Bisexual Invisibility and the Sexual Health Needs of Adolescent Girls

LGBT Health. 2016 Oct;3(5):342-9. doi: 10.1089/lgbt.2016.0035. Epub 2016 Sep 7.


Purpose: The purpose of this study was to analyze bisexual female youth perspectives on their experiences accessing sexual health information and services provided by a doctor, nurse, or counselor. Specifically, we sought to: (1) understand how youth perceptions of providers' attitudes and behaviors affect their seeking and obtaining sexual health information and services; (2) examine how social stigmas within the family context might be associated with barriers to sexual health information and services; and (3) assess school-based sources of sexual health information.

Method: We utilized a mixed-method study design. Data from bisexual female youth were collected through an online questionnaire and asynchronous online focus groups addressing lesbian, gay, bisexual, and transgender health and HIV prevention. Data were analyzed with descriptive statistics and thematic analysis.

Results: Barriers to sexual healthcare included judgmental attitudes and assumptions of patient heterosexuality among healthcare providers, and missed opportunities for HIV and sexually transmitted infections (STI) testing. Bisexual stigma within families was associated with restricted youth openness with providers, suggesting fear of disclosure to parent or guardian. School-based sexual health education was limited by a restrictive focus on abstinence and condoms and the exclusion of STI risk information relevant to sex between women.

Conclusion: We recommend that practitioners integrate nonjudgmental questions regarding bisexuality into standard contraceptive and sexual health practices involving female youth, including discussion of HIV and STI risk reduction methods. Further support for bisexual health among adolescent girls can come through addressing stigmas of female bisexuality, increasing sensitivity to privacy while engaging parents, and expanding the reach of school-based sexual health education.

Keywords: HIV prevention; STI prevention; adolescent health; bisexuality; healthcare; sexual health.

MeSH terms

  • Adolescent
  • Bisexuality / psychology*
  • Discrimination, Psychological
  • Education, Distance
  • Family / psychology
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Patient Acceptance of Health Care / ethnology*
  • Patient Acceptance of Health Care / psychology*
  • Perception
  • Physicians / psychology
  • Sex Education*
  • Sexual Health / ethnology*
  • Sexually Transmitted Diseases / prevention & control
  • Social Stigma
  • Surveys and Questionnaires
  • United States