Abstract
In order to better serve bisexual women, clinicians and researchers need tools that accurately reflect and capture bisexual women’s experiences of stigma and affirmation. These tools are essential as research indicates that bisexual women experience poorer mental health than either heterosexual or lesbian women. Our community-based study developed and psychometrically evaluated the Bisexual Microaggression and Microaffirmation Scales for Women (BMMS-W). We held focus groups and advisory committee meetings with bisexual women to identify common experiences of microaggressions and microaffirmations and drafted over 200 potential survey items. Exploratory factor analysis of data from 382 participants across Canada and the U.S. yielded five microaggression factors (dismissal; mistrust; sexualization; social exclusion; and denial of complexity) and four microaffirmation factors (acceptance; social support; recognition of bisexuality and biphobia; and emotional support). Confirmatory factor analysis of data from a separate sample of 323 participants across Canada and the U.S. tested the model. The development of the BMMS-W responds to calls to examine the distinctiveness of bisexual women’s experience and gives mental health service providers and researchers a tool to better understand their experiences.
Similar content being viewed by others
References
Access Alliance Multicultural Health and Community Services. (2011). Community-based research toolkit: Resource for doing research with community for social change. Toronto, ON: Author.
Alarie, M., & Gaudet, S. (2013). “I don’t know if she is bisexual or if she just wants to get attention”: Analyzing the various mechanisms through which emerging adults invisibilize bisexuality. Journal of Bisexuality, 13(2), 191–214.
Balsam, K. F., & Mohr, J. J. (2007). Adaptation to sexual orientation stigma: A comparison of bisexual and lesbian/gay adults. Journal of Counseling Psychology, 54(3), 306–319.
Bennett, K. (1992). Feminist bisexuality: A both/and option for an either/or world. In E. R. Weise (Ed.), Close to home: Bisexuality and feminism (pp. 205–231). Seattle, WA: The Seal Press.
Bostwick, W. B., Boyd, C. J., Hughes, T. L., & McCabe, S. E. (2010). Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. American Journal of Public Health, 100(3), 368–475. https://doi.org/10.2105/AJPH.2008.152942.
Bostwick, W. B., Boyd, C. J., Hughes, T. L., & West, B. (2014). Discrimination and mental health among lesbian, gay, and bisexual adults in the United States. American Journal of Orthopsychiatry, 84(1), 35–45.
Bostwick, W., & Hequembourg, A. (2014). ‘Just a little hint’: Bisexual-specific microaggressions and their connection to epistemic injustices. Culture, Health & Sexuality, 16(5), 488–503.
Brewster, M. E., & Moradi, B. (2010). Perceived experiences of anti-bisexual prejudice: Instrument development and evaluation. Journal of Counseling Psychology, 57(4), 451–468.
Callis, A. S. (2013). The black sheep of the pink flock: Labels, stigma, and bisexual identity. Journal of Bisexuality, 13(1), 82–105.
Cohen, D., & Crabtree, B. (2006). Qualitative research guidelines project. Retrieved November 20, 2017, from www.qualres.org/HomeMaxi-3803.html.
Copen, C. E., Chandra, A., & Febo-Vazquez, I. (2016). Sexual behavior, sexual attraction, and sexual orientation among adults aged 18–44 in the United States: Data from the 2011–2013 national survey of family growth. National Health Statistics Report 88 (January 7). http://www.cdc.gov/nchs/data/nhsr/nhsr088.pdf.
Dodge, B., Herbenick, D., Friedman, M. R., Schick, V., Fu, T. C. J., Bostwick, W., … Sandfort, T. G. M. (2016). Attitudes toward bisexual men and women among a nationally representative probability sample of adults in the United States. PLoS ONE, 11(10), e0164430. https://doi.org/10.1371/journal.pone.0164430.
Eady, A., Dobinson, C., & Ross, L. E. (2011). Bisexual people’s experiences with mental health services: A qualitative investigation. Community Mental Health Journal, 47(4), 378–389.
Eliason, M. J. (1997). The prevalence and nature of biphobia in heterosexual undergraduate students. Archives of Sexual Behavior, 26(3), 317–326.
Field, A. (2013). Discovering statistics using IBM SPSS statistics. Thousand Oaks, CA: Sage Publications.
Feinstein, B. A., & Dyar, C. (2017). Bisexuality, minority stress, and health. Current Sexual Health Reports, 9, 42–49. https://doi.org/10.1007/s11930-017-0096-3.
Flanders, C. E. (2015). Bisexual health: A daily diary analysis of stress and anxiety. Basic and Applied Social Psychology, 37(6), 319–335.
