UCLA

Experiences and perceptions about sexuality of older breast cancer survivors are unspoken, overlooked, neglected and underexplored in clinical settings and the scientific literature. Stereotypes about age and sexuality impede sexual assessment and conversations with these women. Consequently, little is known regarding sexuality and femininity subsequent to the diagnosis of breast cancer from the distinctive knowledge base, worldview and voices of older women. The purpose of this qualitative dissertation was to understand and describe perceptions of sexuality and femininity among women with early stage breast cancer who were 65 years and older at the time of the interview. The rationale for this study was influenced by the assumption that the sexuality of older women is impacted by the diagnosis and treatment of early breast cancer. The purposive sample of 19 participants, all residing in Southern California, participated in personal interviews from August 2015 to January 2018. Qualitative description with a constructivist grounded theory framework for data collection and analysis was used to organize the data into three overarching themes: receiving the diagnosis, experiencing sexuality and describing femininity. Each of these themes was subsequently organized into three subthemes of inner processes, outer processes and moving forward. The findings vividly illuminated this sample of older women’s perspectives on the significance of sexuality and femininity in their lives subsequent to the cancer diagnosis. The preservation of femininity was challenged by the diagnosis and treatment of breast cancer. Additionally, maintaining or re-initiating physical intimacy after treatment required strategizing for engaging in intimate encounters. Knowledge generated by this study reveals the opportunity for health care providers to understand and address the sexuality and femininity needs of older women after the diagnosis of early stage breast cancer. Recommendations for future studies with older breast cancer survivors include the identification of barriers to discussing sexuality among patients and oncology clinicians, development of guidelines for effective communication and improvement of the assessment of sexuality and femininity.