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The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding
showed that the bisexual adults reported higher levels of identity confusion (uncertainty about one’s sexual orientation) and lower levels of self-disclosure and community connectedness than the lesbian and gay adults (Balsam and Mohr, 2007). Another, smaller study (n = 43) using qualitative methods to explore minority stress among bisexual men and women, gay men, and lesbians showed that the bisexual men and women felt that both heterosexual and homosexual individuals can have biased opinions of bisexual people. Bisexual participants felt that some members of the gay and lesbian community perceived bisexuality as an inauthentic identity and viewed bisexuals as promiscuous (Hequembourg and Brallier, 2009). Bisexual participants reported feeling invisible and indicated that they lacked comfortable social spaces catering to bisexual people. Bisexual participants also reported concealing their bisexual identity to blend in better in gay/ lesbian or heterosexual social spaces (Hequembourg and Brallier, 2009).
Research with convenience samples of transgender people in various communities across the United States highlights a high prevalence of enacted stigma and discrimination based on gender identity. In a study of 402 transgender people, 56 percent reported verbal harassment, 37 percent employment discrimination, and 19 percent physical violence (see below) (Lombardi et al., 2001). Among a sample of 248 transgender people of color in Washington, DC, 43 percent reported having been a victim of violence or crime and 13 percent of sexual abuse; 43 percent attributed this victimization to homophobia and 35 percent to transphobia (Xavier et al., 2005).
The extent to which transgender individuals are accepted within the LGB community has not been adequately studied. Qualitative data from a convenience sample of transsexual men with a gay or bisexual identity revealed mixed acceptance (Bockting et al., 2009a). Among a convenience sample of lesbian and feminist women, attitudes toward transsexuals were generally positive, particularly for those who knew a transgender person personally (Kendal et al., 1997).
Sexual minorities are at particular risk for hate or bias crimes based on their minority status; they may also be at risk for intimate partner violence. While the vast majority of studies focus on male victims, females in gay populations also frequently experience antigay violence. Convenience samples have revealed a high level of violence against transgender people as well (Lombardi, 2001; Xavier et al., 2005). As a result of hate crimes based on sexual orientation, lesbian and gay survivors have been found to manifest significantly more symptoms of depression, anger, anxiety, and posttraumatic stress compared with lesbian and gay victims of comparable