Testicular Cancer

Masculinity and self-image after testicular cancer

Previous research suggests that men who have had a testicle removed may feel less masculine immediately after surgery or chemotherapy, but once they have had time to adjust and make sense of what has happened, they no longer feel that their masculinity is threatened. This may be because men who have lost a testicle are usually able to have sex and return to work quite soon after surgery, and they take up sports and other normal activities as soon as the incision has healed (see 'Sex' and 'Work').

Some men said that they never even considered that masculinity might be affected by what they considered to be a 'minor' operation. 

Some men, however, said that just as women who lose a breast might feel their femininity is threatened, men might feel that their self-image is affected by the removal of a testicle. One man said that the removal of a testicle was initially a 'tremendous blow' because it went to the core of his sexuality.

One man, whose self-image was affected, and who opted for a false testicle, suggested that gender identity isn't only about body shape, but about state of mind and how others see you.

Threat to masculinity may be greatest immediately after surgery. One man said that he felt “a great sense of loss” for about ten days. He regretted losing a body part and also felt a loss of masculinity. However, he soon realised that sexual function wasn't impaired, and quickly got used to living with only one testicle. Another man also said that initially his sense of masculinity was affected, which may be why he chose to have a false testicle. (See 'False testicles').

In rare situations, men may lose both testicles or they may be born with one testicle, and then lose the other testicle due to cancer. However, men in this situation can have testosterone replacement (see 'Hormone treatment'), and thus can continue to have a full sexual relationship, with penetrative sex. One man, who initially said that losing one testicle had been a tremendous blow (see above, Interview 37), and who felt emasculated when he lost the other testicle, started on hormone replacement therapy and then felt more positive, asserting that 'there is no reason whatsoever for a man to feel any less of a man because a small part of the body has been removed.

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One man recalled that when he heard he was about to lose his only testicle he was glad to be offered two false ones. He worried about his masculinity and feared that others might think he was a homosexual because of his lack of interest in women. Only later did he realise that he could have an excellent sex life with the help of hormone replacement therapy and that the false testicles weren't in the end so important.

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One man, however, born with only one testicle, who was treated for cancer many years ago, was not offered hormone replacement therapy when he had his testicle removed, and describes a deep sense of stigma, loss of masculinity and lack of self-esteem. He feels that he will never get over the pain, the humiliation, the disappointment and shock of being castrated.

Last reviewed December 2017.


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