Flanders, C. E., & Hatfield, E. (2014). Social perception of bisexuality. Psychology and Sexuality, 5(3), 232–246.
Flanders, C. E., Robinson, M., Legge, M. M., & Tarasoff, L. A. (2016). Negative identity experiences of bisexual and other non-monosexual people: A qualitative report. Journal of Gay & Lesbian Mental Health, 20(2), 152–172. https://doi.org/10.1080/19359705.2015.1108257.
Flanders, C. E., Tarasoff, L. A., Legge, M. M., Robinson, M., & Gos, G. (2017). Positive identity experiences of young bisexual and other nonmonosexual people: A qualitative inquiry. Journal of Homosexuality, 64(8), 1014–1032. https://doi.org/10.1080/00918369.2016.1236592.
Friedman, M. R., Dodge, B., Schick, V., Herbenick, D., Hubach, R. D., Bowling, J., … Reece, M. (2014). From bias to bisexual health disparities: Attitudes toward bisexual men and women in the United States. LGBT Health, 1(4), 309–318.
Herek, G. M. (2002). Heterosexuals’ attitudes toward bisexual men and women in the United States. Journal of Sex Research, 39(4), 264–274.
Jorm, A. F., Korten, A. E., Rodgers, B., Jacomb, P. A., & Christensen, H. (2002). Sexual orientation and mental health: Results from a community survey of young and middle-aged adults. British Journal of Psychiatry, 180, 423–427. https://doi.org/10.1192/bjp.180.5.423.
Kerr, D. L., Santurri, L., & Peters, P. (2013). A comparison of lesbian, bisexual, and heterosexual college undergraduate women on selected mental health issues. Journal of American College Health, 61(4), 185–194.
Klesse, C. (2005). Bisexual women, non-monogamy and differentialist anti-promiscuity discourses. Sexualities, 8(4), 445–464.
Koh, A. S., & Ross, L. K. (2006). Mental health issues: A comparison of lesbian, bisexual and heterosexual women. Journal of Homosexuality, 51(1), 33–57.
MacDonald, A. P. (1983). A little bit of lavender goes a long way: A critique of research on sexual orientation. Journal of Sex Research, 19(1), 94–100.
MacLeod, M. A., Bauer, G. R., Robinson, M., MacKay, J., & Ross, L. E. (2015). Biphobia and anxiety among bisexuals in Ontario, Canada. Journal of Gay & Lesbian Mental Health, 19(3), 217–243. https://doi.org/10.1080/19359705.2014.1003121.
McLean, K. (2008). Silences and stereotypes: The impact of (mis)constructions of bisexuality on Australian bisexual men and women. Gay & Lesbian Issues in Psychology Review, 4(3), 158–165.
McNair, R., Kavanagh, A., Agius, P., & Tong, B. (2005). The mental health status of young adult and mid-life non-heterosexual Australian women. Australian and New Zealand Journal of Public Health, 29(3), 264–271.
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(4), 674–697.
Miller, M., André, A., Ebin, J., & Bessonova, L. (2007). Bisexual health: An introduction and model practices for HIV/STI prevention programming. Retrieved August 1, 2017, from http://www.glhv.org.au/report/bisexual-health-introduction-and-model-practices-hivsti-prevention-programming.
Mohr, J. J., & Rochlen, A. B. (1999). Measuring attitudes regarding bisexuality in lesbian, gay male, and heterosexual populations. Journal of Counseling Psychology, 46(3), 353–369.
Mulick, P. S., & Wright, L. W. (2002). Examining the existence of biphobia in the heterosexual and homosexual populations. Journal of Bisexuality, 2(4), 45–64.
Muthén, L. K., & Muthén, B. O. (1998-2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.
Nadal, K. L. (2013). That’s so gay! Microaggressions and the lesbian, gay, bisexual, and transgender community. Washington, DC: American Psychological Association Books.
Nadal, K. L., Whitman, C. N., Davis, L. S., Erazo, T., & Davidoff, K. C. (2016). Microaggressions toward lesbian, gay, bisexual, transgender, queer, and genderqueer people: A review of the literature. Journal of Sex Research, 53(4–5), 488–508.
Paul, R., Smith, N. G., Mohr, J. J., & Ross, L. E. (2014). Measuring dimensions of bisexual identity: Initial development of the Bisexual Identity Inventory. Psychology of Sexual Orientation and Gender Diversity, 1(4), 452–460.
Peter, T., Adkins, T., Watson, R., Adjei, J., Homma, Y., & Saewyc, E. (2017). Trends in suicidality among sexual minority and heterosexual students in a Canadian population-based cohort study. Psychology of Sexual Orientation and Gender Diversity, 4(1), 115–123.
