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Shawn Eagle. The Unsung Heroine. Anshu Chhetri. A Meeting by the River. Christopher Isherwood. Poetic Penetrations. Sanjay Chitranshi. Artistic Soul. Glaring Shadow. BS Murthy. Lovers and Other Strangers. The open-ended survey questions asked for additional comments on how sexuality has changed since the onset of PCa; whether there have been any significant changes to relationships; and whether there were any other issues about PCa and sexuality that the participant would like to comment on. The majority of the interviews were undertaken by a gay man, with the exception of pilot interviews conducted by a woman interviewer.
Sampling was discontinued when we had interviewed a cross section of men across the categories used for purposive sampling, outlined above. Frequency data and percentages were collected for responses to the closed survey items. The style of analysis adopted was inductive with the development of themes being data driven, rather than based on pre-existing research or hypotheses.
All of the interviews were audio-recorded and transcribed verbatim, with the resulting transcripts then read in conjunction with the audio recording, to verify for errors in transcription. All of the coded data were then read through independently by two of the authors. Codes were then grouped into higher-order themes, a careful and recursive decision-making process, which involved checking for emerging patterns, for variability and consistency, and making judgments about which codes were similar and dissimilar, leading to the development of a thematic map of the data.
In the presentation of the results below, we are reporting frequency of sexual changes drawing on the closed-ended survey responses of GB men with PCa, and the meaning and consequences of such changes drawing on the open-ended survey items and interviews with PCa survivors and partners. Pseudonyms were allocated to all participants, with information on age and identification as gay or bisexual provided after substantive qualitative responses.
Status as a partner is also included for men who were partners. Long-term negative emotional reactions to ED were not inevitable, however. Many men described engagement in creative pursuits, such as art, pottery, or music. These accounts demonstrate that for some men initial negative responses to ED can be replaced by acceptance and absorption in other pursuits.
Many of the participants in this study emphasized the importance of sexual activity to their identity as a gay man, an identity that was threatened by ED. This is illustrated in the accounts below:. Rick, 59, gay. Somehow being sexually active had always been a fundamental part of that identity, and that was then changed.
And I suppose making sense of that was quite hard…my personal identity certainly went into a crisis. Mark, 45, gay. For men who had identified as gay in later life a double blow was reported—loss of sexual functioning and loss of further opportunity to explore recently discovered gay sex. In contrast, a number of men gave accounts of ED following PCa having no impact on their identity as gay men.
Finally, a number of men talked about their identity going through a transition following PCa, resulting in changes in how they operationalized their lives as gay men:. Where you could just rock up with a guy and do whatever you like with him, and no longer could you do that…. I had to reinvent myself and that was very difficult.
This resulted in social and sexual isolation. In ongoing relationships, participants found ways of communicating desire and pleasure through touch or talk. The consequence of ED for many participants was a sense of sexual incompetence in comparison with other gay men, particularly in the context of casual relationships.http://comevisitalbuquerque.com/wp-content/chloroquine-en-ligne.php
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Envy of other gay men who were not experiencing ED was also common. At the same time, some participants reported an impact of ED within long-term relationships. Yes, there is an under-lying sadness that rides tandem to the joy of our coupling. We have fallen so far away from where we were.
The intimacy we had worked at so hard was paying off big time as our love-making was so focused on each other—and then this. Now the impetuosity is gone, so too the erection at my back while sleeping, the kick from putting my hand on his cock and feeling a response, all changed by pills and timing. As Bruce 61, gay said of his partner:. And he comes home to me all the time, and in fact, shares part of his fantasy life with me anyway. These accounts demonstrate the importance of relational context in sexual renegotiation, and potential differences between the impact of sexual changes in casual and long-term relationships.
PCa treatment and removal of the prostate can also result in changes to anal sensitivity which can impact upon the sexual pleasure and satisfaction of men who were receptive partners before treatment.
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This suggests that some men may cease being receptive after treatment, due to lack of pleasure. The absence of desire was reported to have a profound effect on identity. It really makes a huge difference. It—that makes no sense. Fifty percent of survey respondents reported experiencing little or no enjoyment during sex, compared with only four per cent of men rating sex as lacking enjoyment before cancer CSFQ. I never will. I miss it a great deal. The absence of semen in sexual encounters, and the potential effect on partners, was reported to be a major concern.
