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CRITICAL CONCEPTS FOR REACHING POPULATIONS AT RISK: Rebecca M. Young and Ilan H. Meyer The Trouble With "MSM" and "WSW": Erasure of the Sexual-Minority Person in Public Health Discourse Am J Public Health 2005; 95: 1144-1149 [Abstract] [Full text] [PDF]

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The Downside to Parsimony and Reductionism

Cynthia M Saunders   (13 October 2005)

The Downside to Parsimony and Reductionism 13 October 2005
Cynthia M Saunders, Assistant Professor California State University, Long Beach Send letter to journal: Re: The Downside to Parsimony and Reductionism csaunder{at}csulb.edu Cynthia M Saunders	Reductive labeling, regardless of subject, results in a loss of contextual understanding beyond the risk factor. Whether the label is hypertensive, psychiatric, uninsured, or obese, an enormous amount of thick, descriptive information is lost. Young and Meyer bemoan (1) this lack of context in the “MSM” and “WSW” label, which provides a parsimonious, unambiguous, and understandable description of behavior. Providing a deeper meaning of the identity and community of individuals thus labeled likely leads to better primary prevention. Data reduction is a goal of all research whether qualitative or quantitative materials are collected. In fact, the terms suggested by the authors are themselves reductive: “sexual minority, top, bottom, bareback, gay, lesbian, bisexual.” The labeling is a consequence of the “number crunchers hegemony” in health services and social science research, as evidenced by qualitative researchers labeling their participants as MSM (2) or BMSM (3) in order to disseminate studies. Young and Meyer suggest that participants be discussed using their full range of identity terms, although this process would likely be unwieldy with insufficient power to draw quantitative conclusions. For example, in an open-ended question of “What is your ethnicity?” in a college-age health education study, over 90 ethnic categories were identified by students, which ultimately forced a recoding of data, mimicking the United States census choices (4). If the goal is to make data understandable, data reduction is necessary. To shift to a world of dissemination where labels are minimally used, researchers must be willing to go beyond the comfort of their armchair analytic experiences and be on the periphery of the group, perhaps feeling awkward, embarrassed, and out of place (5). Opposing the current methodological paradigm which clearly favors quantitative studies is a professional risk for funding and publishing, when it is much easier to follow the status quo (6). University faculty must acknowledge the need to teach both qualitative inquiry and quantitative methods to students. Journal editors must broaden their guidelines for manuscripts, deeming that a paper go beyond the current quantitatively favored word count. A world of qualitative inquiry will further the aim for a deeper understanding of variations in our communities. Young RM, Meyer IH. The trouble with “MSM” and “WSW”: erasure of the sexual-minority person in public health discourse. Am J Public Health. 2005; 95(7):1144-1149. Niang CI, Tapsoba P, Weiss E, et al. ‘It’s raining stones’: stigma, violence and HIV vulnerability among men who have sex with men in Dakar, Senegal. Cult Health Sexuality. 2003;5:499-512. Malebranche DJ, Peterson JL, Fullilove RE, Stackhouse RW. Race and sexual identity: perceptions about medical culture and healthcare among black men who have sex with men. J Natl Med Assoc. 2004;7:55-80. Lindsey B, Saunders C. College students health interests: a comparison by ethnicity, gender, and other demographic variables. J Health Educ. 1999; 30: 36-41. Wax RH. Doing fieldwork: warnings and advice. Chicago: University of Chicago Press, 1971. Morse JM. Are there risks in qualitative research? Qual Health Research 2001; 11(1): 3-4.