Couples Coping with Prostate Cancer: Women and Men (Re)Negotiating Discourse of Gender, Sexuality and Intimate Relationships

Abstract

This dissertation project investigates the ways in which men and their female partners navigate discourses of sex, gender, and relationships as they cope with recovery from prostate cancer and engage in penile/sexual rehabilitation. Study I involves a discourse analysis of online patient information sources for prostate cancer-related penile/sexual rehabilitation with a focus on how sex, erections, gender, patients, and relationships are depicted. Study II involves discourse analysis of in-depth interviews with prostate cancer survivors, female partners of men with prostate cancer, and couples, to explore the social norms and collective meanings they adopt when speaking about sex, their identity as a man/woman, recovery, and relationships. Analyses also explore discursive points of connection and discordance between the two studies. Penile rehabilitation is positioned in both studies as a medical imperative through close alignment with scientific empiricism. Sexual side effects (e.g., changes in erections) are framed in biomedical and mechanical terms, and penile rehabilitation is presented as a scientific and effective solution. Both Study I and Study II convey that one’s health and recovery are largely individual responsibilities. Ideal patients are framed as entrepreneurial, responsible, and informed in Study I, and Study II participants largely adopt these discourses. Online information sources situate sexuality within the realm of health and medicine so that changes in erections are positioned as medical issues best resolved using the expertise of medical specialists. The findings from Study II, however, challenge a purely biomedical or health-focused approach to erections. Many patients emphasize the relational and psychological aspects of sex and the inability of pro-erectile interventions to adequately address the injuries caused by prostate cancer treatment. Online materials from Study I reinforce narrowly defined views of masculinity/femininity and (hetero)sexuality. Masculinity and femininity are framed as complementary and distinct opposites, and intercourse is positioned as an essential sexual practice. Many participants frame prostate cancer as a major disruption to successful gender performance and to the sexual status quo. A number of participants resist medicalized/healthisized discourses of sex, and hegemonic masculine subjectivities. They espouse alternative definitions of what it means to be a lover and man/woman. Implications and recommendations are discussed.