How Mental Health Professionals Can Do Better for the Bi+ Community

Zori A. Paul, PhD, LPC, NCC

As a clinical mental health counselor, I learned early on that my clients are experts in their experiences. As a Black bisexual woman, I have also learned early on that for some clinicians, the client is only the expert of their experience when they are not bisexual. In those cases, the client is confused, going through a phase, or their sexual identity is viewed as not important for understanding their negative mental wellbeing.

From both professional and personal experiences, I have seen the prevalence of biphobia and its insidious impact both in and out of the mental health field. Despite the recent Gallup survey (Jones, 2025) showing once again that bisexual individuals make up over 50% of the lesbian, gay, and bisexual community, bisexual+ individuals still report high rates of depression, anxiety, disordered eating symptoms, isolation, substance abuse, and domestic violence compared to their heterosexual and even gay and lesbian counterparts. Our bi+ experiences are invalidated. Bi+ people are treated by both the larger LGBTQIA+ community as well as the heterosexual community as if we are indecisive, confused, unfaithful, and/or just looking for attention.

Though the societal stigma is harmful, as a bi+ counselor, it is even worse to hear clients share about their experiences with other mental health professionals, even those who also identify as being LGBTQIA+, who completely dismiss or misrepresent bisexuality and potentially cause further harm to our bi+ clients. Therefore, as your friendly neighborhood bi+ counselor and researcher, let me break it down for my fellow mental health professionals who want to improve their work with bi+ clients. 

Common Ways Mental Health Professionals Fail Bi+ Clients

As a counselor, I have seen the ways other mental health professionals, either intentionally or unintentionally, promote bi-erasure and biphobia through assumptions about clients, binary language, and clinical practices that invalidate bi+ identities. I have heard stories from clients, friends, and students about how colleagues in our field have dismissed bisexuality as a phase or failed to explore how biphobia and bi-erasure impact client mental health. In the last decade, there are still books published by known LGBTQIA+ individuals in the field who still define bisexuality as being attracted to both men and women. Though sometimes unintentional, these microaggressions often have lasting impacts on the clients we work with who dare to be vulnerable in what should have been a safe and affirming space.

Unfortunately, many bi+ clients sometimes leave therapy sessions feeling invalidated. For example, bi+ individuals may experience their sexual identity used to pathologize them in ways that their gay and lesbian counterparts do not experience. These and other biphobic experiences leave many bisexual+ folks with a bad taste in their mouths, resulting in early termination and potentially being less likely to seek mental health services in the future, even if they need it (DeLucia & Smith, 2021). As mental health professionals and as helping professionals, we need to make sure that we are multiculturally competent and aware of both personal and societal biases that may impact our bisexual+ clients.   

How Mental Health Professionals Can Improve

Wondering where to begin to be a bi+ affirming mental health professional? Here are a few starting points:

• Read research on bi+ populations (bonus points if they’re by bi+ researchers). The Journal of Bisexuality is one place to start. It’s essential to recognize that bi+ folks have unique experiences that their gay and lesbian counterparts do not have, especially when it comes to intersecting identities such as race, gender, disability, etc.
• Attend bi+ specific trainings and conferences such as the Los Angeles Bi+ Task Force’s B+ Well Conference, the virtual International Bisexuality+ Research Conference, the American Psychological Association’s Bisexual Issues Committee yearly symposium and many more.
• Follow bi+ advocates like Robyn Ochs, Dr. Mimi Hoang, Ross Victory, Dr. Tangela Roberts, Michael Leumus, Vaneet Mehta, Bailey Merlin, and Jace Rios Rivera of the “Bisexual Killjoy” podcast, Steve Spencer and Chad Barnier of the “Give it to Me Bi” podcast, and many, many more!
• Reflect on your internalized biphobia and the internalized biphobia within the mental health field. This could involve examining your own assumptions and beliefs about bisexuality, seeking out diverse perspectives, and engaging in open and honest conversations about bisexuality with colleagues and clients.
• Use open-ended questions when discussing identity and relationships. For example, if a client is interested in exploring their sexual identity, instead of asking if they are gay or lesbian, ask the client if they experience certain types of attraction like sexual, romantic, aesthetic, sensual, emotional, intellectual, etc. Also ask them who they typically experience those attractions towards. Even if the client seems to align with the definition of a bisexual+ identity, leave it up to the client and follow their lead in regard to whatever label, if any, that they want to use.
• Normalize discussions around the fluidity of sexual identities, attraction that goes beyond the binary, and diverse relationship structures. Remember, sexual identities, just as gender identities, are spectrums. There is no one-size-fits model for being LGBTQIA+, especially for bi+ folks.
• Advocate for bi+ inclusion regarding systemic change such as in policy and healthcare access. Also advocate for bi+ colleagues and clients in mental health professional organizations, clinical training, and supervision.

Final Takeaway: Our Duty to Affirm Bi+ Clients

Mental health professionals, whether you identify as part of the LGBTQIA+ community or not, we all have a duty to promote culturally competent and affirming care to the clients we work with. Just as we know there are vast areas of gray when it comes to counseling, it is important to remember that a person’s sexual identity cannot and should not merely be confined to binary options. Each client we work with is a complex individual with unique experiences. Therefore, all clinicians should work to challenge their own biases, create inclusive spaces, and validate bi+ folks’ lived experiences and the unique way they intersect with other identities. Bi+ clients deserve to be seen, heard, and supported fully, and it is our ethical responsibility as clinicians to ensure they receive affirming and affective care.        

Resources

• DeLucia, R., & Smith, N. G. (2021). The impact of provider biphobia and microaffirmations on bisexual individuals’ treatment-seeking intentions. Journal of Bisexuality, 21(2), 145-166. https://doi.org/10.1080/15299716.2021.1900020
• Jones, J.M. (2025, February 20). LGBTQ+ Identification in U.S. Rises to 9.3%. Gallup. https://news.gallup.com/poll/656708/lgbtq-identification-rises.aspx