For many gay, bisexual, queer and trans men, and Two-Spirit and non-binary people (GBT2Q), substances play a role in our lives and in how we engage with each other. In 2021, the Sex Now survey asked GBT2Q people across Canada about how they chose to use substances and how our communities could be best supported. It also asked demographic questions about gender identity and race because we know that oppressive social systems, such as cisheterosexism and colonization, shape many aspects of our lives including our connections to substances.

Of the 5,808 who participated in the Sex Now survey, over 3,800 participants responded to the questions on substance use. We chose to highlight the experiences of Indigenous, Black, trans and gender diverse people, people living with HIV, and people who use drugs as these communities have been stigmatized and excluded when seeking access to substance use-related services. This is what we learned.

We share common motivations for using substances, even across differences in gender and ethnoracial identities, HIV status, and age. Over 90% of GBT2Q people stated they used substances in the last six months. Most frequently, GBT2Q people used them to feel good or better about their lives (64%), to help with life’s challenges (48%) or to connect with others (34%). However, most GBT2Q people expressed a combination of reasons as opposed to just one.

Alcohol and marijuana were most widely used, but use of poppers, cigarettes or vapes, psychedelics and crystal meth differ across our community. In the past six months, 4 in 5 (82%) GBT2Q people reported any alcohol use and 1 in 2 (53%) reported marijuana use, making them the two most used substances. Banned substances, such as poppers, continued to play a role in many GBT2Q peoples’ lives.

We often use substances within sexual settings and to enhance our sexual experiences. About 1 in 4 GBT2Q people reported using substances during sex in the last six months. Some did this “once in a while” (17%) while others did so daily or weekly (5%). Poppers, marijuana and alcohol were most common, but crystal meth, GHB and psychedelics were also often used during sex.

The need for substance use-related services varies across our communities, and those who seek them out still face barriers. Most GBT2Q people (51%) were not actively seeking to change their substance use, while about a third (31%) wanted to reduce or quit their substance use. Among GBT2Q people who used opioids, crystal meth or injection drugs, the need for harm reduction supplies and naloxone/NARCAN kits specifically was high. About 1 in 10 people who used crystal meth (11%) and people who used injection drugs (12%) reported facing barriers to accessing services.

Our communities engage with substances in unique ways and this influences how we access substance use-related supports. Given our intersecting identities, we need sex-positive, queer- and gender-affirming approaches to substance use services for GBT2Q people. Improved access to harm reduction services must meet the needs of everyone in our communities, especially those who are further marginalized by their HIV or substance use status.

Sex Now is Canada’s largest and longest running survey of gay, bisexual, queer and trans men, and Two-Spirit and non-binary people (GBT2Q). To learn more about the types of substances asked about in the survey, see the Sex Now 2021 questionnaire. To learn more about the sample of GBT2Q people who responded to Sex Now in 2021, visit the Our Stats dashboard.

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