Sexual health of LGBTQ + patients undergoing colorectal surgery for benign disease and their experience with healthcare: A scoping review

Introduction Colorectal surgery for benign indications affects patients' sexual health. LGBTQ+ patients often face discrimination, resulting in unmet health needs. We aimed to investigate how colorectal surgery for benign disease affects LGBTQ+ individuals' sexual health, and which barriers exist to access healthcare. Methods PubMed, Embase, Web of Science, Scopus, PsychINFO, Google Scholar, CINHAL, ProQuest, Cochrane library and Joanna Briggs Institute were systematically searched. Screening and data extraction were performed independently by two researchers. Inclusion criteria were adult patients who self‐identified as LGBTQ+; colorectal or anal procedures for benign disease; outcomes of sexual health/wellbeing/pleasure. Exclusion criteria were appendicectomy, transrectal procedures or gender‐affirming surgery and >50% of patients treated for malignancy. Results Of the 719 records, eight articles were selected: one prospective cohort study, three mixed‐methods surveys and four literature reviews. Ten main themes were identified: 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, stigma and discrimination. Colorectal surgery negatively impacts sexual health and relationships. LGBTQ+ patients reported challenges in accessing care and information regarding sexual health after colorectal surgery, whilst facing discrimination and stigma. Conclusion Colorectal surgery for benign disease affects LGBTQ+ patients' sexual health. Literature is scarce, with limited data stratification for sexual orientation or gender identity. Healthcare providers need to be educated about LGBTQ+ needs relating to sexual health and surgery, and inclusive clinical guidelines should be developed.