SSN Key Findings

Why Some Men Have Sex with Men but Identify as Straight, Not Gay or Bisexual—and the Implications for Health Care

Policy field

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University of Oregon

To learn more about why behaviors and identities do not always match, I interviewed 60 rural white men who identify as heterosexual, but have had sex with other men. Social context, I found, plays an important role in mediating the relationship between behavior and identity.  My findings have important implications for public health efforts, particularly in rural areas of the country.

Sexual Identity versus Sexual Orientation

Many people think that straight men who have sex with men are “actually” gay or bisexual. This is not true, because sexual orientation and sexual identity are different. Sexual orientation refers to attractions, fantasies, and desires, as well as sexual behaviors. Sexual identity refers to how individuals understand their sexuality in the context of other aspects of their lives, especially the groups and institutions they feel part of. The men I talked with had varied sexual orientations, but all identified as straight and had experienced sex with men. Key reasons for identifying as straight included loving their wives, finding fulfillment in fatherhood, and enjoying being part of straight communities. Yet a majority expressed support for same-sex marriage and childrearing. They did not identify as straight simply because of internalized homophobia.

Straight Culture

Alignment with straight culture was a key reason for these men’s straight self-identifications. Rural straight culture was what they specifically appreciated, given that the men I talked to resided in such areas. Many were farmers or ranchers, and loved hunting, fishing, shooting guns, or other elements of rural life. “Straight” referred to an identity, a way of life, and a community. Marriage and/or fatherhood were central to what it meant to them to be rural and masculine straight men. 

Some men identify as gay or bisexual because they view their sexual orientation as a key part of their identity. Others, such as the men I talked to, do not view sex with men as meaningful to their identity. As a result, it does not make sense to them to identify as anything but straight. They show that men can, and do, identify as straight even as they enjoy sex with men.

Researchers, politicians, policy makers, and media figures have long discussed gay culture and gay communities. Few have talked about straight cultures or straight communities, however. Like all cultures, straight culture involves institutions that uphold it and groups of people that feel connected to it. Whatever their sexual feelings, people’s identifications and the sexual cultures they feel connected to reflect their social context in youth and adulthood.

Qualitative research is not generalizable, but representative surveys are – and they show that religiosity and conservatism are strongly associated with straight identification for both men and women – including those with or without same-gender sexuality. They also show that many politically liberal people identity as straight even as they enjoy same-gender sex. Results from various studies suggest that sexual identification can affect attitudes, and that attitudes can affect sexual identification. My qualitative research helps explore this more in depth, and shows that sexual culture and social context may be in part responsible for survey findings.

Sexuality Can Shift Over Time

The aging process can affect men’s sexuality. Many of the men I talked to only began having sex with men in middle age and beyond. Most experienced unanticipated changes to their attractions in their 30s, 40s, 50s, or even 60s. Additionally, many explained that sex became undesirable or painful for their wives. Turning to sex with men helped them relieve sexual desires without feeling as though they were threatening their marriage. Men’s sexual attractions and behaviors can be flexible over the life course, even as many continue to identify as straight. Mental health practitioners who work with older clients should be prepared to discuss these changes and any anxiety they cause. Physicians should also encourage testing for sexually transmitted infections even among clients who are older and married. Sexual proclivities or inactivity cannot be presumed.

Implications for Mental Health Care

These findings also have implications for how practitioners address mental health needs of sexual minorities. They should distinguish “closeted” individuals who secretly identify as lesbian, gay, or bisexual from very different kinds of people who identify as straight but also secretly enjoy same-sex eroticism. Only by making appropriate distinctions can health workers, policy makers, and other professionals adequately respond to each group’s needs.

As practitioners continue to help all individuals challenge internalized homophobia, they should also keep in mind that gay and bisexual men have different mental health needs than straight men who have sex with men. The best way to serve straight men who have sex with men is to validate their straightness while also challenging whatever internalized homophobia they experience and giving them support for any stress they experience in keeping their sexual encounters secretive. Recent research using nationally representative data shows that straight men who have sex with men do not necessarily have lower levels of psychological wellbeing than other groups of men.

Tailoring Sexual Health Care to Rural Areas

Many of the men I interviewed were afraid to get tested for sexually transmitted infections. There were few physicians and testing locations in their communities, and they feared friends, colleagues, or family members might learn of any tests they took. Many also seemed to know little about how common sexually transmitted infections spread. To educate such people confidentially, public health officials should utilize online platforms for straight men having sex with men. And confidential, low-cost screenings might be offered in mobile units that regularly travel to rural areas. Another option is to tell men how to collect their own samples to send through the mail. Similar strategies have worked in remote locations in Alaska, suggesting their potential effectiveness in tailoring tests for sexually transmitted infections to other rural areas.