Who\u27s on Top? The Mental Health of Men Who Have Sex with Men

Despite most men who have sex with men (MSM) expressing intercourse position preference (e.g., “top”, “versatile”, or “bottom”), there is little information regarding sexual behavior and mental health sequelae. From the perspective of gender schema theory, the current study examined how position preference related to gender roles, internalized homophobia, and mental health. A total of 70 MSM (U.S. residents, M age = 28.89 years, 68.6% White) were recruited for an online study and grouped according to position preference. Groups were mostly similar across demographic variables, although bottoms had fewer sexual partners and lower condom use than tops and versatiles. In terms of gender roles, tops and versatiles were significantly higher in both masculine and feminine traits than bottoms. Tops were significantly more likely to report internalized homophobia than versatiles and bottoms. After controlling for masculinity, versatiles had the highest mental health. Results suggest further study of different sub-populations of MSM is warranted