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We conclude that a potential reason for this paradox among tops who bottom may be sexual altruism. In contrast, penetrative role dissonance was predictive of relationship satisfaction among tops who bottomed in their relationship, but not bottoms who topped. Multiple regression modeling suggested ideal-reality penetrative role dissonance was predictive of sexual dissatisfaction among tops who bottomed in their relationships and, to a lesser extent, bottoms who topped. We then asked them to rate their relationship on 10 sexual and interpersonal attributes. Through an online survey, we sampled 169 men in same-sex relationships, asking them questions about their ideal penetrative role identities and their reality penetrative roles with their partner. Specifically, we looked at whether adopted sexual position identities were consonant or dissonant (i.e., matching or mismatching) with enacted behavior in relationships and how that impacted men’s attitudes toward different relational attributes. In response, we explored the role of self-label over sexual and relationship satisfaction among gay and bisexual partnered men. Across much of the gay and bisexual male research on sexual position self-label (i.e., calling oneself a top, bottom, or versatile), there exist two commonalities: (1) studies tend to focus almost entirely on individual, relationally single androphilic men (2) studies rarely account for relationships and relationship dynamics.