Chemsex harm reduction responses in Europe often center gay men, leaving transgender people as an afterthought. But a Ukrainian LGBTQ organization found that the need is similar among the country’s transgender and intersex people.
In a study published online on July 22, the Kiev-based group HLGBT surveyed 100 transgender, nonbinary, queer and intersex (TNQI) people about their sexual practices and chemsex involvement. It found that their use of drugs in sexual situations increases the odds of having unprotected sex.
A startling proportion—three-quarters—did not use protection the last time they had engaged in chemsex. Generally, in the six months prior to being surveyed, one in three participants reported that they “often do not use protection” in sex in the past six months, almost three times the proportion of people indicating they “always use protection.”
The risks and harms were diverse. One in three respondents had been diagnosed with HIV, an STI, or tuberculosis in the six months prior to being surveyed. In addition to risky sexual practices, experiences of depression, panic attacks, severe heart pains, constant fatigue, weight-loss, loss of social bonds and non-sexual violence were the most common negative consequences for the 35 chemsex respondents who named them. But most (60 percent) said that “Everything is fine” when asked about consequences of of their chemsex involvement.
The most common type of sex respondents were engaging in was sex work. Within six months prior to being surveyed, 40 percent reported having sex with a “commercial partner,” a proportion larger than sex with casual and regular partners combined. This trend co-occurs with one-third of respondents experiencing “not hav[ing] money for quality food.”
While understanding health risks, many of the surveyed TNQI Ukrainians expressed the importance chemsex involvement in their lives.
“[D]espite all the dangers of the practice of chemsex, many claim that they are completely satisfied with their lifestyles,” said study author Igor Medved in a statement. “One of the first people to tell us this was a trans sex worker: ‘Yes, I take stimulant drugs for sex, and you know what? I’m completely fine with it!'”
Pleasure is an important factor. “If you ask what is good sex for me? That’s when I listen to deep house, have a partner that I like and lots and lots of cocaine,” said one study participant. Another shared, “Not every sex that I have leads to orgasm, so chemsex is everything for me…”
Chemsex can have unique significance for some trans Ukrainians. “Transgender respondents who use PAS/NPS consider that it is important that chemsex practices allow them to feel that they are being admired, which helps them to relax more easily with new sexual partners and accept their gender identity,” wrote the authors.
One barrier to reducing sexual risks for TNQI folks could be the lack of culturally resonant harm reduction materials. “I know that there are organizations which distribute free condoms and lubricants. Once I was given condoms there and I did not like their color and they were all so… monotonous,” said one participant. The desire for aesthetically pleasurable harm reduction materials for queer and trans drug users has been heard on the other side of the world in New York City, where one nonbinary artist is working to “make harm reduction gay again,” as Filter has reported.
“I have no problem at all and I only ask for understanding and support,” said another participant in the Ukrainian study. “You can even tell me what you usually say, like ‘Darling, please use a little bit less today.'”
Photograph of study author Igor Medved by AFEW