Cancer forms a significant health issue for women in Australia and globally, and can result in a range of embodied changes that affect women's experiences of sex and sexuality, continuing long after the conclusion of treatment. Cancer and cancer treatments can result in a range of bodily changes, including vaginal dryness, pain on intercourse, the loss of sexual desire, as well as disfigurement, scarring, bowel and bladder dysfunction, fatigue, and premature menopause. In addition, women report experiencing higher levels of depression and anxiety after cancer, as well as diminished body image and lowered feelings of attractiveness. Previous research has predominantly focused on the material and intrapsychic experiences of sexual changes after cancer, with discursive factors receiving less attention. However, women make sense of their subjectivities following cancer in relation to available discourses of cancer, heterosexuality and femininity. This suggests that research needs to pay attention to cultural discourse, as well as materiality and the intrapsychic. Further, there is a need to conduct research that privileges women's subjective embodied experiences as sources of knowledge, in order to examine how women experience embodied sexual subjectivity after cancer. This study explored how women construct a sense of their bodies and sexual 'selves' in the context of cancer. In-depth semi-structured interviews were conducted with sixteen women across a range of ages, cancer types, and heterosexual relational contexts, including women who were, and were not, currently not in a long-term relationship. A material-discursive-intrapsychic theoretical framework was employed, within a critical realist epistemology. A thematic discourse analysis was conducted drawing on feminist poststructuralist approaches to subjectivity, and the thematic organisation of interview material around subject positions. Three overall themes were identified in the analysis: The Medical Body, The Abject Body and Positioning the Body Inside and Outside 'Sex'. In the theme 'The Medical Body', the women moved between positioning their bodies as 'object', without agency and distanced from discourses of femininity and sexuality, and as 'subject', taking up more agentic subject positions and beginning to re-embody 'sex' after cancer. In the theme 'The Abject Body', the women positioned their bodies beyond abnormality, outside discourses of idealised femininity, and out of control. Accounts of taking up the abject body were characterised by failure, self-blame and shame, while accounts of managing and resisting the abject body included concealment, resisting discourses of feminine beauty and positioning the body as the site of personal transformation. In the theme, 'Positioning the Body Inside and Outside 'Sex', the women positioned their subjectivity around hegemonic cultural constructions of hetero-sex. Accounts of the women positioning themselves inside 'sex' included experience of bodily ease during sex, or containing risk to sexual subjectivity by managing the body during sex. Accounts of the women positioning their subjectivity outside 'sex' included experiencing loss of sexual desire, vaginal dryness and pain on intercourse, or absence of sexual relationships. Overall, in this analysis the corporeality of the cancerous body can be seen to disrupt hegemonic discourses of femininity and sexuality, with implications for how women practice and make meaning of their embodied sexual subjectivity. Implications of this research for theoretical, research, policy and clinical practice are examined, focusing on the need to create 'space' for women's bodies and embodied experiences after cancer.
| Date of Award | 2013 |
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| Original language | English |
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