“What if I die and no one had ever romantically loved me?”: sexual well-being in a sample of YA cancer survivors

PURPOSE: Among young adult (YA) cancer survivors, sexual health is often exclusively focused on sexual functioning, or the completion of sexual tasks. However, it has become clear that there is another element of sexual health, sexual well-being—one’s subjective experience of sex (e.g., body image or sexual/romantic relationship satisfaction)—that may be just as impaired as sexual functioning. In this study, we sought to elucidate potential themes that YA cancer survivors experience that cross both sexual functioning and well-being, thus encouraging more comprehensive sexual health education among those diagnosed with cancer. METHODS: Semi-structured interviews were conducted as part of a larger qualitative study. Three codes developed by a team of coders—Social Isolation: Dating and Sex, Self-Evaluative Emotion: Shame in Dating and Relationships, and Self-Evaluative Emotion: Shame in Body Image/Physical Ability Concerns—included both sexual functioning and sexual well-being, and therefore guided this analysis. RESULTS: Our sample consisted of thirty-five YA cancer survivors who were predominately female (86%) and non-Latino White (77%). Four themes emerged: missing out/aging out, inability to please (potential) partners, body image concerns, and unmet needs for social support. CONCLUSION: While current research has identified sexual functioning as making up most of the sexual health education that cancer survivors receive, there is an interrelationship between sexual functioning and sexual well-being. IMPLICATIONS FOR CANCER SURVIVORS: The clinical ramifications of the data are clear: more work must be done to address sexuality within both the couple and the individual survivor, and that work cannot be exclusively devoted to sexual functioning. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11764-023-01360-x.