Re-imagining queer embodiment: challenges to sexuality and intimacy after cancer

This chapter explores the impact of cancer and its treatment on the sexual well-being and embodied experiences of LGBTIQ+ people. Drawing on data from two studies, it examines how disruptions to sexuality – such as loss of desire, erectile dysfunction, reduced orgasmic ability, and changes to physical appearance – can profoundly affect identity, intimacy, and relationships. These changes often produce grief, isolation, and a disconnection from queer sexual cultures. The chapter examines how cultural expectations around masculinity, femininity, and sexual function shape the ways gay and bisexual men, lesbian and queer women, trans people, and those with intersex variations experience distress and disruption to their bodies and identities after cancer. For many, cancer-related changes to sexual function or appearance challenged not only their physical capacities but also their sense of self, desirability, and belonging within LGBTIQ+ communities. Despite these challenges, many participants actively engaged in strategies to cope and renegotiate sexuality – redefining sexual practices, embracing non-coital intimacy, using sexual aids, and reframing embodiment through queer and relational perspectives. The chapter also explores how affirming relationships and open communication can buffer the emotional toll of sexual disruption, while critiquing the inadequacy of heteronormative and phallocentric medical responses. This research underscores the urgent need for inclusive, LGBTIQ+ affirming cancer care that recognises diverse sexualities, bodies, and relationships. It calls for healthcare providers to move beyond silence or one-size-fits-all models by addressing sexual well-being as a key part of cancer survivorship. In doing so, they can support LGBTIQ+ people to navigate changes, reclaim intimacy, and sustain a positive sense of sexual self after cancer.