(115) SEXUAL SELF-ESTEEM IN TWO SAMPLES OF ADOLESCENT AND YOUNG ADULT CANCER SURVIVORS: A QUALITATIVE INVESTIGATION
Authors: Wirtz M , Miron C , Whalen-Kipp O , Ford J 
Published: June 2024

Abstract

Introduction
As rates of survival from cancer continue to increase in adolescents and young adults, long term physical and psychological impacts are likely to rise. For those diagnosed with cancer during childhood or adolescence, one such late effect may be delayed sexual development. Delayed sexual development may manifest as issues of sexual functioning (i.e., the ability to successfully complete the sexual response cycle) as well as issues of sexual self-concept (i.e., how one navigates the world as a sexual being). These issues may, in turn, impact survivors’ self-esteem. These concerns are likely to be exponentially exacerbated when survivors identify as a member of a sexual and/or gender minority (SGM) group.

Objective
Based on empirical research and two studies from our team, we examine variables that impact the sexual self-esteem of AYA cancer survivors, particularly those that identify as members of an SGM group.

Methods
In our small pilot project, we conducted cognitive interviews to assess whether a novel model, adapted from sexual health frameworks established by Woods (1995) and Evan et al. (2006), applied to AYA cancer survivors. Following analysis of these interviews, we refined our model, and received funding for a larger qualitative study (n = 30) tailored to AYA cancer survivors who identify as members of an SGM group.

Results
Four cisgender female cancer survivors participated in this small qualitative study, which provided preliminary validation that variables such as body image, amount of sexual education, quality of interpersonal relationships, and sexual functioning, were all tied into one’s perception of their sexual self-esteem. Several additional potential variables were identified from these interviews, including amount of sexual equity (how much participants felt that their sexual activity was balanced between them and a partner), religiosity, negative self-evaluative emotions (e.g., guilt and shame), and SGM identity, that could influence sexual self-esteem. Preliminary analyses of our SGM-focused qualitative study have revealed high levels of asexuality and mental health comorbidities that may be affecting sexual self-esteem. Recruitment and analysis for this study is ongoing.

Conclusions
Results from these two studies will provide some of the first empirical research on sexual self-esteem in a population for which sexual health is vastly under researched. We anticipate that this work will lay the foundation for novel measurements and interventions for these individuals. By providing a voice to those who are underrepresented in research, we hope that this research may have high-impact in informing future interventions to become more holistic and culturally-informed to allow for studies to ensure they are reflecting all identities of cancer survivors. Finally, we anticipate that this research may be of significant benefit to oncology providers and clinicians to overhaul and adapt sexual education for patients in treatment, as well as inform areas of concern and assessment for these providers and clinicians, particularly among their SGM patients and survivors.

Disclosure
No.