IN THE EARLY 1980s when the Centers for Disease Control & Prevention created the term “men who have sex with men” (MSM) to refer to an AIDS risk group, many of us criticized the term as a euphemism for gay men.
Now, however, a new survey of “MSM” in New York City shows some important differences between gay men and non-”gay” MSM. That suggests that we were wrong to reject the term entirely, but that the CDC was also wrong to lump us all together.
Our objection to “MSM” had a good deal of merit. It seemed like a social conservative attempt to deny that men could actually be constitutionally oriented toward love and sex with other men, instead treating our orientation as just a succession of sexual acts.
Even more, it rejected our self-affirming label “gay.” After all, one of the first steps of the ex-gay process is to persuade gay men to stop thinking of themselves as “gay” or “homosexual” — i.e., to reject the identity.
Whatever the CDC’s reasoning, it is certainly true that during the Reagan administration, when social conservatives began to wield a great deal of influence, any attempt by the CDC to talk about “gay men” or “gay and bisexual men” would have met vigorous criticism and objection.
BUT OVER THE years, MSM came to have a sort of plausibility. There are large numbers of men who have and may well prefer sex with other men, but who use a variety of rationalizations to evade acknowledgment of their homosexuality or bisexuality, and the CDC’s MSM designation did manage to include them without seeming threatening.
How many? A 2003 telephone survey of more than 4,000 men conducted by the New York City public health department just published in the Annals of Internal Medicine found that MSM who deny being gay are more numerous than self-acknowledged gay or bisexual men.
According to Reuters, fully 10 percent of the men in the survey who identified themselves as “straight” said in the past year they had sex with one or more men but no woman. And that figure is undoubtedly low since telephone surveys traditionally encounter the greatest degree of cover-up of homosexual activity.
Since only 9 percent of the men acknowledged being gay or bisexual (or “unsure”), that means that more straight men are engaging in gay sex than gay and bisexual men are, although further questioning determined that they have fewer partners than the gay/bi men.
They use a variety of rationalizations to deny being gay. They may think “gay” designates a specific set of social behaviors or “lifestyle” — regularly going to clubs, taking drugs, attending parties, obsessing with fashion, etc. That most gays do few or none of these things is irrelevant if the “straight” men have accepted that stereotype.
Or they may think “gay” designates men who act publicly in a feminine (or effeminate) manner — a stereotype left over from the 1950s and still common enough among some males at lower educational levels. They may believe that “gay” men are only the ones who take the receptive or “insertee” role in sexual behavior. This view seems to be particularly common in third world countries.
Then too, some men make a radical distinction between their sexual and emotional desires and deny being gay if, while enjoying sex with men, their only emotional relationships are with women.
NOT SURPRISINGLY given these rationalizations, the “straight” men who had gay sex were more likely to belong to a racial or ethnic minority, to be born in a foreign country, and to have a lower educational level. They were also less likely to have used a condom during their most recent sexual activity with a man.
But if they think that by denying that they are gay or bisexual they are protected from AIDS, they are denying reality. And denying reality invariably has a cost.
The CDC may not be doing anyone, including itself, a favor by using a single term for gay men and for “straight” men who have sex with men. They are different populations with different attitudes and behaviors.
So whatever the CDC wishes to call those “straight” men, maybe after more than two decades it is time for the CDC to start calling us by our own name.
