YOUNG AND MEYER RESPOND

Abstract

In response to our article, we have heard from public health researchers and practitioners from the United States and abroad. Many shared our concerns about problems posed by the terms MSM and WSW and some, such as Khan and Khan,1 Pathela et al.,2 and Ford,3 raised new questions. We are pleased that we succeeded in initiating a conversation among public health professionals about the use of the terms MSM and WSW and thank the writers for engaging in the dialogue. Khan and Khan’s letter demonstrates that the alleged simplicity and universality of MSM is false: the term cannot be applied in a meaningful way in the South Asian context they describe. Pathela and colleagues seem to have understood our main concern to be that MSM and WSW are used “to displace information regarding sexual identity.”2(p766) That is not what we meant to convey. Our primary concern was that while WSW and MSM were introduced to be precise and nonproblematic terms, they have too often been used as single, benchmark terms that relieve researchers of the task of collecting or reporting on other aspects of sexuality that may be relevant, including, but not limited to, sexual identity. Pathela et al. present data showing variation across samples in the concordance between gender of sex partners and sexual identity. These data do not refute our arguments, as the authors seem to suggest. We see in these authors’ data another example of why measures of multiple dimensions of sexuality are preferable. In our article we did not suggest that using identity terms is always preferable, and we certainly did not suggest a preference for one identity term (e.g., gay) over others. Rather, our main point was that researchers and public health practitioners need to pay careful attention to the phenomena they describe and use terms that do these phenomena the most justice. We take this opportunity to reiterate that we do not wish to “ban” the terms MSM and WSW—as some have suggested in writing to us—but to urge greater examination of how and when these terms are appropriate.