So, my reader questions are nothing like I expected them to be. Which probably makes them more fun to answer. This question has to do with sexual identity, so skip it if it’s not something you are comfortable reading about.

Q: Why did we begin using the term MSM? I thought it was because not all men who have sex with men consider themselves to be homosexual or bisexual. I thought there was a trend of allowing individuals to determine his/her own sexual identity.

I have had an argument with 3 friends, 2 liberal, about this exact conversation. In my head, a man having sex with men does not make him homosexual or bisexual. In the head of my friends, it does. Am I crazy? Am I being overly sensitive and picky about the wording that we use? Is this not a personal descriptor that can only be determined by the individual? Does it actual “make” someone gay? Is this just something that I should get over because it is never going to change? I am not ready to say I am wrong. One friend threw wikipedia and the oxford dictionary out.

A: I think you are exactly right. There are a whole host of emotional and cultural reasons a man might have sex with another man and yet not be homosexual or bisexual. I think we use the term MSM because sexual identity is so fluid and complex that it’s a lot more useful to just describe the situation than to try to apply a label that serves no diagnostic or risk-management purpose. As health professionals, it is useful to know if a man has sex with other men; his reasons for doing so are a lot less important in any immediate calculation.

There are plenty of reasons a man himself might want a more specific label for his sexuality, but that’s not our business. We just want to provide the best services possible.