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Transcript: Interview with Dr. Mimi Hoang, PhD

Lynnette: Welcome to the BiCast, a podcast for the bisexual community. We are speaking with Dr. Mimi Hoang, PhD, a licensed clinical psychologist and noted activist in the bisexual community. Welcome.
John: Welcome.
Mimi: Thanks you so much. Thanks for having me.
Lynnette: Oh, my pleasure, believe me. So can you tell us about your work concerning mental health for the bisexual community?

Mimi: Sure thing, Lynnette. I mean, it really started off with my career in community organizing with my co-founding of the group called Fluid at UCLA which was the first bisexual social support group there. Later on I became a clinical psychologist and I focused on multicultural issues and to me that was such a big part of my own development, identity, and I felt that it’s a really important issue for a lot of folks who don’t fit into the mainstream for one reason or another. Ethnicity, sexual orientation, you know, any other type of cultural identity, and my dissertation in grad school was on sexual identity which I can talk more about later. Throughout my work I’ve worked with a lot of different community mental health agencies as well as university LGBT centers and so I really kind of focused a lot on children, youth, teenagers, young adults, and so a lot of kind of growing, development, and identity, so I was able to work with a lot of folks that were on the bisexual spectrum through that.
So through that I got a lot of clinical experience and now I’m doing a lot of clinical presentations and trainings for other therapists and along the way I also co-founded two other bisexual groups so that continued to inform a lot of the mental health work that I do, and also in line with the training that I do, a few years ago I started my professor role at Antioch University Los Angeles and they have an LGBT specialization there for their Masters in Psychology program so I feel very blessed to work there and to teach the only bisexual affirmative therapy class. It’s a one day, eight hour workshop for the Masters in Psychology students there. So that’s a very unique opportunity and for me to train budding therapists, that’s also what I do. My main job right now is working with Student Psychological Services at Loyola Marymount University.
Lynnette: That’s fantastic.
John: I will just say we’ve done two interviews in the last few weeks. One with a therapist who works mainly with bi clients and one who works mainly with trans clients and both of them said that they needed to do most of their training on the job. The bi therapist was in LGBT mental health in her school and what was it, a half day seminar on bisexuality for the whole course work? So it’s really important that you’re doing your work and helping therapists learn what we need. Kind of goes to my first question. I think for a lot of us, last year’s Celebrate Bisexuality Day White House event was really important and I know that there was a lot about our health issues, especially our mental health issues, and since I’ve seen – you know, since this happened, we’ve really done amazing work in even educating ourselves about our mental health issues. Could you talk a little bit about your work at the White House event and since?
Mimi: Yeah, sure. It was definitely a really phenomenal time for the community. So it was a really amazing time. I felt so blessed to be one of the 33 bi leaders that was invited to this bisexual community roundtable at the White House and as you probably know it was an off-the-record event so I can really only discuss what I did there, but my section of this three hour meeting was to present on bisexual mental health. So through that I was actually tapped with coming up with all this data and research which I mean, a lot of this I had seen just through my community work and through the client that I had worked with, but to see all of that, all together, with research backing it, it was just really impactful. And also very startling because it just seems that study after study that I was reading, it just kept showing that bisexual people were really the worst compared to heterosexual and even gay and lesbian people. Not only do we face minority stress which I think in and of itself sometimes is underestimated, that bisexual people are minorities, we are marginalized, we don’t have that kind of privilege that a lot of people think we do, but not only that, they have a lot more averse life events which does affect our mental health. That’s a pretty intuitive thing but now we have the data to back it up.
And study after study, I mean, anxiety disorders, mood disorders, this goes for adults, this goes for college students and it also goes for elders. So elders also faced poorer mental health and higher risk of depression than gay and lesbian elders. A lot of elders already are facing a lot of lacks of resources and social isolation and things like that so that’s definitely a high risk group. With suicidality also stats were really, really disturbing. Common knowledge is that LGBT folks face higher risk of suicidality and suicide risk and attempts than heterosexual people but if you break it down between gay, bi, and lesbian, bisexual people face an even higher risk of lifetime suicidality. Six times more than heterosexual people. Lesbian might be just four times more risk.
