MSM (men who have sex with men)

MSM stands for men who have sex with men, a term from public health and epidemiology. It was introduced in the 1990s to shift the focus onto behavior rather than identity — because some men who have sex with men do not identify as gay or bisexual, and an identity label would both miss them and drive away people who reject the label from health services.

There is a real logic to that starting point, but it has also drawn steady criticism. Detractors point out that MSM compresses living people into a “risk category,” erasing identity, relationships, and community belonging; and when the term surfaces only in the context of “HIV risk,” it can quietly reinforce the stigma that “gay = disease.” So it is a useful tool that has to be handled with care.

Register note: MSM belongs to epidemiological and public-health literature, describing a defined study population. It is not a self-identifier — no one says “I’m an MSM.” In everyday and community contexts, use identity words like tongzhi or gay.

Common misuse: treating MSM as a synonym for “gay men.” The two are not equivalent — it describes behavior and covers people of every kind of self-identification, or none at all.