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Validate the bisexual client

November 06, 2015

I can understand people being gay, but I just can't wrap my head around people being bisexual. To me that's a sign of deep confusion. Not knowing who you are. Not being able to make up your mind. Maybe just wanting the attention.”

I sat there with a lump in my throat, shocked and unsafe, after hearing a respected member of my local recovery community share these beliefs about bisexuality. Having previously viewed this individual as progressive and compassionate with the women she sponsored, I didn’t really know how to respond. At the time, I self-identified as bisexual but was not out to many people. Hearing a statement like this from someone whom I saw as liberal heightened my apprehension about going fully public.

Her commentary, as I’ve since discovered, is indicative of how many addiction professionals view the bisexual client presenting for services. Such biased statements about bisexual individuals are not exclusive to straight commentators. Some of the most hurtful statements I’ve heard or read about bisexuals come from individuals who are gay or lesbian.

I do not strive to provide you with a long list of treatment statistics in this article. Rather, I seek to present the concept of biphobia as a universal phenomenon. I explain how its manifestation in addiction services can form an emotional barrier for the bisexual client seeking treatment. Finally, I offer some solutions for fostering greater validation for the bisexual client as part of a trauma-informed, proactive recovery culture.

Understanding biphobia

The term “biphobia,” typically defined as fear of bisexuality, is becoming more commonly used in popular media. I see biphobia as more than just a fear issue. Biphobic expressions typically originate from a toxic blend of fear, lack of understanding about bisexuality, and unchecked personal biases about sexuality.

In my own graduate education at both the master's and doctoral level, I “learned” two very erroneous notions about bisexuality. The first is that bisexuality is usually some type of middle step that people must take in the process of coming out fully as gay or lesbian. The second is that to truly identify as bisexual you must have been able to sustain a long-term relationship (a year or more) with people of both binary genders. As part of my own personal work and coming out, I’ve thankfully discovered that the true experts vehemently refute both notions.

Bisexual activist Robyn Ochs expresses that “I call myself bisexual because I acknowledge that I have in myself 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.”1 Even the American Psychological Association recognizes the continuum nature of sexuality and validates that the stigma experienced by bisexuals can yield significant stress responses.2

According to, the public outreach project of the American Institute of Bisexuality founded by Dr. Fritz Klein:

“A bi person has the capacity for romantic and/or sexual attraction to more than one gender. For most people, that simply means that you can be attracted to both men and women. If you honestly feel you meet that criteria, then you are bisexual. As a bi person, you do not have to feel the same kind or intensity of attraction to all genders. As a bi person, there is nothing for you to prove, nothing to consummate, no requirement to 'maintain' your bisexuality. Understanding and acknowledging your own sexuality is a personal process and is about living with integrity and being true to yourself.”3

This simple paragraph beautifully encapsulates the teachings of Klein, creator of the Klein Sexual Orientation Grid and author of The Bisexual Option (1978, 1993), the first major book on bisexuality. Yet why do so many addiction and mental health professionals still find themselves flummoxed by this description? Yes, there is the misinformation and poor education variable, as evidenced by my graduate school experiences. However, the most striking answer comes from Klein himself. In The Bisexual Option he provides salient insight into the “threat” that bisexuality poses to a society that is obsessed with neat, clean labels:

“No matter what sexual orientation a person has, he or she lives on a continuum. Despite the certainty of eventual death, the life of an individual goes on until that time. During the course of a lifetime each individual plays a number of roles: father, mother, soldier, teacher, heterosexual, homosexual, and so on. We take comfort in the labels; they help define our relationship with one another and with the world at large. Yet with each label we acquire, we limit our infinite possibilities, our uniqueness. It is our insistence on labels that creates the “either-or” syndrome.”4

Think about it. Most mainstream treatment cultures rely on labeling. Some, I would argue, are even obsessed with it. Making sure that clients are described by manualized, precise diagnostic categories is a form of labeling. Adopting pre-defined treatment curricula for our programs and requiring our clients to respond to the curriculum (instead of modifying curricula to respond to the needs of individual clients) is a form of labeling. When a recovery culture, especially formal treatment, relies on people fitting into neat boxes, I contend that a bisexual-identified client will have a more difficult time being validated by those who are there to help them.

Bisexual writer and advocate Neil Endicott posits that biphobia pushes many bisexuals further into the closet to avoid ridicule and rejection, affecting our well-being and sense of identity. He writes, “It makes it harder for us to develop confidence and be assertive about who we are.”5 If treatment is ideally designed to get clients to open up about their experience and come out of shadows cast by shame, imagine how such invalidating comments about one’s sexual identity can be received.

