Author Jesse BeringA new article in Scientific American explores issues of sex behavior-role labeling among men who have sex with men (a category that includes ex-gays). The article, written by Jesse Bering, refutes some assumptions among heterosexuals about what men do behind closed doors, and how they label themselves:

…Survey studies have found that many gay men actually self-identify as “versatile,” which means that they have no strong preference for either the insertive or the receptive role. For a small minority, the distinction doesn’t even apply, since some gay men lack any interest in anal sex and instead prefer different sexual activities. Still other men refuse to self-label as tops, bottoms, versatiles or even “gay” at all, despite their having frequent anal sex with gay men. These are the so-called “Men Who Have Sex With Men” (or MSM) who are often in heterosexual relations as well.

The article observes that predominantly insertive and predominantly passive partners tend to be honest in labeling their role — but not necessarily their sexual orientation.

Tops were more likely than both bottoms and versatiles to reject a gay self-identity and to have had sex with a woman in the past three months. They also manifested higher internalized homophobia—essentially the degree of self-loathing linked to their homosexual desires.

Attitudes among predominantly insertive partners appear to differ substantially from those who identify as “versatile”:

Versatiles seem to enjoy better psychological health. Hart and his coauthors speculate that this may be due to their greater sexual sensation seeking, lower erotophobia (fear of sex), and greater comfort with a variety of roles and activities.

The article cites one 2003 Centers for Disease Control study, published in the Journal of Sex Research, which observed that while labels do not directly correlate to unsafe sexual behaviors, they do reflect upon individuals’ likely awareness of safer-sex protocols:

Although self-labels were not associated with unprotected intercourse, tops, who engaged in a greater proportion of insertive anal sex than other groups, were also less likely to identify as gay. Non-gay-identified MSM [again, “Men Who Have Sex With Men”] may have less contact with HIV prevention messages and may be less likely to be reached by HIV-prevention programs than are gay-identified men. Tops may be less likely to be recruited in venues frequented by gay men, and their greater internalized homophobia may result in greater denial of ever engaging in sex with other men. Tops also may be more likely to transmit HIV to women because of their greater likelihood of being behaviorally bisexual.

Another study, published in Sexual and Relationship Therapy in 2008, warns that gay male couples “might want to weigh this issue of sex role preferences seriously before committing to anything longterm. From a sexual point of view, there are obvious logistical problems of two tops or two bottoms being in a monogamous relationship. But since these sexual role preferences tend to reflect other behavioral traits (such as tops being more aggressive and assertive than bottoms), ‘such relationships also might be more likely to encounter conflict quicker than relationships between complementary self-labels.'”