What is sexuality?
Sexuality is important. It is a normal and healthy part of being a human. Sexuality means having sexual feelings and experiences. Sexuality includes the following.
- Bodies and our reproductive organs
- Biological sex assigned at birth (male or female): what physical body parts, chromosomes and hormones you have
- Gender: whether you identify as being a boy, a girl, both, neither, or somewhere else along the gender spectrum (your gender may be the same as or different from the biological sex you were assigned at birth; it can be a fluid definition and may change over time)
- Sexual orientation: used to describe different types of sexual attraction, commonly categorized as:
- Heterosexuality: attraction between persons of opposite sex or gender
- Homosexuality: attraction between persons of the same sex or gender
- Bisexuality: attraction to both males and females
- Pansexuality: attraction to people of any sex or gender
- Asexuality: lack of sexual attraction to others
- Desire (or lack of desire) for sex.
We experience and express our sexuality through:
- our body image
- our sexual desires, fantasies, and the way we experience sexual pleasure
- our sexual behaviours (sexual acts including masturbation)
- sexual or intimate relationships
- our beliefs and ideas about love and sexual relationships
Our sexuality is influenced by many things, including our culture, family, community, experience, spirituality, religion and biology.
What is healthy sexuality?
There are as many ways to express sexuality as there are people in this world. How you express your sexuality is completely up to you. Healthy sexuality is a source of pleasure and makes you feel good.
Central to healthy sexuality is a sense of personal control and agency. Personal control is the ability to make the choices that are right for you and agency is the ability to act on those choices, including giving consent, and define yourself sexually. To make smarter, safer choices that are right for you, you need to know the facts. Read on to learn more about healthy sexuality when you have or have had cancer.
How can cancer affect my sexuality?
- Having any type of health condition can make you feel different from your peers and change how you see yourself.
- Your experience with cancer can influence your social relationships and how you relate to others.
- Cancer can impact your sex organs and sexual development. Treatment can affect how your sex organs function, including lowering the levels of your hormones. This can reduce your interest in sex or your options for sexual activity. Some individuals with a penis may have difficulty getting or maintaining an erection. Individuals with a vagina may experience vaginal dryness. These treatment side effects may go away with time, or they may be permanent. Even though it can be hard to talk about, discussing it with a member of your health-care team is a good idea because they can tell you about the therapies that are available.
- Pain resulting from cancer or treatment can reduce your interest in sex and the pleasure you experience. However, some teens have also said that sex distracts them from their pain and that orgasms have an "anti-pain" effect.
- Cancer and treatment can impact your body image and confidence and how attractive you feel, as well as your sexual desire.
- If you have spent a lot of time in the hospital or away from your peers, you may not have had much time to explore and gain an understanding of your personal sexuality.
- Some of the medications you’re on to treat your cancer may also be in your bodily fluids. Using a condom or a dental dam (placed on the vagina or anus when engaging in oral sex) protects your partner from the medications that could be potentially dangerous for them. This also protects you both from sexually transmitted infections (STIs).
If you've had treatment recently, it's important to give yourself time to recover. There are often ways of dealing with the effects of cancer and treatment on your sexuality. Remember that everyone’s sexuality is affected in different ways. Sometimes it is not affected at all. How you feel now will also likely change over time.
What do I need to know to make safer choices about sex?
To answer this question, we've compiled a list of common myths about sex after cancer and included the facts to help you make safer decisions.
Myth: Radiation or chemotherapy will make me infertile (unable to have a baby).
Fact: Even if you have had chemotherapy and/or radiation, you may still be able to get pregnant or make someone else pregnant.
It can take a long time after treatment has ended for your health-care team to know with any certainty whether you are fertile or not. Your treatment may also affect the development of a baby inside the uterus. It is important to use a condom and/or another form of contraception until you and your body are ready to become pregnant or make someone else pregnant.
For more information on treatment and fertility, check out "Fertility and radiation".
Myth: I'm using the birth control pill, so I can't get pregnant.
Fact: Cancer treatment can make birth control less effective.
Ask your health-care team if your medication will affect how well your birth control works. Be safe and use a condom as well. Condoms are the only effective form of protection from sexually transmitted infections (STIs).
Myth: I beat cancer, so nothing can hurt me now!
Fact: You can still get a sexually transmitted infection (STI) whether you have had cancer or not!
Most sexual activities are risky. Always use protection such as a condom or a dental dam. Respect yourself and protect yourself.
Myth: My questions are too weird or embarrassing. I just can't ask anybody!
Fact: Chances are that if you're wondering about something, many other teens are wondering about it too!
Most questions that teens with cancer have about sex are the same as those asked by other teens. When it comes to sexuality, it's normal to feel different! Talking about it with a trusted friend, family member, or member of your health-care team can help. The communication section has tips for how to arrange a meeting with a member of your health-care team alone (without your parent/caregiver).
Should I tell my partner I had cancer (if they don't already know)?
This is, of course, up to you. But ask yourself this question: If I don't feel comfortable telling a person the truth about a major experience in my life, do I feel comfortable being sexual with them?
I still have questions!
Well of course you do! Sexuality is a huge topic for all teenagers! It's normal to have questions. Finding answers is part of becoming an adult and exploring your own sexuality. This section only offers a very quick introduction. Many websites can help you develop a healthy sexuality. Here are some other trusted sources of sexual health information:
- Macmillan Cancer Support – Relationships, sex and fertility: A section of a UK-based site about cancer that offers advice about sex, fertility, and relationships especially for teens and young adults
- Scarleteen: An American site offering real-world sex education and advice online
- Sex & U: A Canadian site that takes a real life approach to questions and issues around sex and sexuality
- Teen Health Source: A site from Planned Parenthood that will help you learn about safer sex and healthy exploration
