Bisexuality, often stigmatized, typically has been lumped with homosexuality in previous public health research. But when Indiana University scientists recently focused on the health issues and behaviors specific to behaviorally bisexual men and women, they found tremendous variety, and that commonly used labels, such as heterosexual and homosexual, can sometimes do more harm than good.

Bisexual, gay, lesbian, queer, men who have sex with men (MSM), women who have sex with women (WSW) - these are just some of the terms commonly used to characterize sexual partnering and attraction in recent research. Behavioral science researchers have long known that socially constructed sexual identity “labels” (like “gay”) are often not always reflective of the diversity and complexity of an individual’s sexual behaviors. A study led by Vanessa Schick, assistant research scientist at the Center for Sexual Health Promotion at IU Bloomington, found that how women relate to their label could influence their health.

Schick’s study involved 2,578 women who reported a history of attraction or sexual encounters with women. The Web-based survey asked about mental, physical and sexual wellness. In the paper “Bidentity: Sexual Behavior/Identity Congruence and Women’s Sexual, Physical and Mental Well-Being,” Schick reports finding that the women who identified themselves as bisexual or lesbian reported the best health when their sexual identity matched their recent sexual history.

Schick, however, warned against interpreting this as evidence that women should declare a sexual identity that corresponds to their sexual behavior. Instead, she points to the experiences of women who labeled themselves as “queer,” a sexual identity that is sometimes endorsed by individuals who want to reject traditional labels that suggest the gender of their sexual partners.

“Unlike the other women in the study, the mental, physical and sexual well-being of queer-identified women was not related to the gender of their recent sexual partners,” she said. “This suggests that, instead of encouraging women to adopt labels that are more descriptive of their behavior, we should be more flexible in the behavioral expectations that we attach to these labels.”

For a variety of reasons, men and women often identify openly or just to themselves with a label that is different from their sexual history. One such reason is biphobia, the stigma and discrimination that bisexual individuals experience from both heterosexual and homosexual individuals.

Brian Dodge, associate professor in the School of Health, Physical Education and Recreation and associate director of the Center for Sexual Health Promotion, found in his study on sexual health among bisexual men that factors associated with biphobia contributed to feelings of isolation and social stress reported by many of his study participants. Dodge’s qualitative study, which is funded by the National Institutes of Health, is based on in-depth interviews with 75 bisexual men from the Indianapolis area, ages 19 to 70, equally divided among Latino participants, non-Latino black participants and non-Latino white participants.

“There have been large quantitative studies that examined the mental health status of men who have sex with both men and women,” Dodge said, “but no one has sat down and talked with these men about it. When we did, men were saying explicitly that being bisexual, not having a community to be involved with, not having people they could disclose to, homosexual or heterosexual, was tied to their experiences of adverse mental health.”

These are just some of the findings in the special issue of Journal of Bisexuality, published last week. Guest edited by Dodge and Schick, the special issue includes articles that stray from the more typical focus on sexual risk and sexually transmitted infections and covering topics including physical health and wellness, sexual health, and mental health among people whose identities or behaviors indicate bisexuality. Researchers contributing to the issue come from such institutions as Emory University, George Mason University, Columbia University, George Washington University and the IU School of Medicine.

“The issue gives a nice snapshot of how diverse bisexuality is among both men and women,” Dodge said.