So that’s just huge and all of this was like, now I know this information, I can’t ignore it anymore, and now we’re telling people about it. So people really can’t ignore it anymore. Bisexual people are not doing well and not only do we exist but we really need support and we need help. The goal of the roundtable was really to prevent this information, to garner interest from White House officials and to hopefully get that dialogue going so we can make some systemic change
So on a personal level it really galvanized my interest now in bisexual mental health specifically, not just general well-being but mental health and so I’ve tried to focus a lot more of my talk and presentation and community work on this issue. Myself and in my steering committee with our Los Angeles Bi Task Force, we talk more and more about each other’s health, how we’re doing these days. So it’s just something that has really become on the forefront of my mind.
Lynnette: Because of all your good works at the White House, I think there was a lot of work that went on behind that but I think that was a spark that ignited the community because we are more aware of our issues now too and we have voice for that and that’s very important.
John: The follow-up to the BRC and Bisexual Health Awareness Month I think really put a lot of that together and put it out, and I will say, it struck me when you were talking because we have a bi mental health professional at my local bi group and at one of our events she said, I know there’s problems but when I read these resources from Bi Resource Center, it struck me how… you know, it shocked me. It even affects us who know bi experience, our issues.
Mimi: Absolutely. All of my community work and the groups that I run and the events that I run, I’ve seen a lot of bisexual people not doing well and even compared to gay groups, lesbian groups that are out there, when I go to a bi event I see a lot of folks who don’t seem to be doing well and even our own LA community, in the past several years there have been a few bi elders who’ve died suddenly. Might have been suicide, we aren’t sure, but it affects us personally. It’s not just numbers out there. I think having the numbers in a way makes it not such an isolated incident and so now it’s there in our face and it is very important to do something about this. At Los Angeles Bi Task Force we actually [speaking of the health ??? 10:19] we published a bisexual health calendar back in March of this year. 31 days of bi wellness and so that was our attempt to really raise awareness and educate people on resources that are out there, to take care of their physical health and their emotional health. You know, their community health, so we’re trying to take steps.
Lynnette: Yes, we utilized that calendar and shared it quite a bit. It was very helpful. I just want to say, in my own life, because I want to say I’m a walking bisexual statistic really, it gave me a lot of retrospect on my own life and that was good because you do feel quite alone and I see that, well, my story really wasn’t that much different than a lot of other stories and it was very helpful for me. So you also did a couple books on bi women also. Can you tell us about that?
Mimi: Sure. One of them was my dissertation and another was a book chapter, but my dissertation, I knew that I wanted to do something on bisexual identity and my inspiration really came from reading a book called Tipping the Velvet, kind of a common book in the queer women’s community, but I remember reading a story where the main character falls in love with a woman and they have this relationship which, when other people discover their relationship, this girlfriend kind of ran away and ended up with a guy. And to me I got all these questions about, well, why did she do that? Is there something she was ashamed of about her same sex relationship and it then led to this sort of affair or act of infidelity that you might call it. And I think at the time, too, I was also experiencing a lot of personal experiences of lesbian women who were accusing bi women of being cheaters and not being able to settle down, so I came up with these sort of research questions about, maybe infidelity that happens could be related to bi identity development. That could be something that causes this and maybe some kind of internalized stigma. Something that could be external to the person and not just because, oh, they’re bisexual, but they’re facing this kind of prejudice. So I created this study to examine those three constructs.
So bisexual identity, which I framed as bisexual identity congruence. So to me the more congruent a person is with their attractions, their behaviors, their self-identification, that is a symbol of more identity strength, and I looked at internalized biphobia. At the time there wasn’t really any measure of that. There was no instruments or questionnaire for that so I had to adapt that from the lesbian internalized homophobia scale and I created a measure for infidelity, and this is infidelity as measured in a monogamous – an agreed upon exclusive relationship. And so I just distributed this study to women and all together I got about 87 women and I came up with some good results in terms of what I had thought and so I found the higher the bi identity congruence in a person, the lower the internalized biphobia.
