"I Had a Mastectomy at 25, No One Tells You How to Exist Sexually in Your Body Again"

Originally published in Popsugar UK: https://www.popsugar.co.uk/bal...

In 2016, head of brand at sexual wellness brand Smile Makers Samantha Marshall discovered she was positive for the BRCA gene after getting tested. The breast cancer gene has been found to impact a person's chances of developing breast cancer according to the National Breast Cancer Foundation.

At the time, Marshall was 24 years old, the same age her mother was when she was diagnosed with breast cancer. Her three sisters had fortunately tested negative for the gene, and health experts told her that, thanks to her age, she didn't need to act until at least 30 years old in the UK. "I wasn't trying to rush myself into any sort of decision, I was still super young," Marshall tells PS UK.

She continues: "But there was this one moment where I was on my way home on the central line, I opened the newspaper and I read a story about two sisters who had gone through a double mastectomy and reconstruction, and I just thought, what am I doing? I've got this opportunity to make a decision about my health that my mum never had. And from that point, I was certain that I was going to go ahead with the surgery."

The surgery in question was nipple-sparing mastectomy with pre-pectoral implants and ADM reconstruction. At 25 years old, Marshall underwent a double mastectomy and surprisingly her first thought post-op was of gratitude, but found herself thinking of things she'd never thought of before. "I was super grateful to be diminishing the risk of having breast cancer at a young age. Plus, I've got such older sister syndrome so I was happy that it happened to me, as opposed to any of my other sisters. But I found myself thinking about things I never expected to be thinking about at 25, like breastfeeding and kids."

Understandably, entering the dating world after a mastectomy had its hurdles and for Marshall, she realised the intention and reactions from men had changed, but also struggled on deciding whether to share her life-changing reconstruction or not.

"I saw a difference in how a man reacts to certain body parts, which was eye opening to me. When I started dating again after my surgery and after breaking up with my boyfriend, it made me think 'Do I have to tell them on the first date? Do I share this intense piece of information about myself, or is that too much? Am I okay with the fact that they might think it was just a boob job (and boob jobs are completely fine), but this is so much more? Do I owe them a story about my body?'

"But ultimately, I discovered that I do not owe anyone an explanation about my body, it doesn't matter if someone walks away thinking something about me, I get to share my stories on my terms."

"I do not owe anyone an explanation about my body ... I get to share my stories on my terms."

Seven years on from her mastectomy, Marshall tells us that she's still getting used to her new breasts, but notes that there was a missed opportunity to discuss how to exist in her body sexually and emotionally, which could've helped her journey of self-exploration and acceptance earlier on. "I was fortunate enough to be able to have nipple preserving [reconstruction], but I was terrified to look at them. I'd been told they could go off, or go green so you have to keep an eye on them. I'd look away from the mirror whilst my boyfriend at the time checked them, because I was too scared to."

She adds: "I'd detached myself from them and I'm still getting used to them now. They feel different, firm and they don't feel natural. They also feel cold. When it came to discussing these changes with doctors and health experts, there was never a conversation about what's it going to be like for you sexually to exist in your body again? Or how to learn about your body, how it's going to be different. And then if it was spoken about, if sex was spoken about, it was so centred around partnered sex."

According to a study published in the National Library of Medicine, 71% of women who had a mastectomy reported a decrease in the quality of their sexual life, but Marshall doesn't want the importance of reconnecting with ourselves, outside of the context of a partner, shouldn't be underestimated.

"Exploration of your body doesn't only exist with a partner."

"When we experience things like this, anything that makes us look or feel differently in our body, it's important to realise that we all deserve pleasure and to be able to reconnect with ourselves again," she insists. "Something that Smile Makers has really helped me understand is that exploration of your body doesn't only exist with a partner, being able to understand that it's okay to touch myself in places that aren't my genitals when I'm by myself and being able to really understand your body is all part of it. I think there's so many amazing tools out there nowadays, whether that's vibrators at Smile Makers, massage oils or erotic audio books that really encourage you to do that."

From being a key member in her BRCA Babes WhatsApp group chat and volunteering at show and tells (Marshall tells us this basically includes "get your tits out so people can see different examples, because again, it's not something you have when you go into a doctor's office") to working as head of brand at Smile Makers, Marshall is taking strides in raising awareness around the experience of breasts and sexuality with the BRCA community and beyond.