Negotiating consent, sexualized substance use, and digital platforms among two-spirit, gay, bisexual, trans, and queer men: Perceptions of Canadian service providers

The interplay of digital platforms and sexualized substance use has reshaped Two-Spirit, gay, bisexual, trans, and queer (2SGBTQ) men’s sociality and wellbeing. 2SGBTQ men use digital platforms and sexualized substances at unprecedented rates. The overall aim of this research was to explore the perspectives of Canadian health service providers regarding the intersections of digital platforms, sexualized substance use, and wellbeing. Guided by an intersectional queer approach, which explicated the normative regimes of power and criminalization across multiple intersecting 2SGBTQ men’s lived experiences, we recruited nine service providers largely working in various urban centres across Canada. Using reflexive thematic analysis, we synthesized our findings into three key themes: 1) the messy and contextually specific organization of sexual consent communication and negotiation, 2) how substance use has, and continues to, reshape 2SGBTQ sociality, and 3) how dating apps diminish and bolster 2SGBTQ connection. Our findings interrogate the complex and messy arrangements of digital platforms and sexualized substance use, shaped by cisheteropatriarchal, racialized, and criminalized socio-political contexts. Across accounts, service providers emphasized a need to address sexuality-related, substance use, and anti-2SGBTQ stigma to promote the wellbeing of 2SGBTQ men. Public health interventions must incorporate anti-carceral, holistic, intersectional, culturally relevant, and concerted approaches.