Where breast cancer is concerned, every woman’s viewpoint is unique.
And in each individual patient, we’ll never know what that viewpoint is until we ask.
Last week’s blog highlighted the importance of discussing sexual function within the context of breast cancer treatment, not only when a patient expresses concern. A brief recap: 60% of women hope you’ll introduce the topic of sexuality, but the talk takes place just 23% of the time.
Today, we’ll explore sexuality and breast cancer beyond the clinically sterile word, function. Because, as you well know, if you live in the Western world in the 21st century, breasts are not just functional body parts that happen to be a cancer site. Complex doesn’t even begin to describe the role they play in terms of a woman’s sexuality, sexual self-image, and sexual relationships.
Sexuality potentially suffers from many aspects of breast cancer treatment, and that may arise from pain, hormonal changes, relationship upheaval, and a realigning of life priorities following an unexpected and frightening major life event.
When discussing sexuality is taboo, as it all-too-often is, none of these issues come to the fore.
And neither do breasts. Specifically, what they mean to a woman facing tough decisions about treatment alternatives, reconstruction options, and behind-closed-doors scenes that will play out when she’s standing alone before the mirror or sharing an intimate moment with a sexual partner.
In speaking with several survivors, dabbling in the sparse literature on the topic, and eavesdropping on virtual conversations online, I am reminded that today’s women of all ages face complex pressures (cancer-imposed, self-imposed, partner-imposed, and society-imposed) when making cancer-related decisions about their breasts.
Can a woman be a card-carrying feminist and still yearn for a restoration of the beauty as well as the sexual function of her breasts, or the "fetishized sexual objects that men have turned them into" – as one blog poster put it?
Listen to one survivor posting on a British online bulletin board for women, as she asks that very question:
I am and have always been a feminist, raised in a feminist household, raising my [daughter] in a feminist household. Part of my feminist beliefs have always included a firm stance that we as women are more than our biology, are more than our physicality and are more than the way we look. Ergo I have always thought I would shun breast augmentation – presenting oneself as "well-groomed" to the patriarchal world being one thing, cosmetic surgery designed to hyper-sexualise my being another entirely. (note, I judge not those who chose these things, just have always believed they aren’t for me). I now find myself having to think about what I to do in the event of double mastectomy. It seems I am somewhat more attached to my breasts than I thought I was! It seems that my feminine persona is more wrapped up with them than I realized – and I somehow can’t help feeling like I would be less of a woman, or maybe just less of me without them, and its making me really sad trying to imagine dressing differently, having sex differently, etc. And think that I want the reconstruction. But then the "head" part of me thinks that I’m falling into the trap of defining myself by the way I look, all of the things that I’ve spent my life arguing against. Which quite frankly is making my head explode with confusion. Not sure if its even relevant but I have medium-large breasts, I don’t dress to emphasise them, but neither will I apologise for them or dress to hide them – they are there and they are part of me, and if a man thinks that I should hide them away in case he’s tempted to stare at them then that’s his issue not mine. So, what would you do, then? Is this a feminist issue? Am I betraying my principles? It’s not really any better than a boob-job, is it? Or am I just getting myself twisted up over nothing at all?
Answers poured in to the confused poster on the Mumsnet site, with most respondents warmly reassuring "TheBossofMe" that reconstruction was not incompatible with feminist ideology, and that she should do whatever she could to help herself heal.
One poster, for example, responded:
My mother had a single and no reconstruction – I don’t think it was that available then and she always had issues with it – it’s much harder to cope with one in terms of dressing etc. She used to cry when she saw her special bras hanging on the line. Please don’t worry about the decision from a feminist/non-feminist pov – it’s all about how you feel and what will make you feel whole and come to terms with the whole thing.