So this definitely validated a suspicion that I had that the more congruent and kind of streamlined your identity, there’s some connection to having less of that internalized stereotype and negativity. I found that especially there were higher levels of pride and acceptance, you know, with women in my study who have more congruence. Also when I looked at the participants who had cheated in their relationship versus those who had not cheated, those that had cheated had higher levels of internalized biphobia, so that also validated and confirmed my suspicion that this kind of prejudice has something to do with their relationship behavior. Unhealthy relationship behaviors.
So it was very exciting to get this data and not only confirmed for my profession but really this was the first time that identity congruence among bisexual people was looked at in a research study and also internalized biphobia. I mean, that as a construct was never really studied empirically. So since my study there have been a few other studies that have looked at internalized biphobia.
So all of those findings were really great and I was able to also adapt the Klein sexual orientation grid in my study which hopefully a lot of people are aware of. Klein when he originally [treated] it actually didn’t have a bisexual category and so in my study I adapted it, I put in some bisexual categories, and so now I have the KSOG adapted which is also available on my website. So that was something that came out of the study.
And so with my book chapter, that came a little bit later but I was asked to write a book chapter in the Essential Handbook of Women’s Sexuality by Doctor Donna Castaneda, so my chapter was on bisexual women’s sexuality, in volume 2, and so I really got a chance to talk a lot more not only about my dissertation study but really about bisexual women, sexual identity and relationship in general. I talk about sex and love with heterosexual men, sex and love with lesbian women, and sex and love with bisexual and transgender people as well as culture and community. So I kind of cover a whole gamut there and it’s a book that’s great, not just for therapists and (inaudible 17:17) educators but really just community members, laypeople, it’s a very readable book and so I hope that a lot of people are able to read that and learn a little bit more about bisexual lives.
Lynnette: And you have the link for that on your website, is that correct?
Mimi: It is on my website, yes.
Lynnette: OK, great, and for the study too?
Mimi: Yes.
Lynnette: Great.
John: I was gonna follow up quick on the congruence because I have seen some of the other studies and one of the stats that just screams out at me every time I see it is the women, the more openly bisexual they are the less problems, especially health problems they have so you kind of started that idea that being out really saves you.
Mimi: Yeah, you know, it does, and it’s been a common and I think intuitive thing that we understand about gay and lesbian people but for some reason it hasn’t really trickled to the bisexual community. I think a lot of bisexual people are still in hiding, are still trying to live quietly, they may be trying to pass, and even if they go to see a therapist that therapist might not necessarily encourage them to come out, but why wouldn’t it be the thing for bisexual people or any other cultural minority. You know, when you hide something about who you are, that means that there’s a sense of shame and pain about it so the more you can just say this is who I am and it’s okay and I’m proud of it, it’s normal, it’s natural, it’s real, the less of that burden it is and the better your mental health. Also there have been studies with men as well showing that the more concealment that bi men have regarding their identity, the poorer their mental health. So it’s the same for bi men as well.
John: Yeah, I can say from personal experience that’s true. Living a lie or leading a double life is not a healthy way to live.
Lynnette: Well, you just feel wrong about yourself and even if you in your mind know that possibly you’re not, you still do psychologically, because you’re hiding, and the two things go together. The mind and body go together so the physical problems do not surprise me at all. So let’s get going.
John: You talked a little bit about the calendar but what else does the LA Bi Task Force do in the bisexual community and what is its program?
Mimi: The Los Angeles Bi Task Force was started in 2008 and it was upon the urging of Jerry Mussari, a long-time bisexual activist here, and he really felt we needed to create some kind of a center for bisexual people and so at first we were called the LA Bi Center planning committee and we had a loose steering committee of different folks and we even got some help from [Shelton Pan] and Kyle Schickner and the (inaudible 20:46) of some of the bi bigwigs in our community. We had some difficulty getting sponsorship for a national center or facility so we started to focus on programs which we’ve been doing so our goals now are really kind of three-pronged. We do education, we do cultural enrichment, and we do advocacy, and so our signature programs are visibility at LA Pride, our annual Bi Arts Fest which commemorates Bisexuality Day on September 23rd. We do have a very big and special event coming up this September 23rd and we’re going to be featuring the new Spectrum Artist Collective which is a new gathering we’re working on. We’ve done the Bi Health Month calendar, invited Dr. Diamond to talk.
