Blood Pressure & Bi+ Black Men: Stress & Survival

TL;DR

High blood pressure is killing us slowly—and not just from what’s on our plates. For bi+ Black men, hypertension is often rooted in stress: the stress of racism, masculinity performance, and queer erasure. Understanding how identity-based trauma raises our risk is key to protecting our hearts—literally.

The Problem

Hypertension (a.k.a. high blood pressure) is called the “silent killer” for a reason. It can go unnoticed until it’s too late—and Black men are disproportionately affected. But here’s the part most doctors don’t say out loud: the stress of navigating life as a bi+ Black man is a health risk all on its own.

Whether it’s trying to “act straight” to avoid judgment at work, navigating homophobia at home, or hiding your softness in public just to feel safe, many of us live in a near-constant state of stress and hypervigilance. Add in medical mistrust, poor access to affirming care, and limited safe spaces to decompress—and our hearts are doing overtime just to survive.

The Psychology

Stress doesn’t just feel bad—it rewires the body. Chronic stress activates the hypothalamic-pituitary-adrenal (HPA) axis, which floods the bloodstream with cortisol and adrenaline, tightening blood vessels and raising heart rate (McEwen & Gianaros, 2010). Over time, this leads to hypertension.

But bi+ Black men face unique stressors:

• Minority Stress Theory shows that queer folks of color experience compounded emotional and physiological distress due to systemic oppression and stigma (Meyer, 2003).

• Internalized homophobia, biphobia, and misogynoir can lead to suppression of identity—causing emotional strain and disconnection from healing resources (Parent et al., 2013).

• Masculinity norms discourage emotional vulnerability and help-seeking, which are critical for managing stress and hypertension (Griffith et al., 2011).

These layers of psychosocial pressure build up in the body. And unlike episodic stress, this is chronic—ongoing, embedded, and often invisible.

The Facts

The numbers speak for themselves:

• Nearly 60% of Black men over age 20 have hypertension, according to the CDC (2022).

• Black Americans are 1.5 times more likely to die from heart disease than white Americans (American Heart Association, 2023).

• In a study of gay and bisexual men of color, those with high levels of internalized stigma had significantly worse cardiovascular outcomes (Hatzenbuehler et al., 2014).

• Only 36% of Black LGBTQ+ people report having a doctor they feel comfortable talking to about their health (KFF, 2022).

And yet, much of the mainstream conversation around hypertension focuses only on diet and exercise, ignoring how racism and queerphobia are part of the physiological equation.

The Advice

Here’s the truth: no diet or supplement can fully offset the impact of chronic, identity-based stress. But we can take action—on our own terms.

1. Learn your numbers.

Get your blood pressure checked regularly—even if you feel “fine.” Early detection saves lives. Ask about ambulatory blood pressure monitoring if you’re unsure whether readings are accurate.

2. Rethink what “relaxation” looks like.

We’re often told to “calm down,” but for many of us, stress comes from needing to stay alert to stay safe. Try culturally rooted practices like breathwork, journaling, somatic healing, or guided meditations specifically for Black queer folks.

3. Reclaim movement.

Exercise helps manage hypertension—but only if it feels safe. Find routines that center your comfort: dance, boxing, yoga, solo lifting, walking with friends. You don’t need a toxic gym culture to get strong.

4. Talk to your people.

Community is medicine. Whether it’s a group chat, support group, or platform like Bi+ Black Men, staying connected helps lower stress hormones and build emotional regulation. Isolation raises risk.

5. Demand affirming care.

You deserve a doctor who sees all of you. Look for Black LGBTQ+ health networks, or use LGBTQ+ provider directories to find someone who won’t shame or silence your identity.

Join the Conversation

This isn’t just about numbers on a chart—it’s about creating a life where your body feels like home. We deserve to survive, thrive, and feel seen while doing it.

Listen to Bi+ Black Men: The Podcast on all major platforms or visit [bisexualblackmen.com/podcast]

Let’s talk about stress, softness, and saving our lives—together.

References

American Heart Association. (2023). Heart disease and African Americans. https://www.heart.org

Centers for Disease Control and Prevention. (2022). High blood pressure facts. https://www.cdc.gov

Griffith, D. M., Gunter, K., & Allen, J. O. (2011). Male gender role strain as a barrier to African American men’s physical activity. Health Education & Behavior, 38(5), 482–491.

Hatzenbuehler, M. L., Slopen, N., & McLaughlin, K. A. (2014). Stressful life events, sexual orientation, and cardiovascular disease risk. Health Psychology, 33(10), 1185–1194.

Kaiser Family Foundation (KFF). (2022). LGBTQ+ Black adults and access to care. https://www.kff.org

McEwen, B. S., & Gianaros, P. J. (2010). Central role of the brain in stress and adaptation: Links to socioeconomic status, health, and disease. Annals of the New York Academy of Sciences, 1186(1), 190–222.

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations. Psychological Bulletin, 129(5), 674–697.

Parent, M. C., DeBlaere, C., & Moradi, B. (2013). Approaches to research on intersectionality. Sex Roles, 68(11), 639–645.