The Lived Experiences of Male Sex Workers: A Global Qualitative Meta-Synthesis

Round 1

Reviewer 1 Report

The Lived Experiences of Male Sex Workers: A Global Qualitative Meta-Synthesis

This paper analyzed major themes about male sex workers in 66 qualitative publications about this population. Male sex workers (MSW) are an under-examined population, and it is useful to have a paper which overviews qualitative research about them. Overall, I think the authors do a great job synthesizing the literature in this under-studied area. This paper would fit well within the special issue. I have some suggestions for revisions, which are intended to help the authors strengthen the manuscript to help it reach its full potential.

Major:

I recommend that you include this article in the review:

Oselin, Sharon S., and Kristen Barber. 2019. “Borrowing Privilege: Status Maneuvering among Marginalized Men.” Gender & Society 33(2):201–23. doi: 10.1177/0891243218823354.

Please also use a term other than “adult industry”, which brings to mind pornography. Please instead use a different term, such as “sex work industry”, throughout the paper.

“Studies that included various perspectives on the experiences of cisgender men who sell sex, such as clients, female sex workers, and health care providers, were not included because findings specific to the experiences of MSWs could not be separated from those of other respondents.” This statement is a bit unclear. It is certainly reasonable to exclude research that focused exclusively on *perspectives about* cisgender MSW, or research that did not separately analyze data from MSW and other groups. However, I recommend that the authors include research that, for example, contained interview data from cisgender male sex workers as well as their clients. In the context of this review, the authors would only analyze the parts of the articles that included data from cisgender male sex workers, and ignore the data about perceptions of clients, providers, etc. Based on the current description, I am unsure whether that type of paper would have been included in the synthesis. Basically, what I am suggesting is that all research that contained qualitative data from male sex workers should be included in the review so long as the MSW data in that research can be analyzed separately from other groups (clients, etc.).

Table 1 “Qualitative tradition” column: I recommend an overhaul of this column. Rather than “qualitative tradition”, which unhelpfully includes many “NS” cases, you can present method: ethnography (which is already present), case study, interviews, focus groups, etc. I think this breakdown would be more informative than the current information.

The “theme” box for Corriveau (2014) appears incomplete, given that there is an ellipsis “…”

Why are the themes missing for certain articles? Themes should be present for each article.

Table 1 presents geographic location inconsistently: some boxes have city and country, whereas others only have country. Additionally, with city and country, some rows list country first (e.g., Manchester, United Kingdom) and others list it second (Czech Republic & Prague). I recommend including only the country for consistency.

I also recommend that Table 1 includes a column to identify whether the MSW sold services to men, women, or both.

I recommend that Table 1 is organized by year rather than by the first author’s last name. This organization seems more relevant and logical for the reader.

Theme 2, Theme 3, and Theme 8 should be organized into second-level headers, given that they are long sections.

Under each of the nine themes, please state the number of articles that discussed this theme.

Minor:

“The adult industry's most often cited feminist critiques insist that sex work reifies hegemonic masculinity where cisgender men exert their institutional power to sexually exploit cisgender women (see George et al., 2010).” I recommend that you avoid the term “hegemonic masculinity”, since it has a highly specific theoretical definition not present in this discussion.

“Frequently, female sex work is positioned as more of a public concern than male sex work.” Why do you think that is? I suspect it is due to the greater prevalence of women who sell sex, as well as gender norms about sexuality.

“The involvement of cisgender men as sex workers challenges some of the heteronormative assumptions of women’s bodies as commodified objects (Minichiello et al., 2013).” How so? Please explain more.  

“leaving countries like sub-Saharan Africa, East and Southern Asia, and the Middle East largely ignored.” These places are global regions, not countries.

“Second, we hand searched for gray literature produced by organizations that sought conduct research with or offer services to MSWs. These organizations included U.S. Department of Health and Human Services, Global Network of Sex Work Projects, Red Umbrella Fund, ect.” First, I’m not sure what you mean by “sought conduct research.” Second, please state all of the organizations rather than writing “ect” (which should be etc.).

Figure 1: please provide more detail in the box for “records excluded (N = 273)”, specifically what the authors wrote about those papers not having a qualitative component.

Page 14: define IMSW.

