Frank’s (2018) article provides an excellent summary of transdisciplinary research
concerned with collective sex environments, synthesizing highly diverse studies spanning
five decades. The contributing papers utilize a broad range of methods and reflect
many key sexual health risks across several diverse and distinct populations. For
many readers, such as ourselves, with a particular interest in a single population,
Frank’s synthesis provides a much needed and entirely fascinating wider perspective.
This overarching vantage point can teach us about similarities and differences across
populations, while simultaneously illuminating the populations and research we know
so well through a different lens. As such, the paper provides an essential contribution
to the literature. However, rather than champion the paper’s many strengths, within
this Commentary we wish to grapple with what could be seen as its potential shortcomings.
Our aim here is not be critical for the sake of it, but to somewhat playfully push
debates further about many issues addressed within the paper. In this way, we wish
to initiate more dialogue concerning collective sex, concomitant risks, and imaginative
ways to ameliorate such risks.
Looking Backwards Not Looking Forwards
First and foremost among the “shortcomings” of Frank’s (2018) article is the retrospective
gaze of the review methodology. Of course, this limitation is not unique to this article
and represents a potential failing for all review work. However, the necessary retrospective
focus of a review, the demands of synthesis, and the need to build cumulative knowledge
though layering new information upon what has gone before brings multiple challenges.
Critically, review epistemology in general fails to accommodate recent and contemporary
changes and cannot address the anticipation of the future. Adopting a retrograde and
consolidating gaze also tends to focus upon the common denominators across previous
research. This drags the focus of cumulative knowledge retrospectively and is ill-equipped
to grapple with major and more recent change.
For us, this epistemological limitation is central to explaining the lack of critical
mass identified within the review that is concerned with what could be called the
democratization of collective sex. We would suggest that the recent trends in democratizing
collective sex have materialized through the world of social media and the proliferation
of dating/sexual hookup smartphone apps, and their associated Web sites (Davis, Flowers,
Lorimer, Oakland, & Frankis, 2016; Wu & Ward, 2018). Wider innovations within sexual
health also shake the simple sedimentation of transferable knowledge across the period
of time encompassed by the review. For example, in relation to HIV, biomedical innovations
such as pre-exposure prophylaxis or wider treatment as prevention have profoundly
changed the somatic effects of condomless sex for many populations around the world
(Frankis, Young, Lorimer, Davis, & Flowers, 2016; Young, Flowers, & McDaid, 2015,
2016). Equally, in relation to antimicrobial resistance, the prevalence of drug resistant
gonorrhea has also changed dramatically across the last half century reintroducing
risks to “safer” sexual acts (Unemo & Nicholas, 2012). Among those who use collective
sex environments, an understanding of these issues changes the choreography of sexual
conduct across time. Along these lines, the risks associated with condomless anal
sex are very different now than they were within the recent past encompassed within
the review (Jin et al., 2015).
We also have frustrations that relate to a tendency within the review to “short change”
the reader in relation to conceptual clarity. Arguably, these represent key lost opportunities
for synthesis within the review. To some extent, the messy nature of transdisciplinary
work and paradigm-specific thinking reverberates throughout the review, rather than
there being a sense of attempted cohesion. Of course, to these ends we have tremendous
sympathy with Frank; the unthankful task of the reviewer is to enter the mire of other
people’s thinking and, given the heterogeneity of the research included, other people’s
disciplines. To expect an author to untangle, dismantle, and then rebuild and explain
this complexity is certainly a tall order but one which, if successful, could have
added much to the field. There is a sense that stopping short of delivering conceptual
clarity within the paper represents a key device that enables many of the review’s
central arguments to develop. These issues are explored within the sections below.
Toward a Typology of Collective Sex Environments
As Frank (2018) notes within the paper, harmonizing nomenclature is particularly challenging
given the diverse ways various authors have attempted to classify the complexities
of collective sex environments. Yet, given the time and energy put into the review,
it is a shame that there was a lack of categorization or visualization, to map out
major patterns within the heterogeneity of the review literature. For us, this represents
a lost opportunity to synthesize and then articulate how sex researchers should communicate
about collective sex environments from this point forwards.