Clinical considerations

As a clinical treatment provider, I echo the sentiments of my colleague and friend Jeff Zacharias, MSW, LCSW, owner and clinical director of New Hope Recovery, a treatment program in Chicago that is focused on services for the LGBT community. Says Zacharias, “For treatment professionals, I think it’s important to listen to what our clients are telling us and not just hear the words. Bisexuality exists and always has. Let’s support our clients in their exploration of what it means to be bisexual and have multiple attractions to people regardless of the binary way of thinking that pervades our field.”

Persons presenting for addiction treatment are likely to be carrying a great degree of shame connected to their narrative of behaviors that led them to seek help. Think of how comments such as “You’re just saying you’re bi for attention,” “It’s just a phase,” “You’re confused,” “You’re just not ready to come out as gay yet,” or “You must really be promiscuous if you’ll act out with anyone” can add fuel to the already destructive fire of shame. Treatment and all recovery cultures (e.g., meetings, support groups) must be places where people can be celebrated for who they are, not questioned.

When a person’s very identity gets challenged with some of the statements I mention in this article, it can automatically shut down a bisexual client and make the person feel unsafe in your presence and in your treatment community. A wall is then created that can keep the client from receiving the help that you have to offer. Yes, we often challenge behaviors as part of our treatment. Yet we must be mindful of where such challenges cross the line into hateful comments reflecting our own biases and misunderstandings.

The simple answer here is that we as addiction treatment professionals must further educate ourselves. As a contributor to my 2014 book Trauma Made Simple: Competencies in Assessment, Treatment, and Working with Survivors expressed, “Don’t retraumatize someone because of your own ignorance.” Education is the critical first step in helping ourselves evaluate where our approaches have traditionally been shaming instead of validating. To quote a former client of mine, “People fear what they do not understand.”

It’s been my experience that so many of my colleagues working in the treatment field are not intentionally being harmful; rather, they are mystified by bisexuality and are not confident in how to best support bisexual clients. A solution is to listen to some stories of people who are willing to share them, with an open mind and an open heart. My experience is that I have long embraced the definition of bisexuality that Robin Ochs offers us and it has made a great deal of sense to me as I’ve worked to embrace the fullness of my story as a woman in recovery. Yet as a female bisexual I still hear many of the biased, hateful comments about bisexuality as an identifier used for “attention,” and when I hear other clinicians make such comments I do not feel safe in their presence. So why would clients who are emotionally raw and seeking help feel safe either?

I’ve shared with you some of my experiences, and I also encourage you to seek out other voices, especially from male bisexuals. As Jeff Zacharias notes, bisexual men are vulnerable to a great deal of prejudice and spiteful commenting, often from gay men, about not being brave enough to just admit that they are gay and come out of the closet fully. For bisexuals across the gender spectrum, the hardest journey can be coming out to your friends and community as bisexual when you’ve initially come out as gay or lesbian. There are a plethora of stories to be told, and we can learn from these varied experiences.

Many of the resources that I provide at the end of this article offer the perspectives of people who identify as bisexual. Give these talks a listen and these articles a read to learn more about the bisexual experience. This step alone may prove invaluable in your own development as a trauma-informed, culturally responsive clinical professional.

Taking this a step further, we must recognize the deepest education can be found not just in reading one article or listening to one TED Talk. Rather, we must notice what resonates or gets triggered for us in exploring these resources. As you explore them, notice what comes up for you and regard this information as valuable to your development. If you are ready to take this next, more personal step in your education, seek out constructive dialogue with your own recovery, therapeutic or other support network. If it feels safe for you (depending on your setting), your clinical supervisor may even be a good source of contact as you do some work around addressing your own biases.

Jamie Marich, PhD, LPCC-S, LICDC-CS, RMT, is a licensed clinical counselor and chemical dependency counselor in Ohio, and the creator of the “Dancing Mindfulness” practice. She is the author of Trauma Made Simple: Competencies in Assessment, Treatment and Working with Survivors and Trauma and the Twelve Steps: A Complete Guide to Enhancing Recovery. Her e-mail address is


1. Eisner S. Bi: Notes for a Bisexual Revolution. Berkeley, Calif.: Seal Press; 2013.

2. Glassgold JM (ed.) Appropriate Therapeutic Responses to Sexual Orientation. Washington, D.C.: American Psychological Association; 2009.

3. Am I Bi? Retrieved from on Sept. 2, 2015.

4. Klein F. The Bisexual Option (2nd edition). New York City: Routledge; 1993.

5. Endicott N. Biphobia is a destructive force in our community—And it needs to stop. Retrieved from on Sept. 2, 2015.

Resources on bisexuality

TEDx Talks:

  • Bisexuality and Beyond. By Tania Israel (TEDx UCLA), 2015.

  • Bi the Way, We Exist. By Viet Vu (TEDx Terry), 2015.


Free PDF Resource Download:

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