The block section from Qiao et al., 2019 is a bit confusing. I recommend presenting sections from different parts of that paper on different lines, because otherwise the disparate quotations and other information run together in a way that is difficult to follow.

“For instance, MSWs experienced significant difficulties in maintain time with their extra-vocational relationships”. Please correct this typo: it should be “maintaining time”.

“Additionally, sexual jealousy arose as another significant prohibitor”—this statement sounds odd because the block quotation says the exact opposite.

“Smith et al. (2015, p. 1052) noted that “a number of escorts divided their personal sexual behaviors between casual and relationship partners: escorts often discussed how kissing and anal intercourse were too “personal” or “emotional” to do with clients.”” This information is in two sections, theme 2 and theme 3; I recommend including it in only one.

“don’t often bottom3 for them either”—delete the “3” in that statement.

“purposely start 20omething”—same comment.

The section beginning with “Although they did at times continue” should be indented, as it appears to be a direct quotation from Oselin 2016.

“the source of his additional income…ourth, they wanted”—please fix this typo.

“Article discussing MSWs sexual behavior”—typo; article should be plural.

“Fernando: No, actually...I don’t want to do this work anymore. Physically are you attracted to them? Are you aroused by men?” This segment of the included interview looks like a portion of the interviewer’s question was accidentally included with Fernando’s response.

“Simply put, MSWs were able to increase their value in the eyes of their clients by way of developing parasocial relationships, i.e., one-sided relationships wherein one or more of the members of a relationship are pretending to be more emotionally engaged and invested than they authentically are.” This description I think is unfair—the language of “pretending” and “authentic” contrasts with the next sentence, about “bounded authenticity,” which is more analytically appropriate.

“social relationship intensives for clients”—please fix this typo.

“For instance, Curtis et al. (2019) found that to combat experiences of stigma and cope with some of the practicalities of the industry; many participants choose to…” The semicolon should be a comma.

“According to Perkins and Bennett (1985), violence against sex workers is a product of society's belief that they were doing a service for the community.” This statement doesn’t seem right—if society believed sex workers were doing a service, then why would violence be normalized? The rest of this section makes sense. It is just this statement that reads as incorrect.

“This Findings in a global ignorance”—typo.

“the rhetoric of all queer men being sex workers is still prevalent in popular culture.” This comment is an overstatement.

“such as homophobia resulting from implicit queerness”—I recommend rephrasing to “resulting from assumptions of queerness” or “associations with queerness”.

Thank you to the authors for doing this work and best of luck in the revisions.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

The Lived Experiences of Male Sex Workers: A Global Qualitative Meta-Synthesis

This paper contributes to the scholarly literature by synthesizing and drawing conclusions from a body of studies of male sex work. Overall, it is an impressive work, but there are several important issues that need to be addressed before the paper can be reconsidered for publication.

Articles were eligible if they were published between 2000 and 2021. However, the authors screened out so many articles that readers will wonder if what remained is sufficient basis for the conclusions presented. The initial screening identified 8,761 articles, but after removing those that the authors considered ineligible, we are left with only 66. I note that a 2008 study, by Dennis, analyzed a much larger body of work, 166 articles, making the 66 included in the present paper even more surprising in light of the increase in relevant publications from 2008 to the present.

Part of the reason is that, in the screening process, the authors read only the abstracts of papers, not the full papers. I also question why they eliminated quantitative studies, which can certainly address the author’s research questions (i.e., focused “exclusively” on actors’ “lived experiences”, line 132), and instead limited the sample to qualitative works. And why not include articles that included a significant amount on lived experiences but also addressed other aspects of participants’ work lives? And provide a better justification for excluding quantitative studies.

The findings are organized around 9 themes. The take-aways from these sections would be stronger had the authors linked each to the existing literature on cis female sex workers. Each of the thematic sections could begin or end with a short paragraph describing what research shows about female workers, then move to your analysis of the male-worker literature. (The authors make only a very brief comment on female workers in the Conclusion.) As I read through each section, I kept saying to myself: “That is exactly what the literature on other sex workers shows.” If the authors decide not to include such comparisons, I think it is a missed opportunity. And readers will be especially interested in how the male literature DIFFERS from the female studies and how best to EXPLAIN those differences. Doing so would make the paper a much stronger contribution to our understanding of how gender does and doesn’t make a difference in the field of sex work. There are several state-of-the-field articles on female sex workers that could be mined here—e.g., by I. Vanwesenbeeck, R. Weitzer, etc.

