For the reason that international monkeypox outbreak began to unfold this previous spring, extra individuals are seeing the time period “males who’ve intercourse with males,” or MSM, within the information and public well being messages. You’ll have additionally heard this time period in locations like HIV prevention campaigns or on the physician’s workplace.
I’m a behavioral scientist who focuses on decreasing well being disparities and enhancing well being fairness for sexual and gender minority populations at highest danger for poor outcomes. On the most elementary stage, males who’ve intercourse with males is a time period that was initially supposed to explain the chance of HIV transmission related to intercourse between two males. However in actuality, MSM describes a various group of behaviors and identities, bringing with it a fancy net of social, political and cultural concerns about the way it’s used.
Why use MSM?
HIV researchers have used the time period “males who’ve intercourse with males” since not less than 1988 as a option to describe a selected kind of sexual habits that will have an effect on well being.
The acronym MSM, nonetheless, was launched in 1994 as a brand new idea by some researchers and group advocates in response to public well being analysis and prevention efforts early within the HIV/AIDS pandemic. These efforts nearly completely focused males primarily based on their sexual identification as homosexual. Group advocates criticized this strategy for excluding Black and Latino males who’ve intercourse with males who have been affected by the pandemic however didn’t establish as homosexual, gay or bisexual. MSM was thought of to be a extra inclusive, much less stigmatizing time period that may very well be used to achieve a broader vary of individuals.
AP Picture/Rick Maiman
From a scientific perspective, utilizing an identity-free time period like MSM permits medical suppliers and public well being practitioners to bypass the complexities of the social, cultural and political context of sexual orientation. As a substitute, they will then give attention to the habits which may put somebody in danger for an an infection reminiscent of HIV or monkeypox. This strategy is meant to assist improve the chance of screening, diagnosing and treating these on the best danger.
Prevention methods that concentrate on individuals primarily based on “what you do” somewhat than “who you’re” attain extra individuals who could also be affected by a public well being concern, together with heterosexual males who’ve intercourse with males, somewhat than limiting outreach simply to those that establish as homosexual or bisexual. They provide a bigger variety of males the chance to know their danger and take the steps mandatory for cover or remedy. Additionally they assist lower stigma for many who establish as homosexual or bisexual.
Limitations of MSM
Regardless of its usefulness in some contexts, the time period MSM has been hotly debated by students and group advocates because it was coined. Disagreement on its use is normally grounded in three arguments.
The primary is that the time period is ambiguous. Some researchers argue that distilling MSM all the way down to “intercourse between two males” is simply too simplistic. For one, there are a variety of nuances and elements that affect the quantity of danger related to intercourse between two males, reminiscent of how intercourse is carried out and who and what number of companions are of their sexual community. There may be additionally confusion about how regularly or lately somebody will need to have intercourse with a view to be thought of MSM. And there’s no consensus about whether or not transgender males who’ve intercourse with males must be thought of MSM.
The second critique is that the time period undermines the identities of sexual minority group members, notably individuals of colour. Many public well being researchers use MSM as a impartial time period to push again towards the concept there is just one professional homosexual identification. Nevertheless, some have criticized the time period for erasing different sexual identities reminiscent of queer, two-spirited and same-gender loving by being the default time period utilized in analysis, regardless of contributors describing themselves as in any other case.
Lastly, the third argument is that the time period conceals the social, political and cultural dimensions of well being necessary for public well being analysis and intervention. One of many best benefits of MSM is that it’s grounded in tangible behaviors that researchers can goal for well being promotion and prevention efforts. However sexual well being is influenced by a constellation of things, and specializing in habits alone is commonly not sufficient to fully defend towards sickness.
Past sexual habits, discrimination and social marginalization put sexual minorities at vital danger of poor well being outcomes. These can take the type of structural elements, reminiscent of anti-gay laws, and group elements, reminiscent of discrimination and stigma. Interpersonal elements like relationship abuse and particular person elements like internalized stigma additionally play a task. These elements improve the chance of psychological sickness, reminiscent of melancholy and suicidal ideas, in addition to dangerous well being behaviors, reminiscent of intercourse with no condom or whereas beneath the affect of medicine.
Nearly 30 years because it was launched, the time period MSM is changing into more and more ubiquitous in each medical and public well being areas. But it surely does have limitations. Contemplating the sociopolitical context of whether or not MSM must be used, somewhat than utilizing it by default, may also help help the self-determination of those that belong to traditionally marginalized communities.
JaNelle Ricks doesn’t work for, seek the advice of, personal shares in or obtain funding from any firm or organisation that might profit from this text, and has disclosed no related affiliations past their tutorial appointment.
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