I can already hear what some readers might be thinking. “But surely that just means they’re bisexual?” or “Maybe they’re in denial or dealing with internalised homophobia.” And yes, in some cases that might be true. Human beings are complicated and sometimes people do struggle to accept parts of themselves. But that is not always the full story. In societies like the United Kingdom we tend to like clear labels and tidy categories. We like to put people into boxes so that we can understand them quickly: straight, gay, bisexual. Yet human sexuality, intimacy and identity do not always behave in such neat ways.
Many of us were raised in cultures where masculinity is quite rigid. From a young age boys are often taught, directly or indirectly, what a “real man” should look like and how he should behave. Psychologists such as James O’Neil have written about this through the idea of gender role conflict, where men feel pressure to live up to strict expectations of masculinity. In this framework masculinity can feel very binary: you are either masculine or you are not. You are either straight or something else. There is little room for curiosity, vulnerability, or exploration.
Because of this pressure, some men end up living what feels like a double life. On the surface they fulfil the roles that society expects: husband, father, provider, dependable man. But internally there may be parts of themselves that feel unexplored or unexpressed. That curiosity might be about sexuality, intimacy, or even simply about experiencing closeness and connection in ways that are not normally allowed within traditional masculine norms.
Then there is the practical reality of adult life. Many married couples, particularly those raising children, move into very busy and structured lives. Work, school runs, bills, and responsibilities take up most of the emotional space. Sexual relationships sometimes become less frequent or less exploratory. That does not mean the love has disappeared, but it can mean that certain needs or curiosities remain unspoken. For some men those unexplored parts of themselves do not simply disappear; they sit quietly in the background.
The difficulty then becomes where does a man explore those parts of himself, and with whom? Many men feel they cannot speak openly with their partners about these thoughts because they fear judgement, rejection, or the collapse of the relationship. So the exploration, if it happens at all, often happens quietly and privately. This is one of the reasons counselling can be so valuable. Therapy creates a space where a man does not have to defend himself or fit into a label. Instead he can slow down and ask deeper questions about identity, masculinity, intimacy and what his experiences actually mean to him.
If you are the average person, then maybe when you saw the phrase “men who have sex with men” (MSM) you might have immediately placed it into a familiar category. Many people instinctively assume it must mean someone is gay, bisexual, or somewhere on that spectrum. But the reality is more complicated than that. In research and counselling, the term MSM is often used precisely because sexual behaviour and sexual identity are not always the same thing. A man can identify himself as straight and genuinely see himself that way, yet at certain points in his life he may have had sexual contact with another man. Researchers began using the term during studies around HIV/AIDS because they realised that identity labels alone did not accurately describe people’s behaviour.
For many readers this can feel confusing because we are used to thinking about sexuality in clear categories. But sexuality is often more fluid in behaviour than people realise. In counselling conversations I have had many women say that at some point in their lives they have kissed another woman or experimented sexually with another woman, yet they would never consider themselves lesbian. Some describe situations such as threesomes or sexual encounters that happened because it excited their partner, rather than because it reflected their own sexual orientation. Their identity remained heterosexual even though their behaviour at times did not fit neatly into that category.
The same thing can happen with men. Context and circumstance can influence behaviour in ways that do not necessarily change how someone sees themselves. For example, researchers have documented situations where men who identify as straight have had sexual encounters with other men in environments such as prisons, single-sex institutions, or certain social subcultures. In these situations the behaviour may be linked to opportunity, power dynamics, loneliness, or the absence of women rather than a change in sexual identity. Early sexuality research by Alfred Kinsey already suggested that human sexual behaviour often sits on a spectrum rather than in strict categories, something reflected in the Kinsey Scale.
Part of the reason for writing about this is that these men are often misunderstood, and in many cases they do not fully understand themselves either. This is where counselling can help. In therapy the goal is not to judge, label, or pathologise someone. The role of a counsellor is to create a space where people can explore their experiences honestly and safely, understand what their behaviour means to them, and reflect on how they want to live their lives moving forward. Sometimes the conversation turns out to be less about sexuality itself and more about identity, loneliness, masculinity, or emotional connection.
