WHY OUR RESEARCH MATTERS

Our mission is to transform the scientific paradigm of sexual health for female, gender-expansive, and sexual minority persons with cancer to one that is more just and equitable

The experience of sexual pleasure is essential to human sexuality across the lifespan, including for cancer survivors, and should receive equitable consideration for female, gender expansive, and sexual minority persons.

Sexual activity is an individual’s capacity for consensual and pleasurable sexual experiences.

This capacity rests on the intricate interplay between many factors including the hormonal, psychosocial, economic, legal and historical/cultural, in addition to underlying functional sexual anatomy. For female, gender-expansive and sexual minority persons, basic anatomy itself is the oft overlooked and incompletely characterized keystone component of this complex ecosystem.

Maintaining sexual health and the capacity for sexual activity after the biological, physiological, and psychosocial sequelae of cancer therapy can be fundamental to quality of life for cancer survivors.

Specifically, the function of and damage to erectile tissues (including the bulboclitoris and nipple-areolar complex, which are primary organs responsible for sexual pleasure) in female and gender-expansive persons with cancer remains an under-represented scientific domain — so much so that the anatomic basis of orgasm has been largely omitted in cancer literature, toxicity measurement, and medical coding; rather, difficulty with orgasm after cancer treatment is attributed to psychogenic etiologies in female persons, despite the substantial damage of cancer treatments to the erectile tissues and associated nerves and vessels. Similarly, damage to prostate sensation and capacity for anal-receptive intercourse and the role in sexual pleasure and sexual health in certain sexual-minority males have also been overlooked.

In contrast, maintaining capacity for pleasurable sexual activity after cancer treatment via the study of male erectile tissue function has received wide and substantial scientific, structural and financial investment, enabling accelerated scientific advancements, development of effective precision interventions, and access to advanced technologies to prevent and mitigate these toxicities.

We have an opportunity to address these systemic and structural inequities.

A more equitable framework for scientific and biomedical understanding of sexual health and capacity for sexual activity must move beyond vaginal intercourse, reproductive ability or interest, and incorporate rather than omit the functional and physiologic anatomic basis for sexual pleasure in female, gender-expansive and sexual minority persons with cancer.

Shifting the paradigm of sexual health for female, gender-diverse, and sexual minorities persons with cancer will:

• Better align of cancer care with sexual rights that protect all people’s rights to fulfill and express their sexuality and enjoy sexual health, with due regard for the rights of others and within a framework of protection against discrimination (WHO).

• Normalize and affirm sexual pleasure as an important aspect of sexual health in cancer survivorship for women and gender/sexual-minority persons.

• Empower clinicians with evidence for incorporating the anatomy, physiology and pathophysiology of organ function related to sexual pleasure in female, gender-expansive, and sexual minority persons with cancer in a more equitable way during clinical interactions and in providing tailored clinical decision-making.

• Correct the gendered inequities in investment of scientific and biomedical resources for research and development in maintaining organ function for sexual pleasure to accelerate scientific advancement.

• Provide a more equitable and just distribution of advanced technologies that may preserve sexual function after cancer treatment.

• Ethically empower respect for persons and justice in research and clinical care through equitable inclusion of women and sexual/gender minorities.

• Address health disparities for women and sexual/gender minorities in illness burden, treatment experience, and sexual health outcomes.

• Enable communities to translate new evidence into action through advocacy for equity and access.