Federal data sources designed to provide U.S. population estimates rarely include direct questions regarding , but in 2013, for the first time, the National Health Interview Survey (NHIS), which the government uses annually to assess Americans’ health related behaviors, asked about self-identified sexual orientation.[1] Based on responses, the NHIS estimates that 0.7% American adults identify as bisexual.[2] A well-received study by Gates (2011) combined data from five U.S. population surveys to produce estimates of the size of the LGBT community. Gates concludes bisexuals comprise 1.4% of the adult male and 2.2% of the adult female U.S. population. [3]

Previous postings in this blog described “straight men who have sex with other men” (SMSM), a population of males who avoid involvement with the LGBT community, who are often married or romantically involved with an opposite-sex partner, who engage in sex with males or express the desire to do so, and, most relevant to this posting, do not identify as gay or bisexual. Other men, in contrast, identify as bisexual even if they do not engage in same-sex sexual activity. Until recently studies typically included just one dimension of sexual orientation - , behavior, and self-identification - but it is increasingly clear that sexual behavior does not necessarily correlate with sexual and attraction. McCabe and colleagues have repeatedly called for studies to include all dimensions of .[4]

Bisexuality is defined as “the capacity for emotional, romantic, and/or physical attraction to more than one sex or . That capacity for attraction may or may not manifest itself in terms of sexual interaction.”[5] The National Gay and Lesbian Task Force reminds health-care providers that “A bisexual orientation speaks to the potential, but not the requirement, for involvement with more than one gender. This involvement may be sexual, emotional, in reality and/or in fantasy. Some bisexuals may be monogamous, some may have concurrent partners, others may relate to different sexes/genders at various periods of time and others still maybe celibate.”[6] In the word of Robyn Ochs, a candid bi-activist, “I have the potential to be attracted – romantically and/or sexually – to people of more than one sex and/or gender, not necessarily at the same time, not necessarily in the same way, and not necessarily to the same degree” (pg. 21).[7]

Traditionally, sexual orientation has been viewed as a dichotomy, with the options being either heterosexuality or homosexuality. Those who did not fit into these two groups were ignored, elided, and rarely taken into consideration. During the middle of the 20th century Alfred Kinsey and his colleagues enlightened the fields of psychology and sexology when they proposed that sexuality occurs along a continuum and that the orientation of an inestimable number of people sits somewhere between the two poles. During the 1970s, Fritz Klein elaborated on Kinsey’s work and developed his eponymous Klein Grid, a method for describing a person’s sexual orientation in a much more detailed and nuanced manner. The Klein Grid investigates sexual orientation in the past, the present, and in the idealized future (i.e., a prediction as to what one thinks he or she will like in the future) with respect to each of seven factors consisting of sexual attraction, sexual behavior, , emotional preference, social preference, heterosexual/homosexual lifestyle, and self-identification.[8]

Researchers traditionally relied on self-reporting to study bisexuality, but they have recently introduced technological advances into the field, including measurements of physiological response (including genital arousal) and eye-tracking studies. A recent article in Contemporary Sexuality reviewed these studies and concluded, “With the spate of recent studies either published, in press or under review, the scientific evidence is beginning to accumulate: Men, as well as women, can be attracted to both sexes.” [9]

The next several posts in this blog will discuss the experiences of bisexually identified men, and, as will become obvious, their experiences are very different than SMSM, a population that steadfastly denies they are anything but heterosexual.

[1] Somashekhar, Sandhya, “Health Survey Gives Government Its First Large-Scale Data on Gay, Bisexual Population.” Washington Post, July 15, 2014. Accessed October 6, 2015. http://www.washingtonpost.com/national/health-science/health-survey-give...

[2] Ward, Brian W., James M. Dahlhamer, Adena M. Galinsky, and Sarah S. Joestl. “Sexual Orientation and Health Among U.S. Adults: National Health Interview Survey, 2013.” National Health Statistic Reports 77 (2014).

[3] Gates, Gary J., How Many People are Lesbian, Gay, Bisexual, and ? (Los Angeles: Williams Institute, 2011).

[4] McCabe, Sean Esteban, Tonda L. Hughes, Wendy Bostwick, and Carol J. Boyd. "Assessment of difference in dimensions of sexual orientation: Implications for substance use research in a college-age population." Journal of Studies on 66, no. 5 (2005): 620-629.

[5] Miller, Marsha, Amy André, Julie Ebin, & Leona Bessonova. Bisexual Health: An Introduction and Model Practices for HIV/STI Prevention Programming (Washington, DC: National Gay and Lesbian Task Force Policy Institute, the Fenway Institute at Fenway Community Health, and BiNet USA, 2005): 2.

[6] Ibid, 12.

[7] “Being Bisexual,” Equality (Late Fall 2013): 21-23.

[8] American Institute of Bisexuality. “The Klein Sexual Orientation Grid.” Accessed October 12, 2015. http://www.americaninstituteofbisexuality.org/thekleingrid/

[9] White, Jacqueline “The Bisexual Man,” Contemporary Sexuality 46, no. 5 (2012): 1-5.