Is there anything SURPRISING in your findings?  If so, it should be highlighted.

Stylistically, the paper is way too long, 43 single-spaced pages. Related to this is the issue of quoting so extensively from the studies reviewed. Some of this is great, illustrating larger points. But it is done too often and many of the quotations (from line 289 to 907) should be condensed or restated in your own words. I’m sure the authors don’t want to be accused of over-using other researchers’ text. In addition, much of the material in the Findings section is restated in the long Discussion section.

Examples of over-quotation include the interview transcript reproduced on lines 758-800, and the lengthy block quotes throughout the paper (e.g., lines 853-860, 881-892, etc).

183 citations is excessive for a journal article! Some of these citations are redundant, especially some by the same authors. Do we really need 5 citations to Kong, several to Bimbi/Parsons/Koken, 3 to Smith? The paper is very long and can be streamlined.

Author Response

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Author Response File: Author Response.docx

Reviewer 3 Report

It is an original, necessary and very interesting text, but it is extremely long.

The topics on which he works are equally necessary.

You should reduce the text in some redundant parts.

Remove, for example, some "verbatims" fragments.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Review of “The Lived Experiences of Male Sex Workers: A Global Qualitative Meta-Synthesis”

I was one of the original reviewers of this manuscript, and I was excited to read the most recent draft. The authors incorporated most of my suggestions from my prior review, and I have only a few moderate or minor suggestions for revisions, each of which is intended to help the authors strengthen the manuscript so it can reach its full potential.

Moderate:

It looks like Table 1 was edited in light of my suggestions from my prior review, although it is difficult to see definitively because track changes on tables is difficult to follow. Regardless, I see the authors have incorporated the following article I recommended:

Oselin, Sharon S., and Kristen Barber. 2019. “Borrowing Privilege: Status Maneuvering among Marginalized Men.” Gender & Society 33(2):201–23. doi: 10.1177/0891243218823354.

There are two minor concerns with this inclusion and one moderate one. First, Table 1 incorrectly lists the paper as Oselin 2019 when it is Oselin and Barber 2019. Second, the paper does not appear in the reference list.

Third, and most of concern, the stated number of articles/reports in the review remains at 66, even though one paper was added. I counted the studies overviewed in Table 1 and also saw 66—but how is that number accurate when the prior draft overviewed 66 studies and then one was added in this draft? Did the authors delete an article that appeared in the last draft? Please carefully assess whether all relevant articles are included in Table 1, and then please make sure those numbers are accurately reflected in Figure 1. Similarly, if the authors became aware of an article through peer review, then the number of articles included in the “further identification” section of Figure 1 needs to be updated.

Minor:

Please define IMSW. The authors stated that they did so, but I do not see it in this draft.

“This lack of service from nonprofits may reflect how some MSWs feel they are not considered “real prostitutes” because of the difference between how men and women sell sex on the streets (Henriksen et al., 2020).” Is “real prostitute” a quotation from the article? If so, please include a page number.

“Theme 9: Exiting the Sex work industry”—please check for capitalization consistency across section sub-headers.

“Simply put, MSWs were able to increase their value in the eyes of their clients by way of developing a form of parasocial relationships, i.e., one-sided relationships wherein one or more of the members of a relationship are exaggerating their emotionally engagement”—there is a typo here, with “emotionally engagement”.

“is a product of society's belief that they were doing offering an immoral or unethical service”. Typo here—“doing offering”.

“Consequently, violence against MSW’s is if often diminished or overlooked.” Typo—“MSW’s” is not grammatically possessive in this instance.

“While this is no longer the case in or academic scholarship, the rhetoric of all queer men being hyper-sexual and open to engaging in sex worker is still prevalent”. Two issues. First, typo: “in or academic”. Second, this sentence is still overstated. If the authors want to make the claim that there are widespread perceptions that queer-identified men are sex workers, then the author needs to identify multiple works which empirically establish that this perception is widespread.

“Citation” in Figure 1 is misspelled.

