Expressions of affection between people of the same sex are easily accepted in Pakistan but in contrast, women’s contact with men is controlled and socially policed. Many men have sexual relations with each other, and finding male sexual partners is easy. At the same time, such relations are highly stigmatised by society, particularly for partners who may be penetrated rather than penetrate, or who dress in a more feminine manner. Thus similar gender dynamics of heterosexual interactions are played out in relations between men, with the role understood to be masculine being seen to have higher status than the so-called feminine role. Some groups of men who have sex with men (MSM) are more visible than others, such as ‘zenanas’, ‘hijras’ and ‘malishias’ who may dress and act publicly in a more feminine manner, and may sell sex (mainly, but not exclusively to men) in cases of economic need. The majority of MSM do not see their sexual relations with men as defining who they are. More important to identities are the gender roles they play (more feminised or masculine), marital status and class. Many MSM also have sexual relations with women, and as cultural tradition makes marriage socially compulsory, most MSM do marry. This means issues around safety in sexual relations between men are also very relevant to women too. These findings are based on interviews with over 200 MSM in Lahore.