The Effects of Prostate Cancer Treatment on Role-In-Sex in Gay and Bisexual Men: Mixed Methods Results from the Restore-1 and Restore-2 Studies

Sexual Rehabilitation Needs of Gay and Bisexual Men With Cancer

This Viewpoint discusses the importance of concentrating research efforts and clinical training on sexual and gender minority individuals who survive cancer, particularly on sexual rehabilitation.

Coming to Voice as Total Top or Total Bottom: Autobiographical Acts and the Sexual Politics of Versatility on Reddit

For gay, bisexual, and men who have sex with men (GBMSM), sexual versatility encompasses both insertive (top) and receptive (bottom) sexual practices. By contrast, "total top" and "total bottom" roles are often marginalized by those who advocate versatile roles for GBMSM. This article explores how GBMSM "come to voice" as total tops and total bottoms on the social media platform, Reddit. Reading posts and comments as autobiographical acts, the article analyses how total tops and bottoms assert the validity of their claim to sexual knowledge as total top or total bottom while negotiating the sexual politics of versatility on Reddit and beyond.

Heteronormative biases and distinctive experiences with prostate cancer among men who have sex with men: a qualitative focus group study

BACKGROUND

Men who have sex with men (MSM) face many challenges and biases in healthcare. Within urology there is a need to better understand how prostate cancer impacts MSM given the unique ways in which side effects that accompany treatment may affect this population. The goal of this study is to explore the experience of MSM with prostate cancer to advance the existing literature in this area and inform implementation and delivery of clinical practice and policy guidelines.

METHODS

Four focus groups were conducted with a semi-structured interview guide. Using a phenomenological qualitative approach consistent with grounded theory [1] and naturalistic inquiry principles we sought to better understand the direct experiences of MSM with prostate cancer. Audio transcriptions were thematically analyzed to identify themes that impact MSM throughout their prostate cancer journey. An iterative, team-wide classification process was used to identify, organize, and group common codes into higher-order categories and themes.

RESULTS

Patient's choice of provider and their interactions with the healthcare system were strongly impacted by their sexual identities. Participants commented on navigating the heteronormative healthcare environment and the impact of assumptions they encountered. MSM experienced the sexual side effects of prostate cancer treatment in unique ways. Issues with erectile dysfunction and ejaculatory dysfunction had significant impacts on patient's sexual experience, with some describing being forced to explore new modes of sexual expression. Anejaculation was a theme that was distressing for many participants. The emotional impact of a prostate cancer diagnosis was significant in the men interviewed. Common themes included loss of identity and fear for future relationships.

CONCLUSIONS

MSM have unique concerns after prostate cancer treatment that differ from men who don't identify as MSM. It is critical that providers familiarize themselves with the concerns of this patient population regarding prostate cancer treatment. An important step toward reducing heteronormative bias in prostate cancer care is to better understand the goals, identity, and sexual practices of MSM and to provide informed anticipatory guidance.