Exploring the effects of cancer on the lives of gay, bisexual, and queer men

Abstract

Higher rates of distress, concerns about sexual changes and biographical disruption have previously been reported by gay, bisexual, and queer men (GBQM) with prostate cancer. There is a need to look at the subjective experience of these changes, and the broader biographical disruption caused by cancer of any type, for GBQM. This qualitative research study adopted a dialectical critical realist epistemology to investigate the impacts of cancer and cancer treatments on GBQM and their partners. A reflective thematic analysis was used to interpret the accounts of 144 GBQM living with a cancer diagnosis, and 20 partners. These accounts came from the completion of open-ended online survey responses, and from 47 participants who agreed to be interviewed, with 22 participants undertaking a second interview using photo elicitation. Biographical disruption following cancer was associated with the impact of physical changes resulting from adverse effects of treatments on GBQM’s daily lives. To establish biographical continuity, GBQM attempted to manage these physical changes and the existential threat of cancer in their relationships, and adapted their daily activities, including shopping, socialising, and work. Some GBQM experienced changes in sexual function that affected their sexual intimacy and identity, resulting in intrapsychic distress as they decided how to communicate their anxieties to current or future partners, to establish biographical continuity in their sexual relationships. Many GBQM described the impact of urinary incontience and bowel dysfunction on themselves, their relationships, and engagment with their community, in the context of the discursive construction of an abject leaking body. Relational intimacy and support experienced by GBQM whilst living with a cancer diagnosis demonstrates that biographical disruption and reconstruction along the cancer journey is not a singular event. Many GBQM described a hesitation or anxiety to disclose their sexual identity to health care professionals (HCPs), and they described how disclosure had to be repeated across their cancer journey. There was an assumption of heterosexuality on the part of HCPs, and efforts to disclose were hampered by time and environmental constraints during consulations. This research has shown that HCPs in cancer care need to gain an understanding of how the adverse effects of cancer treatments can affect the individual GBQM beyond the changes to specific bodily functions. Prior to diagnosis, GBQM are unlikely to know how cancer treatments could impact their current or future relationships, the importance of having a supportive environment at a time of crisis, or how they are able to regain biographical continuity following treatment. Therefore, HCPs need to consider how to establish a culturally safe environment that allows GBQM to disclose their identity and relationships, but also understand why such disclosure is important in providing treatment and after care.

Date of Award	2023
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Jane Ussher (Supervisor)