Bisexual women’s health and well-being may be affected by the gender and sexual orientation of their partner, according to a newstudy published in the Journal of Bisexuality.

Researchers asked more than 600 bisexual women (and those who report being attracted to more than one gender) about their mental health, how open they are about their sexuality, their experiences with discrimination, and any symptoms of depression. They also collected data about whether the respondents were single or in a relationship and about their partner’s sexual orientation and gender identity.

Among their findings is that bisexual women in relationships with heterosexual cisgender men were least likely to be open about their sexual orientation.

“Most research about relationships has been focused on heterosexual couples,” Casey Xavier Hall, a postdoctoral research fellow at the Institute for Sexual and Gender Minority Health at Northwestern University and lead author on the article, told NBC News. “There is very little relationship research around bi people’s relationships. There are meaningful differences in relationships depending on the sexual and gender identity of bi women’s partners.”

Outness

Bisexual women in relationships with cisgender lesbian women, bisexual cisgender women partners, and bisexual cisgender men partners were more likely to be out than those partnered with heterosexual men.

“Outness” was measured by asking participants, “How out/open are you about your sexual orientation?” with answers ranging from “out to nobody” to “out to everyone.”

Researchers speculated that bi women may be more comfortable disclosing their sexual orientation when in a relationship with a woman. However, bi women were more likely to be out with a bisexual male partner than a heterosexual male partner, suggesting that a shared bisexual identity might be meaningful.

“What’s unique about our finding is that bi women in relationships with bi men were also more likely to be out, compared to bi women in relationships with heterosexual cisgender men,” Xavier Hall said. “It’s about both the sexual and gender identity of the partner.”

Discrimination

Researchers found that the gender and sexual orientation of bisexual women’s partners mattered for their experiences of discrimination and the basis of their sexual identity.

“Relative to participants in relationships with heterosexual cisgender men, reports of discrimination experiences were higher among participants in relationships with lesbian cisgender women, bisexual cisgender women, bisexual cisgender men, and participants who are single,” the study states.

Xavier Hall said the exact reasons for this finding are unclear.

“The visibility of your identity could be at play,” he said. “If you are visibly queer, you may experience more discrimination.”

Xavier Hall also said that bisexual women experience two forms of stigma: homophobia and monosexism.

Monosexism is a kind of stigma experienced by individuals who are attracted to multiple genders, such as bisexuals, pansexuals and some other queer-identifying individuals. The stigma derives from the idea that monosexual identities like gay or heterosexual are normal or superior to sexual identities that are gender inclusive, according to Xavier Hall.

“More research is needed to understand what leads to the discrimination piece,” he said.

Depression

The study also found that bisexual women with cisgender lesbian partners had fewer depressive symptoms compared to single bi women.

Previous research found differences in mental health between bisexual women in relationships with women and men but had not explored the role of female partners’ sexual orientation.

“This makes me want to see more research looking at female-female relationships accounting for differences in partner sexual identity to really know if there are differences and to understand what might account for those differences,” Xavier Hall said.

A Gallup poll released last week estimates that over half of all LGBTQ adults identify as bisexual, and of that, the majority are women.

Xavier Hall hopes that future research explores the specific health needs of bisexual women.

“I think it is important to give voice to the experiences of bisexual people,” he said.