As the social consent for seeking help in the area of psychosexual health increases, specialists observe the current socio-cultural changes and the new phenomena they give rise to be reflected in their patients. One of these relatively new phenomena is chemsex. It is a distinct form of combining highly specific psychoactive substances and sexual activity, practised almost exclusively by men. Due to the heightened health risks, connected both with the drugs used and the frequent lack of protection during sexual activity, international public health institutions consider chemsex a health problem of men who have sex with men (MSM). Although the introduction of MSM as a category in the 1990s – mainly in the context of HIV – was based on important epidemiological premises (the behaviour, not the identification, is what is important in the context of risk), it is neglecting sexual identity that may be one of the missing links in the intersectional understanding and appropriate addressing of problematic chemsex. The article is addressed especially to psychiatrists, psychologists, psychotherapists, addiction and sexologists working with this group of patients.