"The similarities are greater than the differences regarding quality of life. That suggests that the world is moving forward," said Kirsti Malterud. She is one of the researchers behind a new report on the lives of lesbians, gays and bisexuals.

"The previous Norwegian report on quality of life from 1999 presented a dismal picture. We have been keen to provide more nuances," said Malterud, a doctor and researcher at Uni Health in Uni Research.

The study of quality of life of lesbians, gays and bisexuals shows that the situation in most areas is comparable to that of heterosexuals. Yet not everything is rosy.

Worst for bisexual women

"We see signs of marginalization and minority stress in a small group. This group has more mental health problems, poorer self-rated health, more sexually transmitted diseases, experiences loneliness and includes several suicide attempts. This applies to a minority, but it's serious," said Malterud.

Within this minority, bisexual women have the most problems, according to the research report.

"There have been few previous studies of the quality of life of bisexuals in particular, and we did not know much about this in advance. We found differences in the life situation for some people in this group, especially for women. And that means that bisexuals deserve more attention; they're struggling more," said Malterud.

"Have we reached our tolerance limit?"

The lives of bisexual women are inferior with regard to self-rated health, chronic illness, mental health, suicide attempts, harmful alcohol use and loneliness.

The survey also shows that a great many bisexual men and women hide their sexual orientation at work (78 percent of bisexual men and 68 percent of bisexual women). The corresponding figures for gays and lesbians are 18 and 9 percent respectively.

"The fact that some are struggling is related to the attitudes of those around them. Perhaps there's little room in our culture for people who don't want to call themselves heterosexuals, gays or lesbians. Have we reached our limit of tolerance by accepting gays and lesbians, but then that's enough?" asked Malterud.

Not just in or out of the closet

She thinks a diversity policy is needed and that society must become even more inclusive.

"It's not the case that it's up to the individual to come out, this is a responsibility we all share."

The researchers also collected 274 stories about being "in the closet." These have provided new insights into what it means to hide one's sexual orientation.

"The stories show that it's wrong to talk about living in the closet. It's not a question of either staying in or coming out, but it's about the fact that lesbians, gays and bisexuals in a variety of social arenas are doing different things to hide their sexual orientation and considering the consequences of revealing it," added Malterud.

Positive feedback

Malterud has written the report "Sexual Orientation and Quality of Life" with four other researchers, Norman Anderssen, Mari Bjørkman, Tone Hellesund and Hilde Slåtten. The report was commissioned by the Norwegian Directorate of Children, Youth and Family Affairs.

"Our report is important because of our sound methodological procedures. There is a strong probability that we can make definitive statements about differences in quality of life. This is because we used a national sample to be as representative of the Norwegian population as possible, while we also recruited large numbers of lesbians, gays and bisexuals and we asked heterosexuals the same questions."

The report was presented at a major conference in Oslo in early November.

"We've had a lot of positive feedback and it pleases me when people describe the report as nuanced and objective."

No surprise

The report shows that 16 percent of the men in the sample would move away from a gay man on the bus. This comes as no surprise to Malterud.

"I've been out as a lesbian since I was 28, and I've felt good about it. But I'm used to it being an issue, and that people form opinions when I talk about my girlfriends. The 16 percent who would move away is less than before, but still enough to make you unsure of people's reactions if you come out. But we have to be pleased that there's progress," concluded researcher Kirsti Malterud.