative term for freedom for sexual exploration. It is also interesting to note that risk taking is one of the impairments or traits involved with borderline personality disorder (BPD). In previous posts we noted a positive correlation between bisexuality and BPD which may make it a confounding variable.

So what can we take from this connection between genetics and bisexual behavior? Very little. To say risk taking is a genetic trait of bisexuality is a big stretch. Some critics note that this is a study of sexual history, rather than sexual identity. Most of the people in the data base are more than 50 years old and grew up during a time when same-sex sexual experiences were illegal and frowned upon by society at large. This tends to present a negative view of bisexuality as some kind of genetic disorder. It is more likely that the environment may be a more dominant factor of BPD and may pertain to an older generation where men had to take risks because open gay sexuality was often forbidden. Take into account that many of these bisexual men were married or in relationships with women and perhaps had children, and we begin to see the possible causes of at-risk behavior. However, the reluctance to use protection may be an entirely different factor. Coming from the AIDS generation it may be related to suicidal tendencies or some form of self-punishment for engaging in what many religions referred to as sinful behavior.

So what is the positive spin that I can generate because I am just a blogger and can take wild stabs without empirical evidence.

  1. Bisexuality may have some genetic connections but there is no bisexual gene per say. There may be a combination of genes that may result in a genetic predisposition, but they have to be triggered by factors in the environment before they are activated.
  2. This is not a curse. Bisexuality is not a personality disorder and risk-taking behavior does not have to be an impairment or trait of a personality disorder. This genetic combination may also allow us the freedom to be who we want to be and do what we want to do.
  3. If we are bisexuals with BPD we should seek psychological help. But we do not rely only on cognitive therapy which attempts to change how we think. The combination of bisexuality and BPD goes much deeper than just thought and behavior. It involves powerful drives and when combined with environmental influences from religion and family, it can be devastating. We may need extensive empathic therapy to get to the basis of our negative feelings so we can be free to enjoy the power of our bisexual passions.
  4. If we are in a heterosexual relationship, we have to be honest with our partner. Secrecy can literally kill us leading to terrible guilt and suicidal behaviors. We now live in a much more compassionate society where relationships can be more open and honest. We can open up to our partner, let them know we love them, and want to maintain the relationship. But we let them know that we also have these desires for same sex relationships. We make sure we are prepared for the consequences.
  5. Be honest with ourselves. Bisexuality, whether it is genetic or has been forged my environmental influences or a combination of both, it is our reality. We can gain intense pleasure from same sex relationships. We can find friends with benefits that enrich our lives. We should not settle for less. And we always engage is safe sex practices out of respect for our partners and ourselves.

Bisexual behavior genetically tied to risk-taking, controversial DNA analysis find. Rodrigo Pérez Ortega. 3 Jan 2024 (https://www.science.org/content/article/bisexual-behavior-genetically-tied-risk-taking-controversial-dna-analysis-finds Epub 2024 Jan 3.

, Jianzhi Zhang and Siliang Song..Genetic variants underlying human bisexual behavior are reproductively advantageous. Sci Adv 2024 Jan 5;10(1):eadj6958.

Bisexuality and the Human Mind

This next topic is very personal to me. There is no other topic that has caused me more concern and grief. I identify myself sexually as bisexual and gender as non-binary. That is not a problem – that is just my reality. But the problem then is how to keep this in balance, especially sexually. Specifically, how do I control my sexual urges that long to connect sexually with other males and females. Even more specifically I need to know if it’s okay to engage in hooking up just for the sexual experience which I have done occasionally throughout the years but not without concern and remorse. I also need to find clarity and consensus about open relationships. My life-partner and soulmate has encouraged me to exercise my gay side but I do not feel right about doing so.

From a strictly physical view,  I simply have sexual urges, the need for touch and sexual gratification. Some of this urge is part of my biological and chemical expressions connected with procreation. Beyond that I enjoy the wholesome intimacy I experience with my female partners, but I also enjoy the wild excitement I experience with my casual male partners. This is very confusing for me. On one hand I love the sensations that hit the pleasure centers of my brain when I engage in sex with someone new, but then I get all tangled up in in social and guilt issues. It can be very painful.

There is some evidence that my gender identity and sexual orientation are predetermined by prenatal exposure to testosterone and estrogen as well as to pheromonal input from the mother during the fetus stage. Of course, pheromones are obviously a major driver in all animals but not truly understood when it comes to humans. I can tell you it is real; I experience it at the subconscious level. As you know, the olfactory nerve connects directly to the frontal cortex of the brain, and it is through my sense of smell that I experience the pheromones of both females and males and am physically drawn to them. The heterosexual part of me includes my biological desire for procreation and bonding. The same-sex part is strictly a powerful urge for body-to-body connection coupled with sexual gratification. It can be a powerful physical high.

            Family and twin studies indicate that genes play a role, although no specific genes have been identified. It is through the activation of groups of genes from stimuli in the environment that has determined my bisexuality and nonbinary gender and my responses to sexual attraction that I have experienced during various stages of our life. My impulses have a lot to do with sexual regional connectivity and the differences in brain connectivity patterns between the presence of both male and female identification clusters within my brain. Having characteristics from both sexes impacts my sexual predisposition. A lot of my responses are governed by my body’s reaction to sexual attraction. Once my body is charged up for sex, it is very difficult for me to respond rationally.

My bisexuality and nonbinary gender identification has had a profound impact on my brain structures, rational functions, and neurochemistry. The mental component of sexual attraction for us bisexuals includes a range of factors such as sexual curiosity, sexual sensation seeking, and sexual excitability. When it comes to my nonbinary pursuits I have the qualities of both male and female brain functions. As a male I have a higher density of connections in the amygdala, which involves behaviors like aggressive pursuit for mating. The male side of my brain tends to be more efficient to lateralize and compartmentalize which has the advantage of making me more task-focused with less concern for consequences. The female part of my brain has a larger hippocampus for human memory and the maintaining of a life story. My female brain has more nerve connections with constant cross-signals. It takes in more so it tends to see how the sexual experience fits in with the bigger picture of life and family.

            The amygdala is often associated with fear and anger; however, it is also required when I work for rewards such as sexual pleasure and orgasm. For my male and female combined brain, the amygdala activates the neurochemicals; however, dopamine is initially much stronger in my male functions. When dopamine is released in my male brain, I immediately feel a sense of temporary pleasure, sexual arousal, and motivation to pursue resulting in a genital response. My female part of me, however, is slow in getting started but wants to prolong the experience. After orgasm dopamine levels decrease and serotonin levels increase. Serotonin usually decreases sexual behavior but creates a long-lasting feeling of happiness or well-being. Oxytocin is a hormone and a neurotransmitter that is sometimes referred to as the love hormone. It is more dominant in my female side then the male. The male part of me has had its rush and is ready to move on. In the female side Oxytocin levels increase during hugging, orgasm, and post orgasm and are associated with feelings of empathy, trust, and relationship-building.

As you can see, being bisexual and nonbinary have a strong clashing chemical iresponse making me sexually aggressive but much more sensitive. When it comes to casual sex and hooking up, the male part of me is satisfied and is ready to move on, but the female side of me wants to prolong the post orgasm experience and may feel that something is missing after casual sex. My mind also has to weigh social norms and expectations with my desire for sexual pleasure. This often leads to feeling of regret, shame, and guilt.

Alas, poor me, however, I am not a slave to my mind and body. There is part of me that can rationalize and control my impulses. I have to rely more on my heart for the pursuit of love for self and for the people with whom I have sex. Casual sex may meet my body and mind needs but it can be so much more. I need to follow my heart and seek more intimacy and deeper relationships.