What health issues are bi+ patients more likely to present with?

Research consistently finds that bi+ people experience higher rates of psychological distress, sexual violence, and harmful drug use than both heterosexual and gay or lesbian populations. This intersecting burden is partly attributed to minority stress — the chronic stress of navigating identity-based stigma and invisibility — and to the specific experience of being marginalised within both heterosexual and LGBTIQ+ communities. In general practice, this means bi+ patients may be presenting with anxiety, depression, or trauma without the context that makes sense of the clinical picture. Asking open questions about relationships, safety, and support structures — in a non-assumptive way — creates space for relevant history to emerge.

How can a general practice be more inclusive for bi+ patients?

Practical starting points include: updating intake forms to include relationship structure and partner gender as separate questions rather than defaulting to binary options; training reception staff to use inclusive language; ensuring clinical staff have completed LGBTQIA+ health training (RACGP offers funded modules); and implementing routine, sensitive safety inquiries for all patients rather than only those who disclose a relationship type. Longer consultations are often clinically necessary for complex psychosocial presentations — the RACGP has called for higher Medicare rebates to support this. The Kirby Institute's research team and ACON can provide implementation resources.

Bi+ Australians in general practice: new data, persistent gaps

What just happened

A new study from the Kirby Institute at UNSW Sydney, led by Associate Professor Benjamin Bavinton, has surveyed 2,100 bi+ Australians about their health service experiences and health outcomes. The findings, reported by RACGP newsGP on 26 June 2026, reveal a health system that is technically accessible to bi+ patients but clinically underprepared for them.

The engagement figures are striking: 72 per cent of participants have a regular GP, 82 per cent accessed general practice services during the survey period, and 89 per cent had accessed sexual health services at least once. This is not a population avoiding healthcare. It is a population that is highly engaged with health services and finding them inadequate for their specific needs.

The health burden documented is significant. Among the 2,100 participants: 63 per cent reported experiencing adult sexual violence, 28 per cent reported current psychological distress, and 24 per cent reported recent illicit drug use. These rates are substantially elevated compared with both the general population and, in many studies, compared with gay and lesbian populations. The term “bi+ erasure” — the systematic invisibility of bisexual identity in both heterosexual and LGBTIQ+ community spaces — has a measurable clinical cost.

The service satisfaction data is equally revealing. Only 47 per cent of participants felt welcome in LGBTIQ+ specific sexual health services. Just 41 per cent felt that general sexual health services were knowledgeable about bi+ health needs. These figures mean that even in settings explicitly designed to serve LGBTIQ+ patients, more than half of bi+ patients do not feel truly seen.

The both-and

Why this is a general practice issue, not a specialist referral

The instinct when reading data about LGBTIQ+ health inequity is often to reach for the specialist referral — to a sexual health clinic, an LGBTIQ+ specific service, or a psychologist with relevant experience. That instinct is understandable and sometimes appropriate. But it misreads what this data is saying.

Bi+ patients are already in general practice at high rates. They are already having consultations with GPs. The problem is not access — it is what happens once they are there. RACGP Chair of Sexual Health Medicine Dr Sara Whitburn is direct: “Inclusive practice isn’t a checkbox; it’s an ongoing process of learning, reflecting, and adapting.” The structural issue is that most GPs have not been prepared — through medical education, vocational training, or continuing professional development — to understand the specific health risks that bi+ patients carry, or to create consultation environments where those risks can be named.

The minority stress framework and why it matters clinically

The health disparities documented in this study are not random. They are patterned in a way that minority stress theory explains clearly. Bi+ people experience a dual layer of stigma: stigma from heterosexual communities (visibility of same-gender attraction), and stigma from gay and lesbian communities (validity challenges, assumptions of “fence-sitting” or transition status). That chronic dual stigma activates biological stress pathways — elevated cortisol, disrupted immune function, disrupted sleep — that compound over years into measurable health risk.

Clinically, this means that a bi+ patient presenting with treatment-resistant depression, anxiety that seems disproportionate to life circumstances, or recurrent somatic presentations may be experiencing the downstream effects of years of identity-related minority stress. Understanding that context does not require a long conversation — it requires knowing it exists, and asking the right open questions.

The 63 per cent rate of adult sexual violence among participants is particularly important. Sexual violence has a long-established relationship with chronic health conditions — persistent pain, somatic presentations, disordered eating, substance use, and complex post-traumatic stress. A GP who does not know that a patient has experienced sexual violence cannot provide care that is appropriately trauma-informed. Routine, normalised safety inquiries — asked of all patients, not only those who appear to be in crisis — create the conditions for that history to emerge.

What RACGP is recommending

The RACGP is calling for four specific practice-level changes in response to this data: updating intake forms to recognise fluid partner genders; implementing routine, sensitive safety inquiries during consultations; accessing funded LGBTQIA+ health training; and securing higher Medicare rebates for the longer consultations that complex psychosocial presentations typically require.

The ACON — the NSW peak organisation for LGBTQ+ health and wellbeing — also offers resources and training for general practices that want to improve their capacity for inclusive care. Most of these do not require significant infrastructure investment. They require commitment to ongoing learning, and the willingness to update practices that have been shaped by an assumption of heterosexual default.

2 cents

The finding that fewer than half of bi+ patients feel welcome in LGBTIQ+ specific sexual health services is the number that sits with me in this data. These are patients who sought out services explicitly designed for their community and still felt unseen.

That is not a technology problem. It is not a resource problem. It is a culture problem — the culture of clinics, waiting rooms, intake forms, and the assumptions embedded in how clinicians ask questions.

General practice has both the reach and the therapeutic relationship to do this differently. Most people in this country see a GP at some point. The consultation is a setting with genuine potential for trust, disclosure, and appropriate care — if the environment signals that all of a patient’s identity is welcome, not just the parts that match the assumed template.

Verdict: yes — worth knowing about.

Sources cited

RACGP newsGP — Inclusive practice ‘isn’t a checkbox’. 26 June 2026. https://www1.racgp.org.au/newsgp/clinical/inclusive-practice-isn-t-a-checkbox
Kirby Institute, UNSW Sydney — Research and publications. https://kirby.unsw.edu.au
ACON — LGBTQ+ health and wellbeing resources. https://www.acon.org.au