BA Health/Social Care and Criminology/Criminal Justice
On average, one person dies every 12 days from the use of GHB (gamma-Hydroxybutyric acid). Chemsex is the use of three drugs to facilitate sexual activity between gay men: GHB, Crystal Meth (Methamphetamine) and M-cat (Mephedrone), and it is facilitated within the gay community across the United Kingdom. Not only are people dying from the use of the drugs involved in Chemsex, but this process has also been attributed to the increase in rates of infection of HIV and sexually transmitted infections in gay men.
Drugs and sex have been intertwined in the Lesbian, Gay, Bisexual and Transgender (LGBT) community throughout modern history, and this is especially true within the community of gay men. Studies have highlighted that the community is at three times greater risk of substance abuse than those who identify as heterosexual. A substantial proportion of this drug use is associated with sexual activity. So why is Chemsex / sexualised drug use a much more significant problem in the LGBT community than in the heterosexual community? Also, what is being done about it? Although there are many reasons given for the increased use and risks, this article will focus on two of the main reasons.
1. Internalised Homophobia
Growing up a gay man in a straight man’s world takes its toll and being told that the sex you are having is wrong will have an impact. The messages that are created by a 'hetero-normative' society can lead to a range of internalised feelings such as hurt, guilt and inadequacy, to name but a few.
Messages in the media, such as those emblazoned in the headlines in Figures 2 and 3, teach the LGBT community that they are different from the rest of society. This may result in gay men feeling disconnected from both the rest of society and each other. These negative messages are perpetuated across society, creating little cohesion and acceptability of difference. Messages such as: ‘It’s not Adam and Steve, it's Adam and Eve’ have also been used as an argument to justify that homosexuality is abnormal, which can result in gay men feeling excluded from society.
The use of Chemsex within the Gay community has been seen as a way of connecting with other gay men in times where there were very few places to meet in a safe environment. It also allows a level of intimacy while taking back control of the sex that gay men have been told for so long that they shouldn’t have. If Chemsex is used safely then why shouldn’t its use continue? Isn’t this a form of empowerment to an already disenfranchised community?
Systems and institutions have perpetuated an inferiority message throughout the years, for example in healthcare settings, regarding donating blood. Gay and bisexual men who practise safe sex with other men have to wait three months before giving blood, while heterosexual men do not. These messages bring feelings of shame and trauma, which are then internalised and manifest in damaging ways, such as in higher rates of suicide and a higher risk of substance misuse, including through Chemsex.
2. The lack of specific or LGBT-competent services
Evidence has shown that there is a need for more LGBT-competent and specialist services so that this community can access support to address their substance misuse issues, including via Chemsex. There is a fear of having to disclose sexuality and being judged because of it, which then becomes a barrier to accessing support.
However, this is only part of the issue. Since the introduction of the 2010 Equality Act and the 2013 Marriage Bill, societal attitudes towards homosexuality have begun to change, but there is still a need to challenge inequality. LGBT people accessing health care services continue to report that due to lack of knowledge about their specific needs, and the assumption of heterosexuality, they are still experiencing dissatisfaction in healthcare, especially compared to the heterosexual community.
Is chemsex / sexualised drug use a public health issue in Wales?
The rise in sexually transmitted infections and late-diagnosed HIV has prompted Public Health Wales to look into the impact of sexualised drug use, including Chemsex, in men who have sex with men (MSM). However, the current drugs strategy for Wales has no mention of gay men and, therefore, a clear pathway for service users is yet to be set. Wales appears to be stumbling in its handling of the Chemsex issue.
It is difficult to know how many people are engaging in Chemsex, and without this data it is challenging to commission appropriate services. However, at present, no services are providing specific Chemsex support in Wales. The nearest Chemsex services are in London or Manchester, which are the only two LGBT-specific services in the United Kingdom. This means that people in Wales needing support may not be able to access it.
Having to continually prove the right to exist can take its toll on the LGBT community, and this is evident with continual reports that LGBT people are at a higher risk of suffering from mental health issues.
At a time when gay liberation and freedom was taking place, another reason for ‘acceptable’ homophobia came along in the 1980s: HIV and AIDS. This was initially called the GRID: gay related immune deficiency. This period in time seemed to give a green light for society to blame and stigmatise an already weakened community. The only way to support LGBT people to lower the risk of poor mental health, and save lives, is for individuals and institutions in society to be more accepting of differences.
Has Chemsex and other sexualised drug use been an accumulation of years of homophobia? Is the minute support for people using Chemsex in Wales evidence of a lack of insight, or a sign that institutionalised homophobia continues well into the 21st century?
Fig: 1. https://www.vice.com/en_uk/article/vdxny9/an-illustrated-a-to-z-of-chemsex-903
Fig: 2. https://www.pinknews.co.uk/2018/02/16/daily-mail-columnist-richard-littlejohn-attacks-gay-parents-pass-the-sick-bag/
Fig: 3. https://www.pinknews.co.uk/2018/11/30/world-aids-day-1980s-headlines-tabloids/