Archives of Sexual Behavior

Sexual Embodiment and Sexual Renegotiation Post-Cancer for LGBTQ People with a Cervix

Abstract Lesbian, gay, bisexual, transgender, and queer (LGBTQ) people face unique challenges in the context of cancer due to cis-heterocentric constructions of sexuality in oncological care. This paper explores the impacts of these challenges for LGBTQ people with a cervix, examining embodied sexual changes and sexual renegotiation during and after cancer, and the implications for LGBTQ people’s access to relevant, tailored cancer information and support. Semi-structured interviews were conducted with 57 LGBTQ people with a cervix with cancer and 14 intimate partners, representing a range of cancer types and stages. Data were analyzed using reflexive thematic analysis. Several participants positioned changes to their sexual embodiment as abject, instilling a loss of control and uncertainty. Sexual practices were misunderstood by many health-care professionals (HCPs), meaning concerns about bodily changes, sex, and intimacy were poorly addressed in cancer support resources and medical interactions. This left LGBTQ participants and their partners ill-equipped to cope with changes to sexual functioning, feeling unsupported, distressed, and as though their sexual concerns were of less importance than those of cis-heterosexual patients. However, some LGBTQ participants and partners were able to renegotiate sexual practices through engaging in non-genital intimacy and experimenting with non-penetrative sex. This was facilitated through good couple communication, where needs were openly discussed between partners. Assumptions of heterosexuality and cisgender embodiment, identity, and sexual expression have serious implications for LGBTQ people’s physical and emotional well-being, agency, and sexual health decision-making. These assumptions also affect access to relevant and culturally safe sexual health information and care. Findings reinforce the need for the inclusion of LGBTQ content in HCP education and professional training curricula, and institutional support for LGBTQ-inclusive practice behaviors.

Barriers to Cervical Cancer Screening by Sexual Orientation Among Low-Income Women in North Carolina

AbstractWe sought to examine cervical cancer screening barriers by sexual orientation among low-income women in North Carolina. The MyBodyMyTest-3 Trial recruited low-income women (< 250% of federal poverty level) aged 25–64 years who were 1+ year overdue for cervical cancer screening. We compared perceptions of cervical cancer screening among those who self-identified as lesbian, gay, bisexual, or queer (LGBQ; n = 70) to straight/heterosexual women (n = 683). For both LGBQ and straight respondents, the greatest barriers to screening were lack of health insurance (63% and 66%) and cost (49% and 50%). LGBQ respondents were more likely than straight respondents to report forgetting to screen (16% vs. 8%, p = .05), transportation barriers (10% vs. 2%, p = .001), and competing mental or physical health problems (39% vs. 27%, p = .10). Addressing access remains important for improving cervical cancer screening among those under-screened. For LGBQ women, additional attention may be needed for reminders, co-occurring health needs, and transportation barriers.