title: Renegotiating sex and intimacy after cancer: resisting the coital imperative.
abstract: BACKGROUND
  Previous research on sex and intimacy in the context of cancer has focused on documenting sexual changes and difficulties, primarily focusing on heterosexual individuals who have sexual or reproductive cancers. Analyses of sexual renegotiation and the social construction of sex are largely absent from the research agenda.
  
  
  OBJECTIVE
  The objective of this study was to explore renegotiation of sex in individuals with cancer, and in partners, across a broad range of cancer types and relational contexts.
  
  
  METHODS
  Semistructured interviews were conducted with 44 people with cancer (23 women, 21 men) and 35 partners (18 women, 17 men), 86% of whom identified as heterosexual. The data were analyzed with theoretical thematic analysis, from a material-discursive-intrapsychic perspective.
  
  
  RESULTS
  Renegotiation of sex or intimacy was reported by 70% of participants, reflected in 3 themes: "resisting the coital imperative: redefining 'sex,'" "resisting the coital imperative: embracing intimacy," and "adopting the coital imperative: refiguring the body through techno-medicine." The importance of relational context was reflected in the theme "the inter-subjective nature of sexual re-negotiation: relationship context and communication."
  
  
  CONCLUSIONS
  Whereas previous research has focused on embodied changes associated with sexuality after cancer, or their psychological consequences, the findings of the present study suggest that hegemonic constructions of "sex," in particular the coital imperative, are central to the experience and negotiation of sex and intimacy after cancer.
  
  
  CONCLUSIONS
  Resistance of the coital imperative should be a fundamental aspect of information and support provided by health professionals who seek to reduce distress associated with sexual changes after cancer.
authors.affiliation: Author Affiliations: Centre for Health Research, School of Medicine, University of Western Sydney (Drs Ussher, Perz, Gilbert, and Wong); and Department of Gynaecological Cancer, Westmead Hospital, Sydney (Ms Hobbs), Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Ussher
authors.forename: Janette
authors.initials: J
authors.lastname: Perz
authors.forename: Emilee
authors.initials: E
authors.lastname: Gilbert
authors.forename: W K Tim
authors.initials: WK
authors.lastname: Wong
authors.forename: Kim
authors.initials: K
authors.lastname: Hobbs
mesh_terms: D000328:Adult; D000368:Aged; D003075:Coitus / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D017008:Negotiating; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology; D011788:Quality of Life; D012725:Sexual Behavior / Q000523:psychology; D019529:Sexuality / Q000523:psychology; D011795:Surveys and Questionnaires