Putting prostate problems in non-heterosexual men on the agenda

Thanks;Jill Margo/The Australian Financial Review

PUBLISHED: 03 JUL 2013 00:33:18 | UPDATED: 04 JUL 2013 00:45:59

Interest in prostate cancer has increased over the last decade, but when researchers went looking for material on gay men and this cancer, there was hardly anything to be found.

There was an almost complete invisibility of gay men in the resources available, says Anthony Lowe, chief executive of the Prostate Cancer Foundation of Australia (PCFA), which commissioned the research.

“Some organisations had changed the word ‘wife’ for ‘partner’, but any gay man could spot the tokenism. The imagery and language assumed a heterosexual norm.”

“We were a little embarrassed because we realised our resources are like that too,” says Lowe.

The PCFA has since been working to correct this and has set up support groups for gay and bisexual men in Sydney, Melbourne and Brisbane and is in the process of setting them up in other capital cities too.

It is developing other initiatives, including a kit which should be launched in September. While the number of men who will benefit is not known, Lowe says a recent community survey by the PCFA showed 6 per cent of men identified as gay, 4 per cent identified as bisexual and 3 per cent as non-heterosexual.

This means that of the 20,000 Australian men diagnosed with prostate cancer every year, up to 13 per cent, 2600 men, could benefit.

In the aftermath of prostate cancer, gay and bisexual men have some different needs to heterosexual men, according to research conducted by the PCFA with the Australian Research Centre in Sex, Health and Society, at La Trobe University.

First, sexual practices may be affected differently. Anal intercourse requires rigidity, which can often be difficult to achieve after treatment.

Tim Wong, PhD and senior project officer at the PCFA, who is writing up the findings, says men report that more rigidity is required for anal than for vaginal penetration.

That treatment often destroys the ability to ejaculate can be particularly significant for gay and bisexual men. Wong says there is research on the meaning of semen exchange as part of sex play for these men.

Second, the nature of relationships and support mechanisms in the gay communities is often different to that in the heterosexual community.

Many gay men have transient relationships and face fresh challenges when they begin a new one. How do they disclose their continence and potency issues?

Emotional support structures are often different to the gay community. Lowe says the survey showed 50 per cent of heterosexual men say their primary emotional support comes from their partner and 20 per cent say it comes from friends.

In the gay community, 32 per cent get primary support from a partner and 44 per cent from friends. Gay men also talk about a greater sense of isolation when they are diagnosed with prostate cancer.

The third issue is that gay men feel some discrimination in the health system. Many are not comfortable disclosing that they are gay and the hospital assumes their wife will collect them and that there is someone at home to look after them.

Those who don’t disclose often do not go on to address their struggles with potency and continence with their doctors. This results in them having a poorer quality of life after treatment.

Wong says other issues arise when both partners in a gay couple have prostate cancer. While it has its difficulties, there is a possibility of enhanced understanding as each knows what the other is coping with.

But there is no clarity on this. While there has been much analysis of the experience of female partners of men with prostate cancer, Wong says there is almost nothing on the experience of male partners who provide support.

He notes cancer registries do not seek information about sexual orientation, which makes research difficult.


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