By: Darren Bouwmeester, JD, MA (he/him)
As a bisexual man in his fifties, who has been partnered with a woman for over twenty-five years, coming out to my medical providers raised some questions for me.
What was the point of coming out to my healthcare provider?!
and…
Does it even matter?
To quote the iconic Saturday Night Live skit with the Reverend Jesse Jackson, maybe “The Question is Moot!” In my case, I was happily married to my partner, so what was really the point of coming out to my physician or even to my therapist?
Some of my reasons for not coming out to my medical providers were pragmatic. I hate answering questions about myself. I hate talking about my weight. I hate talking about sex with my doctor, much less talking about sexuality. I hate basically offering anything in the way of personal disclosure that might make me feel awkward or uncomfortable. It’s my flight response as my brain perceives “a danger” and I do everything possible to avoid that thing.
In this way, I’m not dissimilar from many men who likewise have difficulty talking about their feelings and mental health. According to 2019 NCHS statistics, only 13.4% of men and 24.7% of women received any mental health treatment and these numbers get worse as people get older.
If the numbers are bad for men, they are even worse for bisexual men, who have higher rates of substance use, mood and anxiety disorders, as well as higher rates of suicidality. Moreover, they have higher rates for asthma and hypertension. Despite these numbers, as few as 24% of bisexual men have come out to their healthcare providers. So, bi men aren’t coming out to their physicians, and statistics show that they experience worse health outcomes.
Something that has colored my approach to Bi+ Health Awareness is that I have worked in healthcare or healthcare adjacent fields for almost thirty years, from everything from radiology to risk management so I know how healthcare is supposed to work. I understand why it’s important that I share information with my primary care provider. I understand the physician patient relationship is a partnership that works best when the patient is invested in the process. I understand that providers should check their biases at the door and that patient confidentiality is sacrosanct.
Unfortunately, I also understand that in America, our healthcare system is broken. Many do not have access to affordable healthcare and sometimes providers are not adequately trained or bring their biases when caring with queer people, or even in talking about sex. I have had primary care providers who have proactively asked me about my sexual experience and I have had others who never mention my sexual health at all.
So, what got me off that proverbial bisexual fence and share about my sexuality with my healthcare provider?
There was the realization that even as a bi man partnered with a woman, that my bisexuality is relevant to my healthcare and to my mental health. There is a mental cost to minimizing and burying your identity under a rock. I think the disproportionate anxiety, depression, and higher rates of suicidality for bi men tell us that much. I may not want to share my sexuality with everyone in the world, or even everyone in my social circle, but at the minimum I saw the value of sharing my identity with my healthcare providers. In my case, the first step was to update my information on my patient portal and to talk about being bisexual with my therapist. My next step was to tell my primary care provider at my annual physical that I am bisexual.
As someone who is bi and who works at a hospital, I believe it’s important that we advocate for our own healthcare. It is essential that we as patients share information with our providers and that we ask questions. Although it can be difficult to transfer one’s care to a new provider or to even find a new primary care physician, if we don’t feel comfortable with our physician or we feel like our medical concerns are being minimized or ignored altogether, then we may wish to consider transferring our care to someone else who is more affirming. Delivering successful care of all kinds means “intentionally creating safe spaces for all patients.” As patients, we should demand nothing less. We need to expect more from our healthcare and if a provider seems insensitive or judgmental, we shouldn’t be satisfied with that level of care.
On one of my favorite bisexual podcasts, Bisexual Killjoy, one of the hosts mentioned that “If you feel safe to come out, then come out.” This ultimately gave me the final push I needed to come out as bisexual to my healthcare providers. I assessed my situation and realized that I was in a relatively safe and privileged position and could come out with minimal risk to myself. In the worst case scenario, I would come out to my physician and whatever happened in this interaction would remain confidential.
Lastly, coming out to my healthcare provider was not just about me advocating for my own health, but it was also a form of activism. I allowed myself to take up space and be counted, so when my healthcare providers run metrics on sexual identity they will see that there is one more bisexual there. Sharing my identity with my physician and my therapist was about breaking the cycle of silence.
“I am bi, and I am here.”
I stand in the queue to be counted because I know that some of my fellow bisexuals may still not feel safe enough to come out to their healthcare providers. Moreover, maybe my coming out will cause my primary care provider to check themselves and their own assumptions and biases. They will say to themselves, “Wow, I would have never clocked that older guy as bi!”
This is why it matters.
Learn more about Bi+ Health Awareness Month at bihealthmonth.org.