Colorectal surgery for benign disease negatively impacts LGBTQ+ patients' sexual health and relationships, while these patients face discrimination, stigma, and challenges accessing care and information, with existing literature remaining scarce and lacking data stratification by sexual orientation or gender identity.
Key Findings
Methods
A scoping review of 719 records identified only eight articles meeting inclusion criteria for LGBTQ+ sexual health outcomes after colorectal surgery for benign disease.
Databases searched included PubMed, Embase, Web of Science, Scopus, PsychINFO, Google Scholar, CINHAL, ProQuest, Cochrane library, and Joanna Briggs Institute.
Of the 719 records screened, only eight articles were selected for inclusion.
Study designs included one prospective cohort study, three mixed-methods surveys, and four literature reviews.
Exclusion criteria included appendicectomy, transrectal procedures, gender-affirming surgery, and studies with more than 50% of patients treated for malignancy.
Results
Ten main themes related to LGBTQ+ sexual health after colorectal surgery were identified across the included literature.
The ten themes were: sexual function/activity and pain, anoreceptive intercourse (ARI), sexual satisfaction and pleasure, mental health and body image, obstacles and coping strategies, dating and relationships, partner response and inclusion, experience with healthcare providers, information sources, and stigma and discrimination.
Anoreceptive intercourse (ARI) was identified as a distinct and specifically relevant theme for LGBTQ+ patients undergoing colorectal surgery.
Mental health and body image were identified as separate but related themes impacting sexual health outcomes.
Results
Colorectal surgery negatively impacts sexual health and relationships in LGBTQ+ patients.
Negative impacts were reported across domains including sexual function, sexual activity, pain, and sexual satisfaction and pleasure.
Effects on dating and relationships were identified, including partner response and inclusion as a relevant theme.
The review identified that these impacts are underreported due to limited data stratification for sexual orientation or gender identity in existing studies.
Results
LGBTQ+ patients reported challenges in accessing care and information regarding sexual health after colorectal surgery while facing discrimination and stigma.
Obstacles and coping strategies were identified as a distinct theme, reflecting specific barriers faced by LGBTQ+ patients.
Experience with healthcare providers was identified as a standalone theme, indicating that interactions with providers were a notable source of difficulty.
Stigma and discrimination were identified as a recurring theme across the included literature.
Information sources were identified as a theme, suggesting LGBTQ+ patients have unmet informational needs related to sexual health and surgery.
Discussion
The existing literature on LGBTQ+ sexual health outcomes after colorectal surgery for benign disease is scarce, with limited data stratification by sexual orientation or gender identity.
Only eight articles met inclusion criteria from a search of ten major databases yielding 719 records.
The authors note that 'literature is scarce, with limited data stratification for sexual orientation or gender identity.'
The paucity of evidence reflects a broader gap in inclusive research practices within colorectal surgery literature.
Conclusions
The authors concluded that healthcare providers need education about LGBTQ+ needs relating to sexual health and surgery, and that inclusive clinical guidelines should be developed.
The review identifies a need for provider education as a direct response to reported discrimination and unmet needs documented across the included studies.
The call for inclusive clinical guidelines reflects the absence of LGBTQ+-specific guidance in current colorectal surgical practice.
The authors highlight that LGBTQ+ patients 'often face discrimination, resulting in unmet health needs.'
What This Means
This research examined how colorectal surgery (surgery on the large intestine and anus) for non-cancer conditions affects the sexual health of LGBTQ+ patients, and what barriers these patients face when seeking healthcare. The researchers conducted a scoping review, systematically searching ten major medical and scientific databases and reviewing 719 records, ultimately finding only eight studies that met their criteria. This small number itself highlights a major gap: very little research has been done specifically on LGBTQ+ people's experiences with colorectal surgery and sexual health.
The studies that did exist identified ten key areas of concern, including changes in sexual function, pain during sexual activity, the specific issue of anal receptive intercourse (which is particularly relevant for many LGBTQ+ individuals), effects on mental health and body image, difficulties in dating and relationships, and negative experiences with healthcare providers including discrimination and stigma. LGBTQ+ patients reported struggling to find relevant information about how surgery might affect their sexual lives, and many encountered healthcare providers who were not adequately informed about or sensitive to their specific needs.
This research suggests that the medical community is not adequately serving LGBTQ+ patients who undergo colorectal surgery. Current clinical guidelines and provider training appear to overlook the distinct sexual health concerns of this population, including practices like anoreceptive intercourse that are not addressed in standard surgical counseling. The authors call for better provider education about LGBTQ+ sexual health needs and the development of inclusive clinical guidelines, and also highlight that future research must collect and report data broken down by sexual orientation and gender identity in order to fully understand and address these disparities.
Marangoni Z, Onghena L, Giacomozzi M, van Nieuwenhove Y, Pape E, van Ramshorst G. (2026). Sexual health of LGBTQ+ patients undergoing colorectal surgery for benign disease and their experience with healthcare: A scoping review.. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. https://doi.org/10.1111/codi.70327