When researchers talk about sexuality, they often use different terms than the ones people use in everyday conversation. One term that appears a lot in research is “men who have sex with men”, often shortened to MSM. This term became common in public health research, especially during studies around HIV/AIDS, because researchers realised that sexual behaviour and sexual identity are not always the same thing. In simple terms, MSM describes what someone does, not who they believe they are.
Men who have sex with men (MSM) simply means a male who has sexual contact with another male. It does not say anything about how the person identifies. For example, a man may:
• identify as straight
• be married to a woman
• have romantic relationships with women
But may still occasionally have sexual encounters with men. Researchers use the MSM term because it captures behaviour without assuming a person’s identity or orientation. In public health and sexual health research, behaviour matters because it helps understand patterns of risk, health needs, and support services.
A gay man, on the other hand, is usually referring to sexual orientation and identity. A gay man is typically someone who:
• is primarily sexually attracted to men
• often forms romantic relationships with men
• identifies himself as gay as part of his personal identity
So the key difference is that “gay” describes who someone is and who they are attracted to, whereas MSM simply describes a behaviour that has occurred.
A bisexual man generally refers to someone who experiences sexual or romantic attraction to both men and women. Bisexuality is also an identity label that people choose for themselves. In many cases bisexual men may have relationships with both sexes at different points in their lives, or sometimes simultaneously depending on the relationship structure.
Psychologists often explain this using a simple idea: sexuality has three different dimensions. These do not always line up perfectly.
• Identity – how someone labels themselves (straight, gay, bisexual)
• Attraction – who someone feels sexually or romantically drawn to
• Behaviour – who someone actually has sex with
Research going back to the work of sexologist Alfred Kinsey in the mid-20th century suggested that sexuality exists more on a spectrum rather than in strict categories. The Kinsey Scale was one of the first attempts to explain that some people may mostly be attracted to one sex but occasionally behave differently.
In counselling settings, understanding these differences is important. A therapist will usually avoid assuming someone’s identity based purely on behaviour. For some men, having sex with another man may be about curiosity, opportunity, loneliness, or emotional connection rather than a change in sexual orientation. For others, it may be part of discovering their identity. Counselling often focuses less on labels and more on helping the person understand their experiences without shame or confusion.
When people talk about sexuality they often assume it is very simple: you are either straight, gay, or bisexual. But when you actually listen to men in counselling rooms or read the research, human behaviour is often far more complicated than that. Studies from the University of British Columbia and sociologist Tony Silva show that there are men who identify strongly as straight, are married to women, and live what most people would consider traditional lives, yet have occasionally had sex with other men. Silva interviewed around sixty men over several years for his book Still Straight: Sexual Flexibility among White Men in Rural America. Many of them hunted, fished, were married, and saw themselves firmly within heterosexual culture. Yet their behaviour did not always line up neatly with the label “straight”. This highlights something psychologists have known for a long time: sexual identity, sexual attraction, and sexual behaviour are three different things and they do not always align.
One reason some men describe in research is quite practical. Some married men said their sex lives with their wives had slowed down, often because of work, children, stress, or relationship difficulties. In Silva’s interviews, some men said sex with another man felt like a “loophole” in their marriage because they believed it carried less emotional risk than an affair with another woman. Their thinking was that sex with a woman might create emotional attachment, threaten the relationship, or become socially visible in small communities. Psychologically, this connects to ideas about attachment and perceived emotional risk. Some men believe sex with men is more transactional and less emotionally complicated. Whether that belief is accurate or not is another matter, but it explains the reasoning some men describe.
