Prostate Cancer and the Social Construction of Masculine Sexual Identity (BRIEF REPORT)

By Arrington, Michael Irvin | International Journal of Men's Health, Fall 2008 | Go to article overview

Prostate Cancer and the Social Construction of Masculine Sexual Identity (BRIEF REPORT)


Arrington, Michael Irvin, International Journal of Men's Health


Perhaps no other disease illustrates the social construction of masculine identity more vividly than prostate cancer, an illness whose common symptoms and treatment effects (for example, erectile dysfunction and incontinence) leave men with a diminished sense of agency over their bodies. This loss of agency reveals the ways in which societal norms regarding appropriate masculine sexual behavior and identity are cultural creations, not biological absolutes. Recalling prior studies of prostate cancer narratives and studies of prostate cancer support groups, this article inquires not only into dominant constructions of sexuality, but also into the possibilities of redefining sexuality and masculinity among prostate cancer survivors.

Keywords: men, prostate cancer, masculinity, social construction, gender, sexuality

From January, 1997 to February, 2001, 1 observed monthly meetings of a Florida chapter of Man-to-Man, a national support group for prostate cancer survivors. What began as a research project on social support grew into a series of research projects that investigated not only social support (Arrington, Grant, & Vanderford, 2005) but also illness narratives that addressed the stigma and attendant identity changes elicited by prostate cancer, the impact of the disease on relationships with partners and friends (Arrington & Goodier, 2004; Arrington, 2005), the impact of the disease on men's in- teractions with health care providers (Goodier & Arrington, 2007), and the impact of the illness on sexual identities (Arrington, 2000a, 2000b, 2003, 2004). These studies employed a variety of theoretical perspectives (the narrative paradigm, grounded the- ory) and research methods (narrative analysis, the constant comparison method). As I reflected on the project and its various components, it became clear that many of my findings dealt with ways in which prostate cancer survivors sometimes perpetuate and rarely resist the dominant society's definitions of masculine sexual identity.

Prostate Cancer and Its Effects

Common symptoms and treatment effects of prostate cancer leave survivors with a diminished sense of agency over their bodies. Survivors often face difficulty in confronting the losses of control of their bodies, schedules, lifestyles, and relationships, and of course, the looming possibility of death, that is, the larger loss of their very lives. Medical treatments often lead to erectile dysfunction, which at best redefines and at worst restricts the survivor's sex life.

Post-surgical side effects include erectile dysfunction and incontinence (Bostwick, MacLennan, & Larson, 1996). Other possible side effects include urethral stricture, cardiovascular problems, blood clots in the legs, damage to the urethra, and rectal injury. Side effects also occur with other treatment options. Men who opt for radiation therapy risk intestinal problems, rectal irritation, and diarrhea, in addition to erectile dysfunction and incontinence. Rectal ejaculation and rectal bleeding are also potential side effects of radiation treatment (Carson & Akwari, 1980; Hanlon et al., 1997). Hormonal therapy reduces the amount of testosterone in the body but also leads to erectile dysfunction, hot flushes, diarrhea, liver toxicity, gynecomastia and breast tenderness, and decreased libido (Bostwick et al., 1996; Clark et al., 1997).

The painful physical changes caused by prostate cancer often pale in comparison to the emotional hurt and psychological effects inflicted by the disease (Fitch, Gray, Franssen, & Johnson, 2000). To put it mildly, prostate cancer scares people. Korda (1997) wrote specifically about men's fear of prostate cancer:

[T]he biggest fear of most men. It carries with it not only the fear or dying, like all cancer, but fears that go to the very core of masculinity for the treatment of prostate cancer, whatever form it takes, almost invariably carries with it well-known risks of incontinence and impotence that strike directly at any man's self-image, pride, and enjoyment of life, and which, by their very nature, tend to make men reticent on the subject, (pp. …

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