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The sexual repertoires of men who have sex with men (MSM), transgender (trans) and gender-diverse groups are poorly understood despite their disproportionate rates of sexually transmitted infections (STIs). The interrelated landscapes and syndemics of the social and sexual behaviour of MSM, trans and gender-diverse groups, and transmission of STIs have changed beyond recognition over the past 20 years.1–3 We are only beginning to understand the complex and evolving sexual behaviours of MSM in mainly urbanised Western populations such as described in the article by Kilner et al.4 The majority of our understanding of sexual behaviour in the trans population comes from studies of trans women, with much less being understood about trans men and almost nothing about non-binary or other gender-diverse people.5 Little is also known about the sexual behaviours of sexual orientations such as pansexual or individuals who mainly have sex with trans or non-binary people, for whom we still lack clear terminology. It is time we included all sexual and gender minorities in behavioural and epidemiological research of this kind.
The changes in the complex sexual and social lives of MSM has been driven partly by social networking, information technology and the increasing social acceptability of MSM in some societies. The internet, and in particular geosocial mobile phone apps, have transformed the way and frequency that individuals and groups meet socially and …
Contributors DR drafted the manuscript, KZN and TN revised the manuscript and all authors contributed to the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Commissioned; internally peer reviewed.
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