We believe Frank’s review work represents a chance to lead the interdisciplinary field
in distinguishing and discussing the range of collective sex environments (e.g., public
sex environments, saunas, gyms, erotic oases, public sex venues, bathhouses, sex clubs,
group sex events, lifestyle events, lifestyle groups, group sex, public sex, sex parties,
chem-sex) and furthermore the kinds of people who use them. Indeed, such an endeavor
would be invaluable. With an agreed framework and vocabulary, it becomes possible
to shape the collection and synthesis of evidence about the effectiveness of various
interventions and their active components within specific contexts and specific populations.
However, Frank does not provide a typology of collective sex environments (i.e., detailing
their similarities and differences). In contrast, she emphasizes the plurality and
specificities of a range of environments used for collective sex. This necessarily
adds weight to the paper’s general argument that attending to such particularity is
pointless. In contrast, we believe that ordering the potential chaos of such pluralism
and examining the patterning of shared and distinct elements of collective sex environments
could represent a viable and useful focus for review. Building such firm foundations
would offer a step forward in understanding the contributions of previous intervention
evaluations across collective sex environments. In turn, this would enable us to develop
improved and more effective interventions which mitigate the range of potential risks
that are related to collective sex–above and beyond those concerned with sexual ill-health
alone.
Toward Conceptual Clarity Regarding Theory and Theoretical Lenses
In a parallel critique to that outlined above, we also believe this review represents
a lost opportunity with regard to developing and synthesizing theory. As Frank (2018)
notes, the way theory is used across the literature is again highly diverse and reflects
a number of distinct and potentially incommensurate paradigms. Given the heterogeneity
of the work covered within the review, we fully acknowledge that there are major challenges
in understanding and integrating multi-leveled and diverse theoretical approaches
and their attendant theoretical constructs. Indeed, a range of specified and unspecified
theoretical constructs are at play within this literature and arguably, this plurality
of theory has limited the field. Some explanatory theory is heuristic for example;
in contrast, some attempt to present a veridical model of sexual conduct. Other theory
still is pitched at levels which are far more macro and relate to different ontologies,
while some researchers adopt more meso-social or micro-social theories; all of which
complicates synthesis still further.
Frank notes, for example, that the literature draws upon literary and critical theory,
feminist theory, queer theory, Marxist theory, materialist theory, psychological theory,
anthropological theory, theories of risk, sexual cultures and socio-cognitive theories.
She also highlights the overarching influence of symbolic interactionism. Once more,
given the heterogeneity of theory within the contributing literature, it could be
argued that this review represents a further lost opportunity to synthesize the theoretical
positioning and illuminations of the work covered therein. Mapping how theories and
their theoretical constructs relate to each other, then detailing how this explains
specific aspects of the social organization of collective sex would deliver even further
added value. Admittedly, the ontological assumptions underpinning certain theories
used within the contributing review studies ensure this would be no easy or straightforward
task. Yet to come so close to synthesizing this literature in this way and not quite
delivering has left us wanting that little bit more from the review.
Meta-theoretical perspectives, such as the socio-ecological model (Baral, Logie, Grosso,
Wirtz, & Beyrer, 2013; Bronfenbrenner, 1979), may have been useful in organizing some
of the maelstrom of theoretical perspectives and constructs, which left unorganized
occlude a theoretical appreciation of collective sexual conduct. Nevertheless, Frank’s
paper does not organize the theoretical contributions across the field. It does not
explain the unique contribution associated with each theoretical perspective, nor
does it illuminate the complementary and potential synergistic effects of diverse
theoretical lenses. Instead, the interrogation of theory tends to be used rhetorically,
to add momentum to the paper’s overall argument. This overall argument suggests that
theory, or the specification of theoretical constructs, has gone too far in relation
to the particularities of sexual conduct within particular kinds of collective sexual
settings. By staging the complexity of theory in this way, the paper builds toward
an argument that simpler theory is warranted and for Frank these theories of choice
appear to be concerned primarily with deviance and transgression.
Paradigms and Pathology: Transgression and Deviance
The selection and priming of theory in relation to the adoption of the anthropological
framework of transgression and its resonance with deviance is a little troubling for
us. Firstly, because these concepts are rooted within pathology and secondly, we are
not convinced collective sex is not normative.
In relation to the orientation of transgression and deviance to pathology, Frank (2018)
claims to not examine deviant people, places and practices. However, it is unclear
to us how the theoretical lenses of transgression and deviance cannot necessarily
illuminate their subjects in these particular ways and, specifically, through a pathologizing
lens. This particular conceptual armament positions deviants as agentic perpetrators
of transgression and simultaneously underemphasizes the social organization of sex
in relation to variations in time and place. For gay and other men who have sex with
men, for example, historically toxic hetero-normative social structures and associated
infrastructure have constrained the possibilities of sex in ways which were not entwined
with collective sex.
