Rock star Alice Cooper said of the song, "You have Pete's sexual ambiguity going on here - it sounds like a gay song. I still don't know exactly what he was trying to say with that song, but I love it, whatever it is. Pete's an amazing mystery."
During a 1989 interview with Timothy White, Townshend made reference to the song "Rough Boys", calling the song a, "coming out, an acknowledgment of the fact that I'd had a gay life, and that I understood what gay sex was about. I know how it feels to be a woman because I am a woman." Five years later, in an interview with Playboy, he said, "I did an interview about it, saying that "Rough Boys" was about being gay, and in the interview I also talked about my "gay life," which—I meant—was actually about the friends I've had who are gay. So the interviewer kind of dotted the t's and crossed the i's and assumed that this was a coming out, which it wasn't at all."
Townsend dedicated Rough Boys to the Sex Pistols as well as his children on the album sleeve of Empty Glass.
The song was performed by Townshend with his band The Who regularly during their 1989 tour. A recording of one of these performances can be found on the live album Join Together.