Threat to gay identity and sexual relationships : the consequences of prostate cancer treatment for gay and bisexual men

This chapter considers the effect of prostate cancer treatment on gay identity and sexual relationships. A total of 124 gay and bisexual men (GBM) with prostate cancer and 21 male partners completed an online survey, and a subsample of 46 men with prostate cancer and 7 partners also took part in a one-on-one interview. Erectile dysfunction, reported by 72% of survey respondents, was associated with reports of emotional distress, negative effect on gay identities, and feelings of sexual disqualification. Other sexual concerns included climacturia, pain or loss of sensitivity during receptive 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 they can result in feelings of exclusion from a sexual community central to GBM's lives. Researchers and clinicians need to be aware of the meaning and consequences of sexual changes for GBM when designing studies to examine the influence of prostate cancer on men's sexuality, advising GBM of the sexual consequences of prostate cancer, and providing information and support to ameliorate sexual changes.