As psychedelic research gains momentum, sexual health professionals will increasingly encounter clients curious about, or already engaging with, psychedelics. Most psychedelic research to date highlights their benefits for depression, PTSD, and anxiety, and clinical programs in Colorado and Oregon are already applying these findings. New studies also point to potential impacts on sexual health, intimacy, and relationships.
For sexual health professionals, staying informed about these developments can help you better support clients navigating sexuality, gender, and relationships in the context of psychedelic use.
Psychedelics and sexual functioning
Until recently, almost no research directly examined how psychedelics affect sexual functioning. That changed in 2024, when the the first research study to quantitatively investigate the effects of psychedelics on sexual functioning found people who used psychedelics in natural settings reported improvements in their sex lives. They reported feeling more pleasure, better communication during sex, and feeling more satisfied with their partner and their own body.
Increased pleasure and satisfaction during sex
Better communication with partner
Greater body acceptance
Another recent study assessed how micro-dosing psychedelics could support psychosexual and couple’s therapy. It found links to reduced performance-related anxiety, improved desire, and more openness in sexual exploration.
Participants reported a positive relationship between micro-dosing psychedelics and sexual and physical well-being through a reduction of performance-related anxiety and stress.
Participants reported increased sexual desire, exploration and communication
Individuals engaging in microdosing alongside therapy reported better communication and intimacy suggesting psychedelics may one day be a useful adjunct in couples or sex therapy.
Psychedelics, gender, sexuality and intimacy
More recently, researchers extended previous knowledge by conducting a study of nearly 600 participants that examined how psychedelics may influence broader views on gender, sexuality, and intimacy. Most participants used psilocybin mushrooms or truffles. Researchers tracked experiences before, during, and after psychedelic use across several domains:
Attraction to partners
Sexual activity
Relationship quality
Interest in multiple partners
Sexual fluidity
Changes in gender expression and identities
Key findings
Sexuality:
The majority of participants reported that their psychedelic experience had some acute and/or long term effect on their sexuality and intimacy.
70% of participants reported some effect on sexuality/intimacy
More participants reported larger shifts in enhanced attraction, better relationship quality, and enriched sexual experiences than negative effects.
Overall, younger participants, gender diverse individuals and women reported more shifts in at least one aspect of their sexuality/intimacy
Gender expression:
About 1 in 10 reported shifts in gender identity or expression. . Gender-diverse participants reported the most shifts. Several themes emerged related to gender identity and expression including: authenticity, openness, self-acceptance, rejection of rigid gender norms.
Several participants shared increased authenticity about gender
Others reported more openness to exploring their gender identity and expression
Many shared new perspectives on gender fluidity and shifts between masculine and feminine expressions
Sexual identity and expression:
All groups reported changes in sexual attraction, indicating an increase in sexual fluidity after psychedelic use. Among men and women participants, researchers saw a significant increase in same-sex attraction.
33% of gender-diverse individuals, 25% of women, and 12% of men reported changes in their sexual attraction
Intimate relationships:
Participants reported shifts in their views related to romantic and intimate relationships. More individuals reported an openness to polyamory, open relationships, or dating multiple partners ost-psychedelic experiences. After psychedelic use:
A significant increase in polyamorous, dating multiple people and open relationships were reported
Significant decreases in commitment to only one person
Decrease in being single
Psychedelic benefits and challenges:
Potential benefits:
Increased authenticity and openness
Greater levels of intimacy
Improved relationship quality
Reduced shame
Potential challenges:
Difficult experiences (“bad trips”)
Confusion or distress related to identity shifts
Limited understanding of long-term impacts
Conclusion
For sexual health professionals, the implications are clear: psychedelics may significantly shape how clients understand and experience sexuality, intimacy, and identity. Being prepared to discuss this topic is imperative. Part of this includes understanding how they work, emerging research and potential risks and benefits.
While in the earlier stages of psychedelic research, it's also important to note the large gap in understanding around psychedelics that persist, especially that includes intersecting identities. Limited psychedelic studies are representative of various sexual, gender and racial identities. More research is needed to empower sexual health professionals in supporting individuals across all stages of their journey.
For more on sexual health and substance use, check out Ashley Manta’s harm reduction guidelines on sex and substances. You can also find information on navigating the aftermath of substance-enhanced intimacy (“chemsex”) here.
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Written by Emma Sell-Goodhand, MPH
Emma is a doctoral student and Global One Health Fellow at North Carolina State University studying adolescent sexual health. She brings prior experience as a Technical Advisor at the World Health Organization.
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