In their response to reviewers, the authors state, “Upon an additional review, this theme box is accurate however, several subthemes include “...” to provide context into minimizing the risk of specific things.” I am not sure what the authors mean and need additional clarification.

Thank you to the authors for doing this work and best of luck in the revisions!  

Author Response

I was one of the original reviewers of this manuscript, and I was excited to read the most recent draft. The authors incorporated most of my suggestions from my prior review, and I have only a few moderate or minor suggestions for revisions, each of which is intended to help the authors strengthen the manuscript so it can reach its full potential.

Moderate:

It looks like Table 1 was edited in light of my suggestions from my prior review, although it is difficult to see definitively because track changes on tables is difficult to follow. Regardless, I see the authors have incorporated the following article I recommended:

The table was reformatted to reflect chronological and alphabetical order. In addition, the clientele served (man/woman/both) was included per request. Third, qualitative tradition was changed to qualitative method. Lastly, we changed country to region.

Oselin, Sharon S., and Kristen Barber. 2019. “Borrowing Privilege: Status Maneuvering among Marginalized Men.” Gender & Society 33(2):201–23. doi: 10.1177/0891243218823354.

There are two minor concerns with this inclusion and one moderate one. First, Table 1 incorrectly lists the paper as Oselin 2019 when it is Oselin and Barber 2019. Second, the paper does not appear in the reference list.

The table is structured in Lead author (date), which is why the entry is listed as Oselin (2019). The reference list has been updated.

Third, and most of concern, the stated number of articles/reports in the review remains at 66, even though one paper was added. I counted the studies overviewed in Table 1 and also saw 66—but how is that number accurate when the prior draft overviewed 66 studies and then one was added in this draft? Did the authors delete an article that appeared in the last draft? Please carefully assess whether all relevant articles are included in Table 1, and then please make sure those numbers are accurately reflected in Figure 1. Similarly, if the authors became aware of an article through peer review, then the number of articles included in the “further identification” section of Figure 1 needs to be updated.

 There was a duplicate entry in the table, the original would have been 65 and with your inclusion of Oselin and Barber (2019) the total number is 66. We have updated the Figure to reflect the accuracy.

Minor: 

Please define IMSW. The authors stated that they did so, but I do not see it in this draft. 

Defined IMSW – Internet-Based Male Sex Work

“This lack of service from nonprofits may reflect how some MSWs feel they are not considered “real prostitutes” because of the difference between how men and women sell sex on the streets (Henriksen et al., 2020).” Is “real prostitute” a quotation from the article? If so, please include a page number.

 Page number has been added

“Theme 9: Exiting the Sex work industry”—please check for capitalization consistency across section sub-headers. 

Fixed

“Simply put, MSWs were able to increase their value in the eyes of their clients by way of developing a form of parasocial relationships, i.e., one-sided relationships wherein one or more of the members of a relationship are exaggerating their emotionally engagement”—there is a typo here, with “emotionally engagement”. 

 Changed from emotionally engagement to emotional engagement

“is a product of society's belief that they were doing offering an immoral or unethical service”. Typo here—“doing offering”.

 Removed doing

“Consequently, violence against MSW’s is if often diminished or overlooked.” Typo—“MSW’s” is not grammatically possessive in this instance.

 Fixed

“While this is no longer the case in or academic scholarship, the rhetoric of all queer men being hyper-sexual and open to engaging in sex worker is still prevalent”. Two issues. First, typo: “in or academic”. Second, this sentence is still overstated. If the authors want to make the claim that there are widespread perceptions that queer-identified men are sex workers, then the author needs to identify multiple works which empirically establish that this perception is widespread.

Changed this sentence to reflect how early interventionists assumed all MSWs were queer identified, which is no longer the case.

“Citation” in Figure 1 is misspelled.

In their response to reviewers, the authors state, “Upon an additional review, this theme box is accurate however, several subthemes include “...” to provide context into minimizing the risk of specific things.” I am not sure what the authors mean and need additional clarification.

We verified that the subthemes for the Corriveau (2014) article ended with ellipses and is thus correct in our table.

Author Response File: Author Response.docx

Reviewer 3 Report

Suitable for publish

Author Response

Thank you for your comment.