In countries and in eras where men could not, or cannot, cohabit as couples, or meet
within safe, legal infrastructures of commercial gay venues, then the only means to
access other men for sex was, and is, within public sex venues (Chauncey, 2014; Santos,
Makofane, Arreola, Do, & Ayala, 2017). In turn, these constraints shape sexual conduct
and contribute to such places as being risky, primarily because of the threat of homophobic
violence and the concomitant risks of social exposure within a hetero-normative social
world. Similarly, there are profound differences between the social organization of
collective sex in the past and the present (Berlant & Warner, 1998; Prior & Hubbard,
2017; Wu & Ward, 2018). Historically, the social organization of sexual opportunities
between men also shaped their sexual interactions, driving men to anonymous sex environments
and limiting the social repercussions of such sexual interactions, for example, curtailing
easy access to the development of longer-term relationships and romantic intimacy.
Once herded into such narrow spatially defined places, heightened vulnerabilities
for homophobic violence and stigma emerged. Thankfully, in some places around the
world, this historic funneling of opportunities for sexual connection between men
into narrow collective spaces has changed dramatically across recent decades in many
places across the globe, with equality and legislation creating new possibilities
of being for men seeking sex with other men. In some cities, there has been a proliferation
of venues profiting from the commercialization and commodification of collective sex,
and in cities with large enough populations to support niche markets, this has enabled
particular venues to specialize in particular kinds of collective sex. In this way
across the scope of Frank’s review, there is a sense that some men in the past had
no choice but to engage in collective sex yet now, in contrast, there are many choice-based
opportunities to engage in varied kinds of collective sex.
More recently, the explosion of geo-spatial sexual networking has opened up a proliferation
of virtual and real spaces, in which (collective) sex can be negotiated and realized.
This has transformed traditional public and commercial sexual spaces but, critically,
also created new possibilities around “pop-up” or opportunistic sex parties in private
homes, often advertised via GPS sexual networking as only semiprivate or even public
events. As such, seismic changes have taken place in relation to the drivers of collective
sex in many places across the world. Much of the literature cited within Frank’s article
the paper is old and inevitably somewhat dated. In particular, this contributing literature
cannot address the major impacts GPS-based technology and digitally realized sociosexual
networking has had in relation to changing the drivers of, and creating new facilitators
for, collective sex. Therefore, where GPS-based technology is currently available
there is a clear sense of the amplification of agency and choices associated with
collective sex, which did not exist in the past.
Although the digitization of sexual opportunities is mentioned within the review,
for example in relation to the introduction of GPS-based mobile applications, we believe
this actually represents a critically transformative moment delivering profound cultural
change and major transformations within sexual cultures for very large sections of
the population. Within Frank’s paper, there is an absence of any single definition
of what constitutes a collective sex environment. But for us, the increasingly public
world of smartphone dating apps facilitating sexual conduct shares far more in common
with the legacies of many collective sex environments than it does with the social
organization of sex per se across recent millennia. In this way, one could argue that
there has been a democratization of collective sex, with large segments of the population
engaging collectively through dating apps with the shared and public commodification
of both the sexualized self and the sexualized other. These platforms clearly share
core elements with other collective sex environments including features securing site
users’ physical, social and psychological safety. Like many collective sex environments,
space and time are segmented to enable site users to progressively enter into more
explicit interactions, and there are clear social norms focused upon ascertaining
intentions, preferences and consent. Moreover, much dating app architecture is concerned
with gate-keeping functions, with demarcations of public and more socially oriented
space (e.g., profile information or discursive spaces) versus those that are more
private and directly concerned with sexual negotiation and interaction. Along these
lines, it is increasingly hard to engage with collective sex environments as either
transgressive or as deviant; indeed, they appear to be increasingly normative. In
relation to imagining interventions for health and well-being in the future for those
who use such dating apps, much could be learned from the long and interesting history
of collective sex environments as detailed within the paper.
