Bisexuality is sometimes looked on with confusion from both the heterosexual and homosexual communities. Researchers from Indiana University conducted a series of studies recently to explore how the stigma and stereotypes of behaviorally bisexual individuals stands up to reality, and how these men and women are actually living out their sexual lives.

Through a web-based survey, Vanessa Schickassistant research scientist at the Center for Sexual Health Promotion at IU Bloomingtonsaid that her team was able to reach 4,000 women respondents. Using that data set, the researchers were able to examine several questions about behaviorally bisexual women. Schick said the core question she set out to answer was "What sort of diversity exists in the sexual repertoire between women?"

Schick said the findings could help medical practitioners and clinicians in talking with and treating patients.

"I want, ideally, medical practitioners and clinicians to consider the diversity in their sexual repertoires when asking women whether they've engaged in sexual behavior with other women," she said. "Oftentimes there's this assumption that women don't need to be asked about whether they're engaging in sexual behavior with other women.

"There's an assumption that that behavior would not necessarily put women at an increased risk for any sexual health outcomes, but what we found is that there is a wider diversity in sexual behaviors that could perhaps, we don't know, may put women at an increased risk."

Schick suggested that medical professionals should consider being more specific in the questions that they ask patients. Rather than asking one general question about whether a woman has engaged in sex with another woman, a doctor might ask a series of questions targeting specific sexual behaviors.

In addition to sexual activities that women engage in with other women, Schick also studied the labels that women use to identify themselves. According to study results, "Women who identified themselves as bisexual or lesbian reported the best health when their sexual identity matched their recent sexual history."

However, Schick warned against jumping to conclusions about the importance of labeling sexual identity. "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."

Another researcher, Brian Dodgeassociate professor in the School of Health, Physical Education and Recreation and associate director of the Center for Sexual Health Promotionconducted a qualitative study of 75 behaviorally bisexual men that also explored multiple questions.

"Behaviorally bisexual men, there are lot of people who would say they don't exist, first of all," Dodge said. "But they're not usually studied separately or distinctly in terms of their sexual behaviors. Usually, when they are it's based on a one-question item that says 'did you have sex with a woman and did you have sex with a man.' What we were interested in was what were their diverse behaviors. We asked about very specific behaviors with male, female and transgender partners. ... We really wanted to get a sense of what behaviors they were engaging in."

One of Dodge's most surprising findings was the isolation that many bisexual men feel.

"I was really surprised to find, among some of the guys, how they weren't open at all about their sexuality," he said. "For a lot of them, it had been the first time they'd ever talked to someone about engaging in sexual behavior with both men and women. There was a lot of stigma, even shame from both gay and straight friends and family members about bisexuality that was above and beyond just typical stigma. For some of them it really did seem like they were clearly linking that with having mental health issues, like feeling depressed or anxious or not comfortable with their sexuality because they felt like they were sort of the only ones. So in terms of the needs for actually doing this type of research, it was really validated."

Dodge would like to see the results of his studies with behaviorally bisexual men lead to more effective health programming for men and their sexual partners.

"Because the content of most current sexual health programs for gay and bisexual men focus only on their behaviors and experiences with male partners, interventions are urgently needed that are specifically tailored to the wide range of sexual behaviors and experiences which bisexual men share with both male and female partners," Dodge said.

Results from Schick and Dodge's series of studies can be found in a special issue of Journal of Bisexuality that the pair guest-edited.