The term “chemsex” is most often used to describe sex between men under the influence of drugs like meth, ketamine, and GHB. This narrow definition leaves out too much.

In this conversation, we expand the frame to ask: What do we mean when we say chemsex? Who gets included, and who doesn’t? What does that reveal about or conceptualiztion of chem sex and the risk involved? We’ll explore how people of all genders and sexualities engage in sex and substance use, and how experiences of disability, chronic illness, trauma, and marginalization shape those choices. We’ll look beyond the typical substances to include alcohol, cannabis, cocaine, mushrooms, and other drugs that are often excluded from chem sex conversations. We’ll ask: What is a substance? What is sex? And how do race, gender, class, and ableism shape our assumptions about “risk,” “pleasure,” and “safety”?

Rather than framing chemsex solely through pathology or danger, we’ll consider how people use drugs in pursuit of connection, agency, and embodiment—especially in contexts where these are otherwise inaccessible. We’ll also critically examine why the public health field has centered certain communities (particularly white, cis, gay men) and excluded others, and discuss how we can shift toward a more expansive, inclusive, and liberatory approach to sex, drugs, and care.

This is a space to question dominant narratives, complicate stigma, and build a conversation rooted in collective health, curiosity, and honesty.