Toward Theory-Informed Interventions
We would also argue that the failure of Frank (2018) to coherently organize, map,
and sift diverse theory into some coherent order limits the ways we can imagine interventions
to improve health and well-being and reduce diverse risks associated with collective
sex. With regard to theorizing interventions, there is little attempt within the review
to understand how the existing literature can offer a wide variety of complementary
and socially nuanced, theory-informed interventions. Sadly, it could be argued that
the paper offers little sense of clarity, or even hope, for future interventions and,
arguably, elicits a sense of pessimism and premature foreclosure with regard to intervention
possibilities overall. For example, toward the end of Section I much is said about
the apparent impossibility of understanding the heterogeneity of people and places
in relation to focusing intervention efforts. Yet, such inertia can easily be overcome
with a sense of how interventions and their content can be targeted and tailored to
meet the specific needs of particular users at particular times in particular places.
In this way, and especially in light of digitally delivered technologies where they
are available, there is ample opportunity to address the “tendency to particularity”
with a range of bespoke interventions, with targeted and tailored active content,
that reduce risks and improve health and well-being.
Equally, within the paper, far more could be made of examining the available literature
from an explicitly salutogenic perspective. Such an a priori focus could identify
and detail the successful components of self-regulating interventions that already
preserve the health and well-being of those who use collective sex environments. Collating
such evidence can rapidly produce a blueprint of potentially culturally appropriate
intervention elements that can be transferred to existing and emerging collective
sex environments, or deployed as rapid responses to infectious disease outbreaks or
other, more social, harms within particular spaces. Identifying beneficial intervention
components has a clear resonance with meso- and micro-social theory and related theoretical
constructs. Potentially transferable, “home-grown” intervention elements are mentioned
within Frank’s paper. For example, this includes the importance of creatively attaining
consent either nonverbally or preceding sexual conduct, and imaginative means of clarifying
and communicating the norms and collective expectations of conduct. Alternatively,
within the review, there is a clear sense of how intervention elements associated
with both identities and communities figure as important protective issues therein,
as do amplified feelings of responsibility for the generic other(s) who share those
collective sex environments. These dynamics represent gold dust for co-designed and
culturally appropriate intervention content for increasing health and well-being associated
with collective sex environments.
We would suggest that embracing the logic of co-produced interventions, or seeking
to understand the self-organizing and self-regulating harm reduction elements of collective
sex environments, jars with Frank’s thinking concerning how and why interventions
are developed and deployed. Within her section “Not the Time or the Place,” there
is an odd, and we would suggest rather unproductive, sense of “them” and “us.” Frank’s
emerging argument, that interventions should not be delivered in situ, is built here
upon a falsely dichotomous foundation. Her dichotomy suggests that there are two groups
of people: those who use collective sex environments and those who seek to impose
interventions upon those users. Setting up such a binary imbues readings of such situations
with power and conflict. Moreover, it diminishes the appreciation of the self-organizing,
harm-reducing, health protective assets that have developed within many communities
who use collective sex environments. Furthermore, it strips away or overlooks the
agency and care of those who use collective sex environments and positions them as
both deviant and having particular deficits. Rather, we argue that empirically and
theoretically informed, ideally co-produced interventions could replace this negative
dichotomy with the possibility of positive, community-led social change and health
enhancements.
Finally, we argue that a pluralistic understanding of theory, pitched at various complementary
levels, is vital to deliver the best kinds of interventions. For example, we need
evidence driven theories that explain what happens within the individual, between
individuals, within communities, within societies and across cultures, in order to
design and deliver the best, theoretically informed interventions to improve health
in the widest sense. In this way, we agree wholeheartedly with Frank that it is vital
to imagine interventions that are directly concerned with changing social structures,
including, for example, legislation and policies that directly address inequalities,
social marginalization, poverty, and associated reduced educational opportunities.
While such interventions make the most of macro-social theory, we believe, however,
that it is equally important to imagine theory-based interventions that function at
the meso- and micro-social levels. Although Frank’s review provides a space for this
dialogue to begin, our aim herein has been to highlight some of the critical issues
that still remain unaddressed, that can be translated into social action and risk
reduction. These kinds of interventions can deliver holistic health benefits.
To summarize, we believe Frank’s review to be an excellent contribution to the literature
yet we believe there is still much to be learned from the historical evidence around
collective sex environments. There is still more that could be offered from a synthesis
which drives forward theoretical and empirical development, redresses the narrative
of deviance and pathology, postulates their increasingly normative nature and, critically,
advances the impact of digital networking technologies therein toward health enhancements.