Platt, L. F., & Lenzen, A. L. (2013). Sexual orientation microaggressions and the experience of sexual minorities. Journal of Homosexuality, 60(7), 1011–1034.
Riggle, E. D. B., & Rostosky, S. S. (2011). A positive view of LGBTQ: Embracing identity and cultivating well-being. Lanham, MD: Rowman & Littlefield Publishers.
Riggle, E. D. B., Whitman, L., Olson, A., Rostosky, S. S., & Strong, S. (2008). The positive aspects of being a lesbian or gay man. Professional Psychology: Research and Practice, 39(2), 210–217.
Roberts, T. S., Horne, S. G., & Hoyt, W. T. (2015). Between a gay and a straight place: Bisexual individuals’ experiences with monosexism. Journal of Bisexuality, 15(4), 554–569.
Ross, L. E., Bauer, G. R., MacLeod, M. A., Robinson, M., MacKay, J., & Dobinson, C. (2014). Mental health and substance use among bisexual youth and non-youth in Ontario, Canada. PLoS ONE, 9(8), e101604. https://doi.org/10.1371/journal.pone.0101604.
Ross, L. E., Dobinson, C., & Eady, A. (2010). Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health, 100(3), 496–502. https://doi.org/10.2105/AJPH.2008.156307.
Ross, L. E., Salway, T., Tarasoff, L. A., MacKay, J. M., Hawkins, B. W., & Fehr, C. P. (2017). Prevalence of depression and anxiety among bisexual people compared to gay, lesbian, and heterosexual individuals: A systematic review and meta-analysis. Journal of Sex Research. https://doi.org/10.1080/00224499.2017.1387755.
Rostosky, S. S., Black, W. W., Riggle, E. D. B., & Rosenkrantz, D. (2015). Positive aspects of being a heterosexual ally to lesbian, gay, bisexual and transgender (LGBT) people. American Journal of Orthopsychiatry, 85(4), 331–338. https://doi.org/10.1037/ort0000056.
Rostosky, S. S., Riggle, E. D. B., Pascale-Hague, D., & McCants, L. E. (2010). The positive aspects of bisexual self-identification. Psychology & Sexuality, 1(2), 131–144. https://doi.org/10.1080/19419899.2010.484595.
Rowe, M. (2008). Micro-affirmations and micro-inequities. Journal of the International Ombudsman Association, 1(1), 45–48.
Rust, P. C. R. (2003). Monogamy and polyamory: Relationship issues for bisexuals. In L. D. Garnets & D. C. Kimmel (Eds.), Psychological perspectives on lesbian, gay, and bisexual experiences (pp. 475–496). New York, NY: Columbia University Press.
Rust, P. C. R. (2009). No more lip service: How to really include bisexuals in research on sexuality. In W. Meezan & J. I. Martin (Eds.), Handbook of research with lesbian, gay, bisexual, and transgender populations (pp. 100–130). New York, NY: Taylor & Francis Press.
Shelton, K., & Delgado-Romero, E. A. (2011). Sexual orientation microaggressions: The experience of lesbian, gay, bisexual, and queer clients in psychotherapy. Journal of Counseling Psychology, 58(2), 210–221.
Steele, L. S., Ross, L. E., Dobinson, C., Veldhuizen, S., & Tinmouth, J. M. (2009). Women’s sexual orientation and health: Results from a Canadian population-based survey. Women’s Health, 49(5), 353–367. https://doi.org/10.1080/03630240903238685.
Steffens, M. C., & Wagner, C. (2004). Attitudes toward lesbians, gay men, bisexual women, and bisexual men in Germany. Journal of Sex Research, 41(2), 137–149.
Sue, D. W. (2010). Microaggressions in everyday life: Race, gender, and sexual orientation. Hoboken: Wiley.
Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A., Nadal, K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271–286.
Tjepkema, M. (2008). Health care use among gay, lesbian and bisexual Canadians. Health Reports, 19(1), 53–64. Retrieved from http://thebridgebrant.com/wp-content/uploads/2013/06/Health-care-among-LGBT-Canada-stats-Can.pdf.
Vaughan, M. D., & Rodriguez, E. M. (2014). LGBT strengths: Incorporating positive psychology into theory, research, training, and practice. Psychology of Sexual Orientation and Gender Diversity, 1(4), 325–334.
Yoshino, K. (2000). The epistemic contract of bisexual erasure. Stanford Law Review, 52(2), 353–461.
