Chemsex and compulsive sexual behaviour: up to 100 free therapy places for gay and bisexual men

Clinical psychologist Dr Michael Yates reflects on what years of working with men experiencing chemsex and compulsive sexual behaviour have taught him about sex, loneliness, shame and change, and why he’s launching Time To Talk About Sex, a new 6-month programme offering up to 100 free therapy places, available through timetotalkaboutsex.org.uk 

Most men who come to see me don’t say they have a problem with sex. They say they have a problem with control.

It might be chemsex sessions that have started to take over the weekend. Or hours lost on apps or porn, hook-ups, or paying for sex. For some, it’s drugs and sex. For others, it’s sex itself. For many, it’s both.

Over the years I’ve worked with hundreds of men going through exactly this. What has always struck me is how much shame they carry, and how long most have struggled on their own before asking for help, wondering why something that should feel good has become a source of distress.

Sex, loneliness, shame and understanding ourselves

As a gay man, I’m aware that our relationships with sex don’t develop in isolation from the world around us.

For many gay and bisexual men, growing up can involve hiding who we are, feeling different or worrying about acceptance. Sex, and for some drugs and sex, can become one of the main ways we find connection, belonging and freedom. For some, that’s where the pattern begins.

For others, it starts later, as a way of coping with stress at work, a break-up or a big change in life. And some simply drift into it without ever really deciding to.

Sex can offer pleasure, intimacy and belonging. Sometimes it can also become a way of managing loneliness, stress, rejection or difficult emotions. Often, it’s doing several things at once.

These experiences aren’t universal, nor do they inevitably lead to difficulties. But they can shape what sex means to us.  However it begins, the behaviour is often meeting a need, even when it starts to cause harm.

Having a lot of sex, using pornography or engaging in chemsex doesn’t automatically mean someone has a problem. What matters is whether someone feels able to make choices about their behaviour and whether those choices fit with the life they want to lead.

Chemsex, using drugs such as crystal meth, mephedrone or G to have sex, often in sessions lasting hours or days, does carry particular risks. G especially has a very narrow gap between a dose that works and one that can make someone lose consciousness.

For some, drugs make sex feel easier: less anxious, less self-conscious, more connected. That’s exactly why it can be so hard to step away from. Over time, though, the sessions can get longer, the comedowns harder, and sex without drugs can start to feel flat or impossible.

For many, the scales tip gradually. The weekend that started on Friday is still going on Monday. The phone comes out at 2am again. There’s another infection, another day lost at work, another relationship that couldn’t survive the secret. Most men I meet have already tried to stop. They’ve deleted the apps and reinstalled them, promised themselves no more hook-ups or sessions, and broken that promise. Then the shame returns, often stronger than before.

That’s the loop. Shame pushes us into secrecy. Secrecy makes us lonely. And loneliness is exactly what sex, porn, the apps and drugs are good at switching off for short periods. None of this is a failing of willpower. Understanding the cycle is how we begin to change it.

In therapy, I’m often less interested in asking why someone hasn’t managed to stop and more interested in understanding what the behaviour has been doing for them.

What needs has it been meeting? What feelings has it helped manage? And how might they find different ways of responding?  That’s at the heart of how we work: helping men understand themselves and make changes without shame being the driving force.

Discovering you’re not alone

For the past five years, I’ve been running specialist group therapy for gay, bisexual and other men who have sex with men struggling with chemsex, compulsive sexual behaviour or both.

One of the most powerful things we have witnessed is what happens when someone talks openly about an experience they’ve carried in secret for years, only to discover that others in the room recognise exactly what they’re describing.

There’s often an enormous sense of relief. The difficulties haven’t disappeared, but something important shifts. They no longer feel quite so alone.

We’ve also been able to evaluate this work through research. In 2026, we published two peer-reviewed papers examining the outcomes and experiences of men attending our groups.

Of those who started the programme, 84% completed it. Among those who completed it, 86% reported a meaningful reduction in compulsive sexual behaviour. Men whose main difficulty was chemsex showed improvements similar to those experiencing other compulsive sexual behaviours. These findings are very encouraging, particularly when those experiencing these difficulties are sometimes described as hard to engage in treatment.

Our experience has been different. When offered support that feels relevant, safe and non-judgemental, many are willing to do the challenging work needed to improve their lives.

So if you’re reading this and recognise yourself, I want you to know that things can be different. You may simply not have been offered the right support yet. And most importantly, you don’t have to work this out on your own.

Why we’re launching Time To Talk About Sex

The specialist support needed remains difficult to access. Services are limited, waiting times can be long, and private therapy is unaffordable for many. That’s why we’re offering up to 100 free places on the Time To Talk About Sex 6-month group therapy programme. 

Time To Talk About Sex builds on the research and aims to make this kind of specialist support easier to reach. The focus of the programme is not simply on stopping behaviours, but on understanding yourself better and building a more fulfilling relationship with sex.

An important part of this is ensuring groups are delivered by specialist clinicians who understand LGBT+ lives.  Gay, bisexual and other men who have sex with men need to feel confident they can speak openly about their sexuality, relationships and sexual experiences without being judged or treated as a problem. We’re not interested in imposing a particular definition of a healthy sex life.

For some, progress might mean stopping certain behaviours. For others, it might involve reducing harm, developing greater choice or rebuilding intimacy. The important thing is understanding what meaningful change looks like for each person.

How to access support

The programme involves weekly two-hour sessions over six months, in small groups of up to ten, either in person in London or online across the UK. We may also run in-person groups in Brighton, Suffolk or Essex, depending on demand. Gay and bisexual men attend groups together, with separate groups available for straight men.

It’s not a 12-step addiction programme, and people joining the groups don’t need to commit to abstinence from sex or have stopped using drugs before seeking a consultation.

Consultations are taking place now, with the first groups starting in January 2027. Up to 100 places are offered free through our Community Interest Company, on a first-come, first-served basis, to men for whom the programme is the right fit.

You don’t need a diagnosis or GP referral, and you don’t need to have reached a crisis point.

Visit timetotalkaboutsex.org.uk for more information or to apply for the programme.

Having worked with so many men over the years, I feel genuinely hopeful about what can change when people have the opportunity to talk openly, feel understood and start to improve their lives. Ultimately, that’s what Time To Talk About Sex is about: making it easier to have conversations that, for too many men, have remained difficult for far too long.

If you’re reading this and thinking of a friend, a partner or someone in your family, please send it to them. It might be what helps them take the first step.

Dr Michael Yates is a Clinical Psychologist and Psychosexual Specialist and Clinical Lead of Time To Talk About Sex, which is run through Men’s Mental Health Clinical Outcomes CIC. He is also Lead Clinician and Psychology Service Lead at 56 Dean Street, Chelsea and Westminster NHS Trust, London. His research is available at drmichaelyates.co.uk/research.