That’s the Bottom Line: Sexual Positioning, Gender Expression, and Psychological Well-Being Among Young Sexual Minority Black Cisgender Men Who Seek Partners Online

Sexual positioning is a salient aspect of identity for many sexually minoritizedmen.However, individuals who take on the receptive sexual role (i.e., “bottoms”) and those with a more feminine gender expression are often subject to greater stigma. There is a severely limited body of quantitative research examining the health impacts of positioning and gender expression stigma among sexually minoritized men. Even fewer studies consider the complicated intersectional dynamics of race/ethnicity. To address these gaps, we collected cross-sectional survey data from 574 young sexually minoritized Black men (YSMBM) who use websites/mobile apps to meet partners. Regression analyses were conducted to examine the association between sexual positioning identity (top, bottom, versatile), the moderating role of gender expression, and mental health/psychological well-being among YSMBM. Versatile men scored significantly higher on depressive symptoms compared with tops. Predominantly feminine or masculine (but not neutral) gender expression affected the self-worth and self-perceived sexual attractiveness of YSMBM differentially based on their sexual positioning role. Feminine tops were the most negatively impacted, while bottoms exhibited some resilience to the pressure of masculinity norms. These findings have implications for emerging priorities in social/applied health sciences with YSMBM and may also have implications for practitioners who work with YSMBM.Public Significance Statement This study examined the associations between sexual positioning identity, gender expression, and mental health/psychological well-being among young sexually minoritized Black men. Versatile men reported higher depressive symptoms relative to tops, bottoms exhibited resilience to masculinity norms, and feminine tops reported lower psychological well-being relative to all groups. These findings have implications for emerging priorities in social/applied health sciences with sexually minoritized men of color and may also have application for clinical practice.