Navigating healthcare is tricky for young people. For young, bisexual people, it’s even trickier. According to a study from Williams Institute, bisexual people are more likely than both gay men and lesbians to opt not to disclose their orientation to health care providers. Without disclosure though, providers don’t know what your specific needs are and it’s hard to get those needs met. Biphobia, and all of the stigmas that accompany it have an impact on how comfortable bi people are with their healthcare providers, which in turn dictates health outcomes for bi people. I spoke with a number of bisexual people about their experiences navigating the healthcare system. Bi people are a diverse group contending with: mental health and disability, substance abuse, access to healthcare due to poverty, and of course, getting good care when it comes to sexual health.

We asked a few people who identify as bisexual to talk to us about their healthcare experiences. Here are a few of the realities bi people experience.

Disability is a barrier before you even get in the door:

“Being both trans and disabled I already had difficulty finding gynecological care. I had a serious problem with my uterus, and getting care for it took years. Doctors offices aren't exactly accessible, so sometimes you have to choose between which doctors are the friendliest to bi and trans people, and which offices are wheelchair accessible. We shouldn't have to weigh being accepted vs. access. Access usually wins because you can't get care if you can't get into an office. We shouldn't have to be anxious and nervous about going to a doctor, but for many of us, that is a reality.” — Dominick Evans

Assumed heterosexuality erases bi people:

“Before I came out as trans (I am a trans man who was designated female at birth), I had a doctor assume my partner, at the time, was male, and that led to unnecessary testing that cost money. My doctor decided, without asking me the gender identity of my partner at the time, to give me a pregnancy test. He automatically assumed my partner was male. If doctors figure out I have an active sex life, their first instinct is my partnership is heteronormative.” — Dominick Evans

Assumed homosexuality also erases bi people:

“I have had OB/GYNs give me completely inaccurate information based on who they assume I am sleeping with. My first visits to the OB/GYN were with a nurse practitioner who told me, ‘Honey, lesbians are god's chosen people. They don't get STDs.’ She initially refused to do a chlamydia test which is pretty routine when you get a pap smear.” — Ariel Boone

Bisexual doesn’t mean promiscuous:

“I was constantly being cautioned about promiscuity, despite having had the same two partners for the last five years. I am hoping to find a provider who is less likely to pathologize my sex life. I was constantly being given redundant STI tests. Like every time. I was paying so much to learn that I still don't have syphilis and it's like, yeah I know because me and my girl and me and my boy only have sex with each other and use barriers. And also raised eyebrows, so many raised eyebrows! I need you to figure out if my thyroid works. I don't need your silent passive aggression about my actually very stable and safe sex life.” — Moira Cohen

Choosing not to come out to providers is easier for some people:

“I usually just generalize to a doctor based on the gender of who I'm seeing at the time and when I started sleeping with women I told my gyno and asked if I needed to know anything else and he said, ‘no it's basically the same.’” — Lena Solow

"I feel unable to [come out] for a variety of reasons. I feel that I'm going to be immediately judged by healthcare providers, especially if I cannot gauge their [level of] conservatism. Talking about sexuality in general is discouraged. I feel like speaking about it encourages this stereotypes about bi women in particular: that we're very sexually active or more so than our straight counterparts. I feel bringing it up would be a hassle. I'm usually hesitant about bringing it up because I'm not sure how [providers] would respond to it.” — Anonymous

Related: Chance the Rapper's Little Brother Came Out As Bisexual