Another factor that comes up in counselling and research is masculinity and pressure. Many men feel they have to perform a very specific role during sex with women: be confident, in control, dominant, and sexually capable. That pressure can create anxiety, particularly around performance. Some men in Silva’s study said that sex with men removed that pressure because the expectations felt different. Others described something even simpler: loneliness and a lack of physical touch. Men are often socialised not to hug, hold, or emotionally comfort each other. For some men, sexual contact becomes the only socially acceptable way they feel they can experience closeness with another man. In psychology this links to research on male loneliness and emotional restriction, something discussed in studies around gender role conflict such as those by psychologist James O’Neil.
Why do many of these men still call themselves straight? In counselling you often see that identity is shaped not just by behaviour but by relationships, community, and how someone understands themselves. Many of the men in the research were married to women, loved women romantically, and lived in communities where heterosexual identity was the norm. So in their minds, their core identity remained straight even if their behaviour sometimes crossed that boundary. Psychologists often describe sexuality as multidimensional:
• Identity (how someone labels themselves)
• Attraction (who they feel drawn to)
• Behaviour (what they actually do)
Counselling can sometimes help men explore these areas without shame or panic. The goal is not to push someone into a label but to help them understand themselves better. For some men, talking openly about sexuality reduces secrecy, guilt, or confusion. For others, it opens conversations about loneliness, marriage difficulties, masculinity pressures, or emotional needs that have nothing to do with sexual orientation at all. In many cases, the sexual behaviour is only the surface of a deeper psychological story.
The paper “Chemsex behaviours among men who have sex with men: A systematic review of the literature” published in the journal International Journal of Drug Policy by Steven Maxwell, Maryam Shahmanesh and Mitzy Gafos looked at a phenomenon called chemsex. The researchers reviewed 38 studies from high-income countries to understand why some men who have sex with men combine drugs with sex, what behaviours are involved, and what the consequences might be.
Let me explain the study in straightforward language, the way you might discuss it in a counselling or psychology context.
First, the paper explains what chemsex actually is. It refers to the use of certain drugs specifically to enhance or prolong sexual encounters. The substances most commonly mentioned in the research include:
• methamphetamine
• GHB or GBL
• mephedrone
• cocaine
• ketamine
The purpose of these drugs is usually to increase sexual desire, lower inhibitions, and allow sex to last longer. In some cases, sexual sessions can last many hours or even days. Researchers found that many participants expected these drugs to improve their sexual experiences or help them feel more connected to their partners.
From a psychological perspective, drugs like these can temporarily increase dopamine and reduce anxiety, which can make people feel more confident, more sexually open, and less concerned about risk.
Second, the study found that chemsex is not something most men who have sex with men engage in. It is a minority behaviour, but it is important because of the potential risks involved. One of the consistent findings across studies was that men who engage in chemsex were more likely to:
• have longer sexual sessions
• have multiple sexual partners
• have condomless sex
• inject drugs in some cases (“slamsex”)
• share injecting equipment
Because of this combination of drug use and sexual behaviour, researchers noted an increased risk of HIV and other sexually transmitted infections among some participants.
This is why public health researchers and sexual health clinics often pay attention to chemsex behaviours.
Third, the review suggests that psychological and social factors are often involved, although the research is still developing. Some of the motivations discussed across the studies include:
• wanting to reduce sexual inhibition or anxiety
• seeking stronger intimacy or connection with partners
• coping with loneliness or stigma
• escaping stress or emotional pain
• enhancing pleasure or sexual stamina
Other research has also found links between chemsex and mental health difficulties such as anxiety or depression, although the relationship is complex and not the same for everyone.
From a counselling perspective, this is important because sometimes the drug use is not just about sex — it can also be about coping, belonging, identity, or emotional regulation.
Finally, the study concludes that chemsex can have negative impacts on health and wellbeing, particularly when drug use becomes regular or compulsive. The researchers say more work is needed to understand the psychological aspects and how services can support men engaging in this behaviour.
In counselling settings, support often focuses on:
• reducing shame and stigma
• understanding why the behaviour developed
• addressing loneliness or trauma
• helping clients regain control over drug use
• improving sexual health awareness
In other words, therapy is often less about judging the behaviour and more about understanding what emotional or psychological need the behaviour is serving.
