Threat of Sexual Disqualification: The Consequences of Erectile Dysfunction and Other Sexual Changes for Gay and Bisexual Men With Prostate Cancer.
Gay and bisexual (GB) men with prostate cancer (PCa) have been described as an "invisible diversity" in PCa research due to their lack of visibility, and absence of identification of their needs. This study examined the meaning and consequences of erectile dysfunction (ED) and other sexual changes in 124 GB men with PCa and 21 male partners, through an on-line survey. A sub-sample of 46 men with PCa and seven partners also took part in a one-to-one interview. ED was reported by 72 % of survey respondents, associated with reports of emotional distress, negative impact on gay identities, and feelings of sexual disqualification. Other sexual concerns included loss of libido, climacturia, loss of sensitivity or pain during anal sex, non-ejaculatory orgasms, and reduced penis size. Many of these changes have particular significance in the context of gay sex and gay identities, and can result in feelings of exclusion from a sexual community central to GB men's lives. However, a number of men were reconciled to sexual changes, did not experience a challenge to identity, and engaged in sexual re-negotiation. The nature of GB relationships, wherein many men are single, engage in casual sex, or have concurrent partners, influenced experiences of distress, identity, and renegotiation. It is concluded that researchers and clinicians need to be aware of the meaning and consequences of sexual changes for GB men when designing studies to examine the impact of PCa on men's sexuality, advising GB men of the sexual consequences of PCa, and providing information and support to ameliorate sexual changes.
Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia. j.ussher@westernsydney.edu.au.
Jane M
JM
Ussher
Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
Janette
J
Perz
Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
Duncan
D
Rose
Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne, VIC, Australia.
Gary W
GW
Dowsett
Menzies Health Institute, Griffith University, Nathan, QLD, Australia.|Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia.
Suzanne
S
Chambers
Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.|Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia.
Scott
S
Williams
Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.|Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Camperdown, NSW, Australia.
Ian
I
Davis
Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
David
D
Latini
D001727:Bisexuality / Q000523:psychology*; D007172:Erectile Dysfunction / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000150:complications* / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology*; D011795:Surveys and Questionnaires
Erectile dysfunction; Gay and bisexual men; Gay identity; Masculinity; Prostate cancer; Sexual changes