We’re still growing. We became a registered non-profit. We’re now currently trying to work on our 501(c)(3) status. This year we also launched our needs assessment which is the first bisexual/pansexual and fluid community needs assessment in the greater LA area. We’re really trying to collect data. Again I think data collection can be very useful for these kinds of things so we’re trying to share directly from the people and hopefully we’ll be able to write a report, publish it and give it out to different agencies so they can start trying to integrate bisexual needs into their programs.
Lynnette: We are big fans of data around here and we’re glad you’re doing that for resources to reach out to the other communities because we really need that too. Involved with the other group, amBi, where’s it been and where’s it headed?
Mimi: I actually started in 2006 and it started as a small monthly meeting of bi individuals. It really grew out because there wasn’t a bi group at the time. We had had BiNet LA which had been around LA for a long number of years but that fell inactive so after I finished my dissertation I was really just excited to get my study and my information out there so we started meeting and I also wanted it to be something that was beyond just a sit in circle type group which there was already at the time with our local LGBT center. I felt like for people that maybe had already figured out that they were bi, they needed something a little bit more active, something that was out and about and that was really kind of the tone that I had set for amBi at the time. All of our events were out in public venues, like on restaurants, go bowling, watch movies, to me it just was, you know, we’re normal people and we do normal fun things together and so it continued to grow and now it’s on led by Ian Lawrence and we’ve grown so big. We have I think close to 1000 members at this point with events pretty much all throughout the month which is really exciting especially for a large metropolitan area like Los Angeles. You really want to try to tap into people in different areas geographically so there’s assistant organizers now who run e vents and I’m more of a background role at this point, with the clinical and LA Bi Task Force, but it’s still really a great tool for community building, for people just to meet other bisexual people and to have a good time. I think we’re kind of moving towards standing even outside of LA to different counties and cities so I think it’s a really good model for bi groups in general. So I really hope that it can serve as kind of a template for bi groups in other cities. Sometimes when you run a bi group it kind of becomes like the thing that is for everyone and for whatever reason the bisexual person comes to one event, they may not like that event or it’s too far from them or something like that, so the way that amBi works now, there’s multiple events to choose from. There’s different people organizing each event. So it just creates a greater likelihood that someone will enjoy themselves and return. That’s really been important in just retaining membership. Oftentimes a struggle is maintaining people in the bi community, so I think that’s really worked out.
Lynnette: Fantastic. We applaud you for that.
John: It sounds like the stuff we’re trying to do here in Washington with Center Bi. If there’s resources to share like, how tos, that would be helpful so that I could train my organizers, but we need to really move and deal with the real tofu at the end.
Lynnette: We have some questions concerning the overall state of mental health and the mental health profession. What do you find is our biggest concern right now?
Mimi: You know, that’s a tough question because I think a lot of the concerns as you heard me talk about earlier, there’s just so many staggering statistics and it’s like, which one do you work on first? But for me I think it really starts with identity development. That’s the first thing. You can’t go out there and start groups and change the world unless you yourself feel okay about who you are and I think so much of bi identity development is impacted by internalized biphobia. It’s really not something that we talk about often but it affects all of us because it’s around all of us every day on TV, in the movies, in high schools and the workplace and you can’t help but absorb this kind of negativity or invisibility, so I think bisexual people really absorb this, knowingly or unknowingly, and it affects how we think about ourselves, it affects how we carry ourselves, whether or not we may mention something about our bisexual identity or lives in some kind of social setting. So this is really I think the heart of what affects bisexual people’s mental health.
And then in turn that affects our relationship. Our dating relationships, marriages if we’re married, people may be very afraid to come out to their partner. They may not come out until their relationship has really evolved and there may be marriage and kids which can then be a very risky time to come out. Or the person may not develop sustained relationships because they are sometimes kind of internalizing a lot of stereotypes themselves. Maybe we can’t find love. Which is absolutely not true at all.
