Gay culture is as varied as the people in it. However, some stereotypes have stuck around for a reason -- they contain a grain of truth. For example, bars and clubs have always been important parts of gay culture since they are historically the only places where it was possible to meet and mingle with other queer people. The gay bar scene can be a lot of fun. It also has a dark side, where unhealthy relationships with substance use can lead to problems, including addiction. The combination of sex and substances, known as “chemsex,” is accepted in our culture. It can be a glass of wine before a romantic evening or a shared joint to “get in the mood.” In gay culture, the combination of sex and methamphetamines (as well as poppers, which are inhalant forms of different kinds of nitrites), is a common form of chemsex.

More About Methamphetamine Use

Methamphetamine, also called “Tina,” is a substance that can contain chemicals like rubbing alcohol and lye. People smoke, inject or snort meth. Some of the common signs of meth use are sweating, enlarged pupils, extremely fast pulse, dizziness, racing thoughts and talkativeness. People who use meth may also grind their teeth or fidget.

Meth use is often linked to high-risk sexual behaviors and more sexual partners, and men who have sex with men can develop serious health problems. These problems can include HIV and sexually transmitted diseases. In addition, meth use can lead to dental problems, loss of bone mass, weight loss, heart attacks, stroke, brain damage and more. Meth use can result in an overdose and death, especially if combined with an opioid like fentanyl.

From a mental health standpoint, meth use can lead to anxiety, panic attacks, problems sleeping and depression. Having a short temper and poor impulse control are also common. Some people become very suspicious and mistrustful and see things that aren’t there.

Meth Use and Sex

Sex without substances can be intimidating for anyone. In fact, one of the biggest reasons many gay men don’t stop using meth is because of the effect it has on their sex lives. At first, methamphetamine causes the person to experience a rush of dopamine, a feel-good chemical in the brain. It also increases energy levels and sex drive. Over time, that sense of energy and euphoria decreases permanently. The thrill is gone.

Encouraging a Healthy Sex Life

When methamphetamine use becomes a problem, regardless of the situation, it’s time to take action. Families can support a loved one by having open, shame-free conversations that are realistic. Focus on the problem, not the person’s identity. Proceed with the understanding that your loved one doesn’t have to give up sex or their community in order to be healthy.

If your loved one uses hookup apps, both Scruff and Grindr have options to indicate that you’re abstaining from substances or in recovery. Tinder or other dating apps have space for that in the bio. (Grindr even banned the “T” emoji from their custom keyboard in an effort to challenge the idea that all gay men use “Tina” or meth during sex.) Seeking out partners who don’t engage in chemsex can be helpful to people who are building confidence in their own well-being. Support your loved one while they adjust. Recovery will change a lot of personal things, such as what sex means to them, how long it should last and what is satisfying. 

Staying Off Crystal: Practical Tips for Gay and Bisexual Men is a guide that can help you understand what your loved one may be going through. You may wish to share it with them.  

Although the first few weeks or months of stopping meth can be challenging, there are enormous benefits: better sleep, a returning appetite, more rewarding relationships with friends and family, clear skin, improved dental health and fewer disease risks. On the other hand, a person giving up methamphetamines may gain weight or  experience feelings of boredom or mood swings. These issues usually resolve over time, either on their own or with the support of a healthcare provider.

If your loved one needs substance use treatment, our treatment resources can be a good place to start. Topics include how to motivate someone to attend counseling or an outpatient or inpatient program, how to find a program that is a good fit for a person in the LGBTQ+ community and more.

Lowering the Risks of Meth Use

The safest option is not to use any meth. If your loved one is not ready to stop, there are ways to lower the risks. You can prepare for what can be an uncomfortable yet realistic conversation.

Additionally, if your loved one intends to engage in chemsex, they can commit to using condoms. They can also get on PrEP, a medication that prevents HIV infections.  Getting an HPV vaccine and an anal pap test are also steps to take to protect health.


There are many resources available for people who need help stopping or want to have safer, substance-free sex. Sober and gay meetups are a fun place to try mingling in substance-free spaces. Some local bars and clubs offer mocktail nights that might ease the perceived pressure of using substances. 

Other options include 12-Step groups, men’s intimacy groups, individual therapy, spiritual counseling and sex addiction groups. Our directory of LGBTQ-affirming resources might help. You can also schedule a call with our helpline to learn more about where to find support for yourself and your family. 

Most of all, know that your loved one is doing their best and will adjust at their own pace. You can support them by being patient and affirming their decision to put their wellness first.