Gender and sexuality diverse women's experiences of sexual and gendered embodiment in the context of cancer

Abstract

This thesis has explored the cancer and cancer care experiences of gender and sexuality diverse (GSD) women. It has examined how participants navigated the embodied intersections of their cancer, gender, and sexual identities in the context of predominantly cisheteronormative medical systems and constructions of cancer. This analysis was guided by a social constructionist epistemology in conjunction with a thematic discourse analysis, and by way of semi-structured and Photo-elicitation interviews, aimed to foreground the complex and diverse nature of GSD women's survivorship experiences. It has drawn on a queer theoretical sensibility to question dominant cisheteronormative discourses in cancer care, and the construction of non-normative subjectivities in cancer culture. This facilitated the questioning of cancer survivorship as a heteronormative temporal relation tied to a form of recovery reliant on gender conformity, optimism, and neoliberal health logics, ultimately arguing for the queer temporality of survivorship itself. While this is a growing field of study, the existing literature suggests that GSD women (and LGBTQI populations in general) face a disproportionate cancer burden compared to their heterosexual counterparts, and overall unique challenges across all stages of the cancer continuum. The research findings presented in this thesis have examined the specificities of those challenges. Assumptions of heterosexuality, and cisgender embodiment, identity and expression were prevalent across GSD women's stories and had implications for survivorship at multiple levels. A number of GSD women described feeling invisibilised by the "pinkification" of "women's" cancers. They did not feel represented by the coding of cisheteronormative femininity present in available information, resources, and support, which emphasised the reinstatement or recovery of "ideal" cisheteronormative femininity. Many GSD women described feeling stripped of their agency in health decision-making in that they felt pressure to undergo breast reconstruction after mastectomy or compelled to cover up the signs of illness with wigs, make-up, and prostheses; whilst a number rejected these pressures and found freedom or gender affirmation in doing so. Assumptions of cisheteronormativity extended also to GSD women's renegotiation of sexual embodiment after cancer, wherein their sexual concerns were often not understood by health providers nor captured by the available resources, which privileged coital (penis-vagina) heterosexual sex. Whilst some GSD women were able to renegotiate sex and intimacy on their own terms, others described feelings of loss in the absence of sexual renegotiation. The biographical disruption posed by cancer enabled some GSD women to reprioritise their lives, whereas others felt pressured to "optimise" their cancer experience.

Date of Award	2023
Original language	English