Let's talk about sex An interactional perspective on sexual health communication in oncology

An individual's intimate and sexual life can be significantly impacted by cancer and its treatments. It is crucial for people with cancer to be able to talk about their sexual concerns with their medical professional at every point throughout their disease trajectory. However, for both cancer patients and oncology healthcare professionals (HCPs), talking about sexuality can be challenging. This thesis therefore investigates how sexuality is actually discussed in online (online health forums) and offline (medical consultations) interactions. By using Discursive Psychology to analyse these naturally occurring interactions, this thesis aimed to uncover what participants in interaction achieve socially in and through talk about sexuality. First, we systematically reviewed studies analysing audio and/or video recordings of medical consultations about sexual health, leading to the identification of seven communication practices used by HCPs and patients. Both these findings and the analysis of oncological consultations presented in chapter 4, indicate that there is a delicacy associated with talking about sexuality. This thesis additionally sheds light on the ways in which oncology HCPs and people with cancer anticipate interactional concerns (i.e., subtle interactional sensitivities that participants in interaction anticipate or manage) and orient towards sexual normativities in their talk. Three studies in this thesis collectively provide the basis for the development of a training programme aimed at empowering oncology HCPs in interacting about sexuality. Ultimately, this thesis contributes to enhancing sexual health communication in oncology, advocating for open and non-judgmental discussions about sexuality to support patients in dealing with sexual issues related to cancer.