Men who may engage in same-sex sexual behaviours, such as these patrons of a gay club, may never self-identify as men who have sex with men, but researchers identify them as such for a variety of reasons.
Men who have sex with men or males who have sex with males (MSM) refers to men who engage in sexual activity with other men, regardless of how they identify themselves; many choose not to accept social identities of gay or bisexual.[1][2][3][4][5] The term was created in the 1990s by epidemiologists in order to study the spread of disease among men who have sex with men, regardless of identity.[2]
MSM is often used in medical literature and social research to describe such men as a group for clinical study without considering issues of sexual self-identity.
[edit] MSM as behavioral category
Young and Meyer (2005) note that the term has been in use within the public health discourse since 1990 or earlier, but that the coining of the initialism by Glick et al. (1994) “signaled the crystallization of a new concept.”[6][7] They trace the emergence of this behavioural concept to two distinct academic perspectives. First, it was pursued by epidemiologists seeking behavioral categories that would offer better analytical concepts for the study of disease risk than identity-based categories (such as “gay“, “bisexual“, or “straight”), because a man who self-identifies as gay or bisexual is not necessarily sexually active with men and someone who identifies as straight might be. Second, its usage is tied to criticism of sexual identity terms prevalent in social construction literature which typically rejected the use of identity-based concepts across cultural and historical contexts.
[edit] MSM as a construct
As a risk category, MSM are not limited to small, self-identified, and visible sub-populations. MSM and gay refer to different things: behaviors and social identities. MSM refers to sexual activities between men, regardless of how they identify whereas gay can include those activities but is more broadly seen as a cultural identity. Homosexuality refers to sexual/romantic attraction between men, and may or may not extend to romantic relationships with the same sex. Gay is a social identity and is the preferred social term, whereas homosexual is used in scientific contexts.
In their assessment of the knowledge about the sexual networks and behaviors of MSMs in Asia, Dowsett, Grierson and McNally concluded that the category of MSM does not correspond to a single social identity in any of the countries they studied.[8] There were no similar traits in all of the MSM population studied, other than them being males and engaging in sex with other men.
[edit] Applying MSM to transgender individuals
The term’s precise use and definition has varied with regard to transwomen, people born either biologically male or with ambiguous genitalia who now identify as female.[2][3][4][5] Some sources consider transwomen to be MSM,[3] others considering transwomen “along side” MSM,[2] and others are internally inconsistent (defining transgender women to be MSM in one place but referring to “MSM and transgender” in another).[5]
[edit] Health issues
When two males have sexual intercourse, there is not a possibility of reproduction. All human sexual behavior that involves contact with the bodily fluids of another person is considered to have some risk of transmission of sexually transmitted infections (STIs). Although the likelihood of transmitting infection varies a great deal by activity, in general all sexual activities between two (or more) people is considered a two-way route for the transmission of STIs; “giving” or “receiving” are both risky, although receiving carries a higher risk.
[edit] Physical
Sex has many health benefits, including relieving stress, boosting the immune system with higher levels of immunoglobulin A, improving cardiovascular health, increasing self-esteem, improving intimacy, reducing pain by production of the hormone oxytocin, reducing the risk of prostate cancer, strengthens pelvic muscles, and promoting good sleep.[9][10][11][12][13] Sexual behavior can be a disease vector. Safe sex is a relevant harm reduction philosophy.[14] A perpetuated stereotype is that MSM are more sexually promiscuous and engage in unprotected sex, but studies have largely discounted these assertions. A 2007 study reported that two large population surveys found “the majority of gay men had similar numbers of unprotected sexual partners annually as straight men and women.”[15][16] With MSM, there are two main forms of sexual activity that carry greater risks, anal and oral sex, although not all MSM engage in them.
Historically, anal sex has been popularly associated with male homosexuality and MSM. However, many MSM do not engage in anal sex. Among those who do have anal sex, the insertive partner is referred to as the top or active partner. The man being penetrated is referred to as the bottom or passive partner. Preference for either is referred to as versatile.
Anal sex most often refers to the sex act involving insertion of the penis into the anus.[17] The term anal sex can also sometimes include other sexual acts involving the anus, including but not limited to anilingus and fingering. It is a form of sexual behavior considered to be comparatively high in risk, due to the vulnerability of the tissues and the septic nature of the anus.[18] As the rectal mucosa provides little natural lubrication, a personal lubricant is often required or preferred when penetrating the anus.
A monk performing auparashtika (oral sex) on an aristocratic visitor. From the temple of Chhapri, Central India, 12th century CE.
Oral sex refers to sexual activities involving the stimulation of the genitalia by the use of the mouth, tongue, teeth or throat. Fellatio and irrumatio refer to oral sex performed on a man. Analingus refers to oral stimulation of a person’s anus. Oral stimulation of other parts of the body (as in kissing and licking) is usually not considered oral sex. People may engage in oral sex as part of foreplay before sexual intercourse, or during or following intercourse. It may also be performed for its own sake. Oral sexual activities are not effective methods of preventing sexually transmitted diseases (STDs), although some forms of STD are believed to be less easily spread in this way.[19][20]
Some receivers regard receiving oral sex as an ego boost, believing that such an act is a form of dominance over their sexual partner because of the overt submissive nature of the act; the giver may often be on their knees before the receiver to perform the act of pleasure.[21] In ancient Greece, fellatio was referred to as “playing the flute”; the Kama Sutra has a chapter on oparishtaka, or “mouth congress”.[22]
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