Sexual Embodiment and Sexual Renegotiation Post-Cancer for LGBTQ People with a Cervix

Abstract

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) people face unique challenges in the context of cancer due to cis-heterocentric constructions of sexuality in oncological care. This paper explores the impacts of these challenges for LGBTQ people with a cervix, examining embodied sexual changes and sexual renegotiation during and after cancer, and the implications for LGBTQ people’s access to relevant, tailored cancer information and support. Semi-structured interviews were conducted with 57 LGBTQ people with a cervix with cancer and 14 intimate partners, representing a range of cancer types and stages. Data were analyzed using reflexive thematic analysis. Several participants positioned changes to their sexual embodiment as abject, instilling a loss of control and uncertainty. Sexual practices were misunderstood by many health-care professionals (HCPs), meaning concerns about bodily changes, sex, and intimacy were poorly addressed in cancer support resources and medical interactions. This left LGBTQ participants and their partners ill-equipped to cope with changes to sexual functioning, feeling unsupported, distressed, and as though their sexual concerns were of less importance than those of cis-heterosexual patients. However, some LGBTQ participants and partners were able to renegotiate sexual practices through engaging in non-genital intimacy and experimenting with non-penetrative sex. This was facilitated through good couple communication, where needs were openly discussed between partners. Assumptions of heterosexuality and cisgender embodiment, identity, and sexual expression have serious implications for LGBTQ people’s physical and emotional well-being, agency, and sexual health decision-making. These assumptions also affect access to relevant and culturally safe sexual health information and care. Findings reinforce the need for the inclusion of LGBTQ content in HCP education and professional training curricula, and institutional support for LGBTQ-inclusive practice behaviors.