Motivations for Sexual Identity Concealment and Their Associations with Mental Health among Bisexual, Pansexual, Queer, and Fluid (Bi+) Individuals

Abstract

Bisexual and other non-monosexual (bi+) people are at increased risk for depression and anxiety compared to both heterosexual and gay/lesbian people. Bi + people are also more likely to conceal their sexual orientation than gay/lesbian people are, and concealment is generally associated with negative mental health outcomes. Despite evidence that concealment is a particularly salient stressor for bi+ people, there has been a lack of attention to their motivations for concealment. As such, the goal of the current study was to examine the associations among concealment, motivations for concealment, and depression and generalized anxiety symptoms in a sample of 715 bi+ people who completed an online survey. Nearly half of participants endorsed purposely trying to conceal their bi+ identity in their day-to-day life, and concealment was significantly associated with higher levels of depression and generalized anxiety. Using exploratory factor analysis, we identified two motivations for concealment: intrapersonal motivations (e.g., one’s bi+ identity not being a central part of one’s overall identity, not being comfortable with being bi+) and interpersonal motivations (e.g., concern about being judged or treated negatively, concern about putting oneself at risk of physical harm). Interpersonal motivations were significantly associated with higher levels of depression and generalized anxiety, whereas intrapersonal motivations were not. In sum, while concealment may generally be associated with negative mental health outcomes, this may only be the case for those who conceal out of concern for discrimination and victimization. These findings highlight the importance of examining bi+ people’s motivations for concealing their sexual orientation in order to understand the extent to which they experience negative mental health outcomes.

Keywords:

• Bisexual
• pansexual
• queer
• non-monosexual
• concealment
• depression
• anxiety

Additional information

Funding

This research was supported by grants from the American Psychological Foundation and the Sexualities Project at Northwestern. Brian Feinstein’s time was supported by a grant from the National Institute on Drug Abuse (K08DA045575). Christina Dyar’s time was also supported by a grant from the National Institute on Drug Abuse (K01DA046716). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Notes on contributors

Brian A. Feinstein

Dr. Brian Feinstein received his PhD in Clinical Psychology from Stony Brook University in 2015. He is currently a Research Assistant Professor at the Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH) at Northwestern University. His program of research focuses on understanding and reducing the health disparities affecting sexual and gender minority (SGM) populations, especially bisexual and other non-monosexual individuals. He is interested in understanding how different types of stress (e.g., discrimination, internalized stigma, rejection sensitivity) influence mental health, substance use, sexual risk behavior, and relationship functioning among SGM individuals and couples. He is also interested in developing and testing interventions to improve health and relationships in these populations. Dr. Feinstein is also a licensed clinical psychologist in the state of Illinois.

Casey D. Xavier Hall

Dr. Casey Xavier Hall is a postdoctoral research fellow at the Institute for Sexual and Gender Minority Health and Wellbeing at Northwestern University. He received his Ph.D. in Behavioral Sciences and Health Education and his MPH in Global Health from the Rollins School of Public Health at Emory University. His research focuses on social influences on sexual health, violence, and substance use disparities.

Christina Dyar

Dr. Christina Dyar received her PhD in Social and Health Psychology from Stony Brook University in 2016. She is currently a research assistant professor at the Institute for Sexual and Gender Minority Health and Wellbeing. Her research broadly focuses on understanding and reducing health disparities affecting sexual and gender minority populations, especially sexual minority women and bisexual individuals. She is particularly interested in understanding mechanisms through which minority stressors (e.g., discrimination, internalized stigma) impact mental health and substance use and how these processes differ for bisexual compared to lesbian/gay individuals and among other subgroups of sexual and gender minorities.

Joanne Davila

Dr. Joanne Davila is a Professor of Psychology at Stony Brook University. She received her PhD in Psychology from UCLA. Dr. Davila’s expertise is in the area of romantic relationships and mental health in adolescents and adults of all sexual orientations and genders, and she has published widely in these areas. Her current research focuses on romantic competence among youth and emerging adults, the development of relationship education programs, and well-being and relationship functioning among lesbian, gay, and bisexual + individuals. Dr. Davila also is a licensed clinical psychologist who specializes in evidence-based interventions for relationship problems, depression, and anxiety.