When you speak to therapists who work with men in big cities like London, one theme that comes up again and again around chemsex and casual sex between men is loneliness. On the surface it can look purely sexual or purely about drugs, but when you sit with people long enough in a counselling room, you often hear something different. Many men describe living very independent lives, working long hours, having active social media lives, but still feeling emotionally disconnected. Sex, particularly when combined with drugs, can become one of the few places where they experience physical closeness, validation, and belonging, even if it is temporary.
Psychology has long talked about the way men are socialised to restrict emotional expression. Researchers in male psychology, such as James O’Neil and his work on Gender Role Conflict, argue that many boys grow up learning that showing vulnerability, asking for comfort, or expressing emotional needs can be seen as weak. As a result, many adult men struggle with intimacy that is not sexual. They may find it easier to have sex with someone than to sit with another man and say “I feel lonely” or “I need support.” In that sense, sex can become a socially acceptable doorway to connection.
Another factor therapists sometimes see is performance pressure around masculinity. In heterosexual relationships many men feel they must be the confident one, the initiator, the one who “knows what they are doing.” Some men report that sexual encounters with other men remove some of that pressure because the expectations feel different. In counselling conversations, some men describe it almost like stepping outside the role they normally play. It can temporarily switch off anxiety about performance, status, or control.
There is also the role of shame and secrecy, which psychology has studied for decades. When behaviours are hidden, they often become more intense. Drugs used in chemsex, such as those discussed in the review by Maxwell, Shahmanesh and Gafos in the International Journal of Drug Policy, reduce inhibitions by altering dopamine and GABA systems in the brain. In simple terms, they quieten the internal critic. Men who normally feel anxious, self-conscious, or judged can suddenly feel confident, desired, and uninhibited. The problem is that the brain can start associating drugs with relief from those feelings, which is where patterns can develop.
In counselling, the conversation often ends up being less about sex and more about deeper questions. Therapists might explore things like:
• Where does the loneliness come from?
• What does intimacy actually mean for this person?
• What role does shame or secrecy play?
• Is the behaviour helping them cope with stress, trauma, or rejection?
When men feel safe enough to talk about these things without judgement, something interesting often happens. The behaviour itself sometimes becomes easier to understand and, for some men, easier to change. Not because someone told them to stop, but because they start meeting the emotional needs that the behaviour was quietly trying to solve in the first place.
How Male Minds Counselling in Reading Supports Men Who Have Sex with Men
Are you a man who has sex with men but still identify as straight? Are you trying to make sense of your experiences and looking for someone you can speak to openly, without judgement or assumptions? Many men find themselves in this position and feel they have no one they can safely talk to. They may worry about being misunderstood, labelled, or having people jump to conclusions about their sexuality or identity. Counselling can provide a confidential space where you can explore these questions honestly and at your own pace.
My name is Kasim and I run a counselling practice in Reading in Berkshire. My office is based on Castle Street, opposite Sweeney Todd. From this space I work with men face-to-face as well as online through the video platform Zoom. Some of the men I see are married, some are single, and many are simply trying to understand parts of themselves that they have never been able to talk about before.
For some men the questions might sound like this:
• Why have I had sex with men if I see myself as straight?
• Does this mean something about my identity?
• Is this about curiosity, loneliness, intimacy, or something else?
• How do I make sense of this while still honouring my life and relationships?
These are not unusual questions. In fact, many men carry these thoughts quietly for years because they do not feel safe speaking about them.
In counselling the aim is not to label you or push you into a category. The purpose is to create a space where you can explore your experiences, your identity, and your relationships without shame. Sometimes the conversation is about sexuality, but often it is also about masculinity, intimacy, loneliness, relationships, and the pressures that men carry in their lives.
If you are based in Reading or the surrounding areas such as Wokingham, Newbury, Theale, or Henley-on-Thames, you are welcome to get in touch. Whether you prefer to meet in person or speak online, counselling can offer a private and respectful place to talk about things you may never have felt able to say out loud before.