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Affirmative Psychotherapy with Bisexual Men

SUMMARY This article describes the range of issues that are of concern to bisexual men seeking psychotherapy. In addressing these issues with bisexual clients, the therapist is well advised to recognize the diversity that exists within this population regarding the pathways that individuals take in the course of acknowledging and coming to terms with their sexual orientation. It is important for the therapist to recognize that for most bisexual clients, the presenting issues are those that are common to most psychotherapy clients, such as anxiety, depression, stress, and relationship issues. For others, however, there are questions about sexual identity, coming out bisexual, and the implications of their sexual attractions to both women and men. An individual may have concerns regarding whether or not to disclose his sexual orientation at the start of a new relationship, or regarding realizing for the first time that he has bisexual feelings within an already established same-sex or other-sex relationship or marriage. There may also be questions and concerns regarding HIV/AIDS. In these situations, the personal impact of living in a social context in which sexuality is thought of in dichotomous either/or terms will be a realistic concern. Current trends in the research and clinical literature regarding bisexual men will also be discussed. The variety of manifestations of bisexuality across racial, ethnic, and cultural groups will be examined, including the challenges that this may pose for clients and therapists who identify with dominant definitions of sexuality within their respective social communities. Finally, the practical value and shortcomings of the main therapeutic schools will be examined in terms of providing bisexual men with effective and affirmative psychotherapy.