Mastery, Isolation, or Acceptance: Gay and Bisexual Men’s Construction of Aging in the Context of Sexual Embodiment After Prostate Cancer

Abstract

Age is the predominant risk factor for developing prostate cancer, leading to its description as an “older man’s disease.” Changed sexual embodiment is a concern for men who develop prostate cancer, often compounding experiences of age-related sexual decline. Although research has examined heterosexual men’s experiences of aging in the context of sexual embodiment after prostate cancer, gay and bisexual men have received little attention. This qualitative study used a material-discursive analysis, drawing on positioning theory and intersectionality, to explore constructions of aging following prostate cancer in 46 gay or bisexual men. Thematic decomposition of one-to-one interviews identified three subject positions: “mastering youth,” involving maintaining an active sex life through biomedical interventions, accessing commercial sex venues, or having sex with younger men; “the lonely old recluse,” involving self-positioning as prematurely aged and withdrawal from a gay sexual scene; and “accepting embodied aging,” involving the incorporation of changed sexual function into intimate relationships and finding pleasure through nonsexual activities. These subject positions are conceptualized as the product of intersecting masculine and gay identities, interpreted in relation to broader cultural discourses of “new aging” and “sexual health,” in which sexual activity is conceptualized as a lifelong goal.

Acknowledgments

This work was supported by a Prostate Cancer Foundation of Australia (PCFA) New Concept Grant (NCG 0512). Thanks are offered to PCFA, Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP), The Sax Institute 45 and Up Study, NBCF Register 4, Cancer Council NSW, ACON, and MaleCare for recruitment of participants. The investigators on the project were Jane Ussher (PI), Janette Perz (CI), Suzanne Chambers (CI), David Latini (CI), Ian Davis (AI), Scott Williams (AI), Gary Dowsett (AI), and Alan Brotherton (AI). Duncan Rose was employed as the research officer. Thanks to Samantha Murray, Margaret McJannett, Greg Millan, Mo Hammond, Chloe Parton, Andrew Kellett, and Jasmine Sproule for assistance and support. Finally, we thank all of the men with prostate cancer and their partners who completed the survey and took part in interviews to share their personal stories of sexual well-being after prostate cancer.