Impact of Mastectomy on Body Image and Sexuality from a LGBTQ Perspective: A Narrative Review

Abstract

Although mastectomy could lead to a decrease in sexual performance among patients, only a handful of studies focused on the psychological and sexual behavioral aspects after the surgery. Research on post-mastectomy sexuality has focused mainly on female subjects but barely on lesbian, gay, bisexual, transgender, queer (LGBTQ), and male patients. This narrative review aimed to explore the importance of sexuality after mastectomy from a LGBTQ perspective. Each sexual minority group has been addressed individually. In general, sexual and gender minority breast cancer (BC) patients undergoing bilateral mastectomy expect a complex treatment plan in terms of physical and emotional outcomes. Bilateral mastectomy or top surgery for masculinization reasons was reported to be the most popular procedure among transmen, which resulted in a significant improvement in the quality of life. Heterosexual and lesbian female patients are willing to undergo mastectomy after repeated lumpectomies or to avoid radiation, despite potential post-operative somatic and quality-of-life complications. Transwomen would seek gender-affirming surgery to improve physical satisfaction and psychological well-being. There is not enough evidence for non-oncological reasons and consequences of mastectomy in gay men and cisgender heterosexual men. Establishing the awareness of the sexuality impact of mastectomy will allow the implementation of tailored perioperative psychological care.

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Leserbrief zur Arbeit: Patientenzufriedenheit nach geschlechtsangleichender Mastektomie in Frau-zu-Mann transidenten Patienten – eine Analyse unter Verwendung eines modifizierten Breast Q Fragebogens

“…Generell hat die Entfernung der Brust einen entscheidenden Einfluss auf das Körperbild der Menschen und auch auf die Sexualität [2] und das natürlich nicht nur bei transidenten Patienten.…”

“…Bei Frau-zu-Mann Pat. zeigte die Arbeitsgruppe [2] in Ihrer Arbeit aus 2021, dass die Mastektomie einen wichtigen Beitrag dazu liefert, dass diese Patienten ihren Platz in der Gesellschaft finden und sich bei Sozialkontakten "leichter" tun. Dieses wiederum trägt dann entscheidend dazu bei, dass sich die Menschen in ihrem Körper wohler fühlen, selbstbewusster sind und die Lebensqualität insgesamt steigt.…”