I think this affects us at a very deep level and then along with relationships of course comes sexual health and so if a person is really not feeling okay about who they are and they feel really ashamed, they may not conduct themselves with the most responsibility or care when it comes to sexual intimacy. So they may not protect themselves, they may not know how to or have a partner that may be pressuring them, and maybe utilizing bisexual stereotypes like [gunsum? 29:14]. There’s also data out there about interpersonal intimate partner violence and I think that a lot of bisexual women especially may be hearing a lot of negative bi messages from your own partners, especially their modern sexual partners, gay and straight. And so this can then of course lead to health problems and all sorts of other issues. And then I think lastly is finding community. This is so important, I think, that in terms of just needs of a human being, on Maslow’s hierarchy of needs, finding a community is the second most important thing after food and shelter, and if you don’t have a place where you can feel at home, where you feel accepted and nurtured just for who you are, then everything else is shaky, so bisexuals, depending on where they live, they may or may not have community.
Luckily there are a number of bi groups here in Los Angeles but if someone is out in a more rural part of the country or it’s just really far, they don’t have transportation, it can be really tough to find other people like them. So they may have to resort to online communities or they may just have to start one, you know? But I think that it’s so important to find people where you really don’t have to explain yourself. So these are some of the foundations in terms of mental health that bisexual people are needing to address.
John: This leads into my question which is, the boiler plate question we always ask bisexual therapists: how do we find bi friendly and bi positive therapy when we’re looking for mental health resources? You know, I was burned when I was very young by what I thought was an LGBT friendly counselor who was really just a gay friendly counselor and so many of us have been so how do we go and find someone when we need therapy who is going to respect us as bisexuals and not try to say, you have to choose or it’s a problem.
Mimi: Yeah, it is not an easy quest. You know, I think that this is a continuing issue. There are some resources that are out there online. BiZone created a bisexuality aware professionals directory. I don’t know if you guys have heard of that. It’s on the bisexual resource center website but I don’t know –
John: It’s a little dated, yeah.
Mimi: But that’s really the only national directory that I’ve seen. For us here in LA I’ve started to create a referral list of therapists around this area and so, through the people I’ve trained or through friends or colleagues, I’ve created this little list. It really boils down to the bisexual leaders within each area to try to come up with something because otherwise it really is gamble. You look on psychology today, you look on LAGPA which is the Lesbian and Gay Psychotherapy Association and maybe you can type in the keyword bisexual but it can be, again, not really a sure thing, because it could be someone who says that they’re bisexual friendly but may not be bisexually aware and sure, they may be accepting, but they may not know a lot of the ins and outs, so it really is tough.
I think that just sort of a way to cope with all this is for bisexual individuals, if you’re looking for a therapist, I say screen them from the get go. Even on a phone call or on your first session with them. Ask them if they have worked with bisexual clients, if they have any competence around this issue. See if they say yes or no. Even if they say no, maybe see if they’re willing to learn. At least that could be something that could still be important. There are plenty of straight and gay therapists that are very well meaning and who would be open to learning so have that be a follow up question. And then if your therapist does express some inaccurate stereotypes I would say, try to correct them if you feel up to it, because you have a right to not have a therapist who gives you inaccurate information.
And if you do end up working with someone who’s really great, I say, spread the word. Tell your local bi group about it or your local LGBT center and let them know this is a vetted person and so then that way other people will find out about them. So therapist shop. Really be selective because it is such an important relationship and you don’t want someone who is actually going to do you more harm than good.
Lynnette: Dara Hoffman in Colorado started a group of programs. She borrowed from someone else and used the model where it is a trans-friendly to trans-aware group of psychologists and counselors who meet every month and share information and they also refer around to each other. I thought that was a really good idea and it seems to be working.
John: And I’m currently organizing my bi mental health professionals to create a referral list and try to work together a little bit to provide those resources for us here, so that when I go to a meetup event and someone asks, where do I find a counselor I can say, here’s a sheet.
Mimi: Yes, that’s where it all starts. It starts with individuals. That starts to create resources in the community.
