There is a growing body of evidence to show that cancer can result in dramatic changes in sexuality, sexual functioning, and intimate couple relationships, with significant implications for both quality of life and psychological well-being. However, the experiences of intimate partners are often neglected in research on sexuality and intimacy in the context of cancer. This study used a material-discursive framework and a qualitative methodology to investigate the ways in which intimacy and sexuality are renegotiated in the context of cancer, and what factors are associated with successful or unsuccessful renegotiation, from the perspective of partners caring for a person with cancer. Twenty participants were interviewed, across a range of cancer types, stages, and age groups. Eleven participants reported that they were unable to negotiate other ways of being sexually intimate when penetrative sexual intercourse was no longer physiologically possible or desirable. Nine were able to renegotiate sexual intimacy in the context of cancer to include practices previously positioned as secondary to “real sex,” such as mutual masturbation, self masturbation, manual stimulation, oral sex, massage, the use of vibrators, kissing, and hugging. Grounded theory analysis identified two themes associated with renegotiation: “Alternative” sexual practices-redefining sexual intimacy, and couple communication and relationship context. Difficulties in renegotiation were associated with adherence to the coital imperative, sexual relationship or communication problems which existed prior to cancer, and the positioning of the person with cancer as a child or an asexual sick patient rather than a sexual partner. The implications for health professional intervention to ameliorate changes to sexuality in the context of cancer are discussed.
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An example of the way in which coitus is seen as “real sex” is in the socio-legal discourse surrounding the Bill Clinton and Monica Lewinsky sex scandal. When asked if he had ever had “sexual relations” with Monica Lewinsky, (as the term “sexual relations” is defined by the Court) Bill Clinton answered that he had never had sexual relations with Monica Lewinsky, because he believed the agreed-upon definition of “sexual relations” excluded his receiving oral sex.
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This research was supported under a University of Western Sydney Grant Scheme. The Chief Investigator on the project was Emilee Gilbert. The larger cross sectional project evaluating the needs and experiences of informal cancer carers, from which this study was drawn, was supported under Australian Research Council’s Linkage Projects funding scheme (project number LP0560448), in conjunction with the Cancer Council New South Wales, Westmead Hospital, and Carers New South Wales. The chief investigators on the project were Jane Ussher and Phyllis Butow, and the partner investigators were Gerard Wain, Gill Batt and Kendra Sundquist. Thanks are offered to Yasmin Hawkins, Mirjana Sandoval, and Angela Pearce for research support and assistance.
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Gilbert, E., Ussher, J.M. & Perz, J. Renegotiating Sexuality and Intimacy in the Context of Cancer: The Experiences of Carers. Arch Sex Behav 39, 998–1009 (2010). https://doi.org/10.1007/s10508-008-9416-z