0. Module 9 Clinical Issues with Bisexuals
A Provider’s Introduction to Substance Abuse for Lesbian, Gay, Bisexual, and Transgender Individuals
First Edition

1. Clinical Issues With Bisexuals
Learning Objectives
Understand myths and facts
Learn psychosocial issues
Understand implications for treatment
Power Point Slide # 8-1, n29
A Provider’s Introduction to Substance Abuse for LGBT Individuals Module Clinician’s Guide

2. Definition of Bisexuality
The contemporary understanding is that bisexuality, affectional, romantic and sexual attraction toward same gender and other gender individuals, is a sexual orientation in and of itself and distinct from heterosexuality and homosexuality.
Power Point Slide # 9-2, n30
A Provider’s Introduction to Substance Abuse for LGBT Individuals Module Clinician’s Guide

3. Myths About Bisexuals
Bisexuals are confused about their sexual orientation.
Bisexuals are afraid to be lesbian or gay because of social stigma and oppression from the majority.
Bisexuals have gotten “stuck” in the coming out process.
Bisexuals have knuckled under to the social pressure to “pass” as straight.
Bisexuals are in denial about their sexual orientation.
Bisexuals are “not fully formed” lesbians or gay men.
Power Point Slide # 9-3, n31
A Provider’s Introduction to Substance Abuse for LGBT Individuals Module Clinician’s Guide

4. Facts About Bisexuality
A variety of sexual behaviors may be engaged in by bisexual women, men, and transgender individuals at any time because behavior and identity can be separate issues.
Continuous Bisexuality: Bisexual identity is formed early in one’s life and remains intact across the lifespan.
Sequential Bisexuality: Desire is experienced by bisexuals as sexual attractions to same-sex or opposite-sex partners at different times during their lives.
Concurrent Bisexuality: Bisexuals express sexual desire toward men and women at the same time.
Power Point Slide # 9-4, n32
A Provider’s Introduction to Substance Abuse for LGBT Individuals Module Clinician’s Guide

5. Facts About Bisexuality
Women and men (including transgender women and men) who identify themselves as heterosexual may have had, or may continue to have, sexual relations with partners of the same gender.
Women and men (including transgender women and men) who identify themselves as gay or lesbian may have had, or may continue to have, sexual relations with partners of the other gender.
People of transgender experience, including male-to-female and female-to-male individuals, may identify themselves as bisexual. This is because bisexuality (and sexual orientation identity generally) is a separate phenomenon from gender identity.
Power Point Slide # 9-5, n33
A Provider’s Introduction to Substance Abuse for LGBT Individuals Module Clinician’s Guide

6. Psychosocial Variables
Cultural norms and standards, political views, and environmental factors many influence bisexual identity and behaviors and keep them separate.
- Same-sex relationships in prison
- Gay-identified men who have a female sex partner
Power Point Slide # 9-6, n34
A Provider’s Introduction to Substance Abuse for LGBT Individuals Module Clinician’s Guide

7. KLEIN SEXUAL ORIENTATION GRID
Directions: Use the following scale to rate each of the following
variables in each period:
1. Other sex only
2. Other sex mostly
3. Other sex somewhat more
4. Both sexes equally
5. Same sex somewhat more
6. Same sex mostly
7. Same sex only
VARIABLE PAST PRESENT IDEAL
Sexual Attraction to
Sexual Behavior with
Sexual Fantasies about
Emotional Preference for
Social Preference for
Self-Identification as
LGBT/Heterosexual Lifestyle
Power Point Slide #9-7, n 35
Prairelands ATTC Toolbox Training Module 5 – 12 Clinician’s Overview