Bilinguals report more tip-of-the-tongue (TOT) failures than monolinguals. Three accounts of this disadvantage are that bilinguals experience between-language interference at (a) semantic and/or (b) phonological levels, or (c) that bilinguals use each language less frequently than monolinguals. Bilinguals who speak one language and sign another help decide between these alternatives because their languages lack phonological overlap. Twenty-two American Sign Language (ASL)-English bilinguals, 22 English monolinguals, and 11 Spanish-English bilinguals named 52 pictures in English. Despite no phonological overlap between languages, ASL-English bilinguals had more TOTs than monolinguals, and equivalent TOTs as Spanish-English bilinguals. These data eliminate phonological blocking as the exclusive source of bilingual disadvantages. A small advantage of ASL-English over Spanish-English bilinguals in correct retrievals is consistent with semantic interference and a minor role for phonological blocking. However, this account faces substantial challenges. We argue reduced frequency of use is the more comprehensive explanation of TOT rates in all bilinguals.