Īmong men who have anal sex with other men, the insertive partner may be referred to as the top, the one being penetrated may be referred to as the bottom, and those who enjoy either role may be referred to as versatile.

Many MSM, however, do not engage in anal sex, and may engage in oral sex, frottage or frot, or mutual masturbation instead. Historically, anal sex has been popularly associated with male homosexuality and MSM. The penetrating man on the right is the 'top' and the receptive man on the left is the 'bottom' in missionary position.