(3) Tops were more likely than both bottoms and versatiles to reject a gay self-identity and to have had sex with a woman in the past three months. They also manifested higher internalized homophobia—essentially the degree of self-loathing linked to their homosexual desires.

(4) Versatiles seem to enjoy better psychological health. Hart and his coauthors speculate that this may be due to their greater sexual sensation seeking, lower erotophobia (fear of sex), and greater comfort with a variety of roles and activities.

One of Hart and his colleagues’ primary aims with this correlational study was to determine if self-labels in gay men might shed light on the epidemic spread of the AIDS virus. In fact, self-labels failed to correlate with unprotected intercourse and thus couldn’t be used as a reliable predictor of condom use. Yet the authors make an excellent—potentially lifesaving—point: 

Although self-labels were not associated with unprotected intercourse, tops, who engaged in a greater proportion of insertive anal sex than other groups, were also less likely to identify as gay. Non-gay-identified MSW [again, “Men Who Have Sex With Men”] may have less contact with HIV prevention messages and may be less likely to be reached by HIV-prevention programs than are gay-identified men. Tops may be less likely to be recruited in venues frequented by gay men, and their greater internalized homophobia may result in greater denial of ever engaging in sex with other men. Tops also may be more likely to transmit HIV to women because of their greater likelihood of being behaviorally bisexual.

Beyond these important health implications of the top/bottom/versatile self-labels are a variety of other personality, social and physical correlates. For example, in the article by Moskowitz, Reiger and Roloff, the authors note that prospective gay male couples might want to weigh this issue of sex role preferences seriously before committing to anything longterm. From a sexual point of view, there are obvious logistical problems of two tops or two bottoms being in a monogamous relationship. But since these sexual role preferences tend to reflect other behavioral traits (such as tops being more aggressive and assertive than bottoms), “such relationships also might be more likely to encounter conflict quicker than relationships between complementary self-labels.”

Another intriguing study was reported in a 2003 issue of the Archives of Sexual Behavior by anthropologist Mathew McIntyre. McIntyre had 44 gay male members of Harvard University’s gay and lesbian alumni group mail him clear photocopies of their right hand along with a completed questionnaire on their occupations, sexual roles, and other measures of interest. This procedure allowed him to investigate possible correlations between such variables with the well-known “2D:4D effect." This effect refers to the finding that the greater* the difference in length between the second and fourth digits of the human hand—particularly the right hand—the greater the presence of prenatal androgens during fetal development leading to subsequent “masculinizing” characteristics. Somewhat curiously, McIntyre discovered a small but statistically significant negative correlation between 2D:4D and sexual self-label. That is to say, at least in this small sample of gay Harvard alumni, those with the more masculinized 2D:4D profile were in fact more likely to report being on the receiving end of anal intercourse and to demonstrate more “feminine” attitudes in general.