Lynnette: So we talked about on the community level what the mental health field should be accomplishing in the future. What about in training, like a standardization of training. There is LGBT training. I’m assuming. I have never been. I heard. Psychologists are trained in some gender studies. Would you like to see that be a little more specific and be standardized when you’re in school?
Mimi: That would be wonderful. As a psychologist there’s different standards for marriage and family therapists as well as licensed clinical social workers. For psychologists we do have to get a human sexuality course to be licensed and so it touches on LGBT. Now, it all depends on who the person training and how much time they spend on the B but I would love for that class to really partition out L-G-B-T so that the B doesn’t just get a little bit of lip service. I also just think therapists should get trained. We all do need to get continuing education to keep up our license and so I think continual education classes, supervision, consultation, these are all things that we need to be doing to keep up with our work. So of course there also needs to be trainers and so if there’s a community leader in that area who’s willing to step up and say, I can be a trainer, I can do this talk, that also provides a resource. So I do what I can here in LA and I’ve done a training for the Trevor Project as well as different universities and mental health clinics, but I’m just one person, and so I hope as a community we can also develop this kind of competence so we can go out there and help the mental health professions.
Lynnette: We do, too. We’re hopeful. We’re very optimistic about all of this. The issue of getting proper bisexual statistics and funding is a real problem. We do not see many studies available at the moment. It does seem to be increasing though. Do you see an increase in studies for us?
Mimi: I think currently it seems like there are more studies on bisexual issues just singularity and then I’m also starting to see more studies that are partitioning the L, G, B, and T time so that’s very important because I think when you lump us all together, it seems like we all have the same needs, but when you actually create different groups and see the numbers come out differently. So I think that this is great because in the world of grants and scholarships, people need to see numbers to see how many people are there in this group and what are their issues that you’re dealing with and why should this money be granted to this program. Also issues of medicine and health research really means a lot when we live in a very science oriented culture. So in some ways we need to kind of structurize and operationalize what bisexual means in this kind of study. Are we just talking about self-identification? Are we talking about behavior or are we talking about attraction? Because really, all of those different constructs, you can come up with different numbers. At least if these studies can start using the same language we can then compare them side by side and I think also what’s important for researchers to know is that bisexual people use many different labels. So we’ve been using the term bisexual on this interview but there are a lot of other labels out there. Pansexual, monosexual, you know, anthrosexual, the list goes on and on, and so researchers hopefully will be aware that in order to capture this community that doesn’t fall into the gay only or straight only we actually need to be aware that there’s different self-identifications and hopefully you know, more bisexual people will come out and participate in these studies because that’s really the only way that we can get the data, is if the community really speaks up. And that way there’s good data. Hopefully with more studies we can really understand a lot more and start to get better programs.
Lynnette: Yes, thank you for saving my question. I worded that all wrong and I apologize, but you said what I wanted you to say.
John: I think the date of the blowup was, I think it was late 2007 or early 2008 when the HRC did an internet survey of LGBT people and whether they liked Hilary or Barrack and not only did the majority support Obama but the majority was bisexual and it was one of those things that was a teachable moment for a lot of people. It was a teachable moment for the Williams Institute because they are one of the organizations that does a lot now to break up out in studies. So we wanted to stress the importance of community building to promote self-value and peer support. We want to thank you for joining us today and taking more time than you budgeted and also thanks for all your hard work and all you’ve done for us. I see the stuff you do on the Internet and through reading and such and I know that you’re a really valuable resource for us.
Lynnette: We appreciate you very much. Is there anything else you’d like to add right now?
Mimi: I think that covers it. I think in general we just need to treat ourselves better. Hopefully gays and straights can also learn to treat us better but it really starts with us taking care of ourselves and practicing self-care and sleeping and eating well and making friendships and taking care of ourselves and so I just hope that conversations like this will get that started.
Lynnette: We do, too. Thank you so much. All the links will be provided on the website. I just want to remind everybody: you are not wrong, you are not broken, you are not alone. You are a human being and you are bisexual. Thank you so much, doctor.
Mimi: Thank you.

(end of audio file)




Lynnette View All

Producer and Co-Host "The BiCast"

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