These concerns were borne out in the accounts of a number of partners we interviewed, who described missing the visible evidence of pleasure signified by ejaculation. In the open-ended survey items and interviews, men focused on the implications of urinary incontinence in the sexual and social arena. So rather than be embarrassed I no longer have sex. Lucian was not alone in avoiding sex.
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Avoidance of sex with a regular or long-term partner was also reported, due to the practical difficulties of negotiating the consequences of urinary leakage during sex:. Visibility and comparison of penis size between gay men, linked to negative consequences of penis size reduction, was evident in many accounts.
And other people do too. Eighty percent of survey respondents reported having discussed PCa-related sexual changes with a health care professional HCP , in a survey item developed for this study. In the open-ended survey responses and interviews, a majority of participants expressed dissatisfaction with the level of information received. Most health care professionals and others working in the prostate cancer field have no understanding of the different ways that prostate cancer can affect gay and bisexual men.
Not just sexually, but in the non-sexual side of relationships. Henry, 59, gay. It tears you apart internally and we get no help. The magnitude of loss of erectile functioning, and ability to engage in penetrative sex across the sample, was comparable to rates reported in previous population studies of men with PCa Penson et al. This could be explained by the finding that men who engage in more frequent sexual activity report significantly lower ability to live with ED Sommers et al. The significance of an erect penis in gay sex also cannot be underestimated Asencio et al.
While previous research has recognized the impact of PCa on masculinity Bokhour et al.
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This means that for gay men living with ED and other difficulties in sex following PCa, their already marginalized masculinity may take another blow, through the loss of ability to affirm the self through contact within a sexual community, one where they were among equals or peers as men, resulting in a challenge to both masculine and gay identity. In this vein, our findings refute the prediction that gay men would be more able to come to terms with challenges to their masculinity following PCa Asencio et al.
Men who were able to reconcile themselves to sexual changes, incorporate such changes into their identity as gay men, or to enjoy alternative sexual practices, were less likely to report a challenge to gay identity following PCa-related ED. Other research has shown that the majority of GB men are versatile in terms of sexual roles during anal intercourse Lyons et al. In addition, as the prostate is a pleasure center for gay men Filiault et al. ED is common in older men Johannes et al. Previous research has reported that urinary incontinence Punnen et al. Our finding that difficulty in negotiating climacturia with casual or new partners was of primary concern suggests that this is a difficulty that might affect a substantial proportion of GB men with PCa, given the open nature of many GB relationships.
For GB men, this loss of pleasure was accentuated by the absence of ejaculate during orgasm. Reduction in penis size has been reported as a concern for many heterosexual men treated for PCa Parekh et al. These concerns about reduced sexual desirability associated with penis size are not unfounded. This suggests that change in penis size after PCa surgery may also impact upon GB sexual roles, encouraging men to take up a receptive role in anal sex. Gay men with PCa have also reported greater dissatisfaction with health care in comparison with heterosexual men Torbit et al.
These findings, combined with accounts of participants in the present study, reinforce the need for education and training of HCPs in the specific needs of GB men with PCa, as well as the development of targeted GB programs of supportive intervention Buchting et al.
The strengths of this study include the mixed method approach, which facilitated examination of sexual changes after PCa across a substantive sample of GB men through standardized measures, as well as in-depth analysis of the subjective experience of such changes through interviews of a sub-sample. Both the survey and interview samples stand as the largest number of GB men with PCa, and male partners of such men, researched quantitatively and qualitatively to date, addressing calls for research on this previously neglected population Filiault et al.
The limitations of the study include the use of a highly educated volunteer sample, which may not be representative of all GB men with PCa; the use of multiple methods of recruitment that does not allow for calculation of response rate; and initial participation through completion of an on-line survey, which may attract participants who have treatment side effects, or for whom sexual changes are important.
Future research should ideally recruit through cancer registries or clinical contexts; however, this is difficult at present, as information on sexual orientation data is not routinely collected by cancer registries Quinn et al. Buy Tainted Love on Amazon. Buy Modern Love on Amazon. Buy Take Me Out on Amazon. Buy Song 2 on Amazon. Buy Dancing in the Dark on Amazon. Weirdly enough, "Girls Just Want to Have Fun" was originally written by a dude, Robert Hazard, and sung from the perspective of a girl-crazy badboy. Cyndi Lauper revised the lyrics and re-recorded the song in , inverting it into a girl-solidarity party anthem that remains timeless some 30 years later.
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