Sexual Health of Adolescent and Young Adults Assigned Female at Birth Post Pelvic Radiotherapy

Purpose Pelvic radiotherapy (PRT) is an effective cancer treatment for pelvic malignancies but often results in sexual dysfunction and long-term complications, particularly for patients with a vagina. This impact is heightened in adolescent and young adult (AYA) patients who face unique developmental challenges, where sexual health issues can profoundly affect relationships, self-esteem, and quality of life. This study investigates the sexual health experiences of AYAs with a vagina undergoing PRT to identify care gaps and inform tailored support and resources. Methods In this mixed-methods study, we surveyed AYA patients receiving PRT at Princess Margaret Cancer Centre (PM) to assess sexual health changes and care satisfaction. Interviews further explored their sexual dysfunction and needs. Descriptive statistics summarized survey data, and thematic analysis guided by Braun and Clarke's framework identified key interview themes. Triangulation compared survey and interview results for a comprehensive understanding. Results Fifty-eight participants (58 female, mean age 32.8) completed surveys and fifteen completed interviews. Triangulation revealed sexual health challenges, such as pain during intercourse, loss of libido, diminished intimacy, communication barriers in relationships, difficulty with fertility and emotional and psychosocial distress. Three main themes emerged: 1) managing the impact of changes in sexual function on relationships and intimacy, 2.) navigating the impact of sexual health changes on fertility and family planning, and 3.) understanding the emotional and psychosocial toll of physical discomfort and sexual dysfunction. Conclusions These findings highlight the critical need for comprehensive, tailored interventions to support sexual health in AYA patients undergoing PRT.