The term "pansexuality" is sometimes used interchangeably with "bisexuality", and, similarly, people who identify as bisexual may "feel that gender, biological sex, and sexual orientation should not be a focal point in potential [romantic/sexual] relationships." In one study analyzing sexual identities described as alternative terms for bisexual or bi-self labels, "half of all bisexual and bisexual-identified respondents also chose alternative self-labels such as "queer", "pansexual", "pansensual," "polyfidelitous", "ambisexual", "polysexual", or personalized identities such as "byke" or "biphilic"." In a 2017 study, identifying as pansexual was found to be "most appealing to nonheterosexual women and noncisgender individuals." Polysexuality is similar to pansexuality in definition, meaning "encompassing more than one sexuality", but not necessarily encompassing all sexualities. This is distinct from polyamory, which means more than one intimate relationship at the same time with the knowledge and consent of everyone involved. The American Institute of Bisexuality stated, "The term "fluid" expresses the fact that the balance of a person's homosexual and heterosexual attractions exists in a state of flux and changes over time."