Yost, M. R., & Thomas, G. D. (2012). Gender and binegativity: Men’s and women’s attitudes toward male and female bisexuals. Archives of Sexual Behavior, 41(3), 691–702.
Funding
Funding was provided by Women’s College Hospital.
Author information
Authors and Affiliations
Corresponding author
Appendix: The Bisexual Microaggression and Microaffirmation Scales—For Women
Appendix: The Bisexual Microaggression and Microaffirmation Scales—For Women
Bisexual Microaggression Scale: For Women
Please think about the number of times you have experienced each situation in the last 6 months, related to your sexual identity. Select the response that best matches your experience.
0—Never
1—Once
2—A few times
3—About once a month
4—About once a week
5—Multiple times a week
6—Every day
7—This situation is not applicable to me.
1. Someone suggested my bisexual identity is a phase |
2. Someone told me I don’t belong in LGBT spaces |
3. Someone said they don’t understand bisexuals |
4. Someone dismissed my bisexuality as a fad |
5. Someone dismissed bisexuality as just a way to get attention |
6. Someone suggested I am confused about my bisexual identity |
7. Someone indicated bisexuals are untrustworthy |
8. Someone implied bisexuals are unreliable |
9. Someone showed mistrust toward me because I’m bisexual |
10. Someone suggested I would leave them for someone of another gender |
11. A romantic partner asked for details about my sexual behavior with people of other genders |
12. Someone was offended when I turned down their sexual advances |
13. Someone asked inappropriate questions about my bisexuality |
14. Someone asked me what genitals I like |
15. Someone asked me about my past sexual experiences when I told them I’m bi |
16. Someone asked whether I have had sex with a woman |
17. Someone asked whether I have had sex with a man |
18. Someone asked how many men I have had sex with |
19. Someone asked me to prove that I’m bi by discussing my sexual history |
20. Someone asked how I knew that I was bisexual |
21. Someone asked which gender I prefer the most |
22. Someone heterosexual seemed to assume I would hit on their romantic partner(s) |
23. Someone made sexual advances toward me when I told them I’m bi |
24. Someone asked if I wanted to have a threesome when I told them I’m bi |
25. Someone assumed that coming out as bi is a way of saying I’m open for anything sexually |
26. Someone indicated that bisexuals aren’t part of the LGBT community |
27. Someone made me feel ashamed to date men |
28. A bisexual character on a show was not labeled as bisexual |
29. Someone discussed an LGBTQ issue that erased bisexuality |
30. Someone defined bisexuality as reinforcing of gender binaries (i.e., the idea that there are only two genders) |
31. Someone gave me less support than they gave people of other sexual identities |
32. Someone who is gay or a lesbian was uncomfortable around me |
33. Bisexuality was excluded from an LGBTQ space or discussion |
34. Someone made me feel I had to be hyperaware of my bisexuality at an LGBTQ event |
35. Gay men or lesbians saw me as an ally more than as part of the community |
36. Someone assumed I cannot be bisexual because of my other identities |
37. I was pressured to constantly validate my other identities because I am bi |
38. Someone called my other identities into doubt because I’m bi |
Bisexual Microaffirmation Scale: For Women
Please think about the number of times you have experienced each situation in the last 6 months, related to your sexual identity. Select the response that best matches your experience.
0—Never
1—Once
2—A few times
3—About once a month
4—About once a week
5—Multiple times a week
6—Every day
7—This situation is not applicable to me.
1. Someone understood bisexuality easily |
2. Someone accepted my being bi without any questions |
3. Someone acknowledged my bisexuality without making a big deal about it |
4. Someone let me figure out my sexuality for myself without making assumptions |
5. Someone supported the relationships of other bisexual people |
6. Someone was attentive to discussions of bisexuality |
7. Someone did something to show their support of bisexuality |
8. Someone recognized biphobia as a serious issue |
9. Someone challenged biphobia when they saw it |
10. Someone acknowledged that being bi is not always easy |
11. Someone respected my opinions about bisexuality |
12. Someone asked sincere questions about bisexuality |
13. I commiserated with other bisexual people about biphobia |
14. Someone was happy for me regardless of the sex or gender of my partner(s) |
15. Someone provided emotional support |
16. Someone supported my relationships |
Rights and permissions
About this article
Cite this article
Flanders, C.E., LeBreton, M. & Robinson, M. Bisexual Women’s Experience of Microaggressions and Microaffirmations: A Community-Based, Mixed-Methods Scale Development Project. Arch Sex Behav 48, 143–158 (2019). https://doi.org/10.1007/s10508-017-1135-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-017-1135-x