(PS7-B41) The Role of Gender Expression in Experiences of Discrimination and Anxiety Among Bi+ adults

Background: Bi+ (e.g., bisexual, pansexual, queer) individuals experience higher rates of anxiety compared to both heterosexual and lesbian/gay individuals (Ross et al., 2018), and these disparities are related to their exposure to unique forms of discrimination (Feinstein & Dyar, 2017). Further, gender non-conformity has been linked to higher rates of discrimination and negative mental health outcomes among cisgender sexual minority individuals (Puckett et al., 2016), but little is known about gender expression among bi+ individuals across diverse gender identities, and most prior studies have operationalized gender expression along a single continuum from feminine to masculine. Given that people can express themselves in both feminine and masculine ways, there is a need to consider how different dimensions of gender expression relate to discrimination and mental health. To address this, we used data from a sample of bi+ adults to examine: 1) the associations between feminine and masculine gender expression and exposure to discrimination from heterosexual and lesbian/gay people; and 2) gender expression and discrimination as simultaneous predictors of anxiety.

Methods: 715 bi+ adults completed an online survey. Cisgender women made up the largest proportion of the sample (31%), followed by cisgender men (27%), nonbinary individuals assigned female at birth (AFAB; 23%), transgender women (9%), nonbinary individuals assigned male at birth (AMAB; 6%), and transgender men (4%).

Results: More feminine gender expression was associated with more frequent discrimination from heterosexual individuals for cisgender men (r = .26, p < .001) and transgender men (r = .53, p = .006). In contrast, feminine gender expression was not significantly associated with discrimination from lesbian/gay people for any groups and masculine gender expression was not significantly associated with discrimination from heterosexual or lesbian/gay people for any groups. When gender expression and discrimination were entered as simultaneous predictors of anxiety, more frequent discrimination from heterosexual people was associated with more anxiety for cisgender women (β = .438, p < .001), transgender women (β = .45,  p < .001), and nonbinary individuals AFAB (β = .235, p = .001); discrimination from lesbian/gay people was not significantly associated with anxiety for any groups. In addition, more feminine gender expression was associated with more anxiety for cisgender women (β = .179, p = .006) but less anxiety for nonbinary individuals AMAB (β = -.299, p = .034). Masculine gender expression was not significantly associated with anxiety for any group.

Discussion: These findings provide useful insights into gender expression, discrimination, and anxiety for bi+ adults. Results suggest that discrimination from heterosexual people may be especially important to consider to understand anxiety among bi+ cisgender women, transgender women, and nonbinary individuals AFAB. In addition, feminine gender expression appears to have a different relationship with anxiety for bi+ cisgender women compared to nonbinary individuals AMAB; further research is needed to understand the mechanisms underlying these associations.