This spring, when I was recovering from a double mastectomy, I consumed a lot of media. Propped up on a wedge pillow as family and friends filtered through with food and news of the world outside, I binged season after season of television and read through some of this year’s buzzy novels. As the weeks stretched into months, two works in particular kept me company: the podcast-turned-TV show Dying for Sex (2025), and the novel All Fours by Miranda July (2024). Both narratives orbit around diagnosis and bodily change—not as an endpoint, but as a portal into altered states of intimacy, risk, and embodiment. They offered me company in thinking through abrupt change not as a crisis—though it can be that—but as an opening: a sometimes bewildering, sometimes exhilarating reorientation to desire, connection, and selfhood. In the wake of my diagnosis, surgery was a threshold. Rather than indexing myself as a BRCA1 ‘previvor’ or breast cancer ‘survivor,’ I felt invited to see myself as a person in continual states of becoming while navigating cancer care.
Dying for Sex is the story of a young woman, Molly, diagnosed with stage IV breast cancer. Based on a podcast produced by Wondery, the show chronicles how a metastatic recurrence unmoors Molly from her life as she knew it. Responding to the “wake-up call” of diagnosis, she leaves her husband, moves in with her best friend, and is propelled into a messy and exuberant exploration of her desires. She roleplays with an array of partners, inhabits fetishes, and eventually comes to practice BDSM after her palliative care social worker invites her to a sex party.
“It wasn’t about the sex, really,” Molly says in the podcast and show. “It was about feeling alive. Feeling something.” Through explorations of dominance and submission, Molly also comes to claim a sense of control over her body, confront past trauma, and bring a sense of power into how she inhabits her oncology encounters and treatments. “There was a time I felt like I had no control over my body. But when I was tied up, oddly enough, I felt powerful.”
Also, as another character articulates: “Topping is a sacred act.”
Dying for Sex (FX, April 2025)
If Dying for Sex is about catapulting into life after diagnosis, All Fours captures the quieter, stranger drift of living inside a changing body. On the surface, July’s novel accounts the story of a woman, who—after deciding to drive across the country—parks herself at a motel close to home, falls in love with a young dancer who lives nearby, and gradually opens up to polyamory. On a deeper level, the book is also about menopause as a kind of fruitful disruption. “It was happening whether I tracked it or not,” July’s protagonist writes. “My body was leaving its old patterns behind.” The narrator drifts psychically and physically, releasing her grip on what she thought adulthood and identity required. “I didn’t know what I wanted,” she admits. “I just knew I didn’t want what I had.” July’s protagonist resists neat arcs of growth or clarity; instead, she follows sensations. She lets herself be confused.
Taken together, these works helped affirm something crucial: bodily change not as an endpoint but as an opening. Living as a BRCA1 carrier for the past decade, I contemplated the future facts of a double mastectomy at great length. Would I opt to go flat or have reconstruction? How would it fit into the broader narrative of my life and self-image? In my mind’s eye, when I reached the point of surgical change, I would have figured a lot of things out: gender, sexuality, ideas of the family. Instead, as I moved from my twenties and into my thirties—and connecting with more queer cancer community in this space, through research projects and advocacy communities—I found my sense of these indices of selfhood to be as slippery as ever. Inspired by queer community, and drawing from a lineage of feminist and queer thinkers who understand the body as always in process, I started finding a home in identity markers defined by fluidity. Cue to thirty-three: diagnosed with an early-stage breast cancer, it was time to decide on an approach for my mastectomy. But I needed to decide: who was I?
Between my diagnosis and surgery, I met with multiple plastic surgeons, each with their own vocabulary of reconstruction: fat grafting, flaps, tissue expanders, implants. I found myself oscillating between wanting to preserve something of my current shape and something flatter, more masculine. Medicine imposes binary, hyperfeminized narratives around breast cancer, so I added ‘genderqueer’ to my medical record. I picked surgeons who also work in the gender clinic. Providers started asking me for my pronouns; but they never stopped assuming I wanted to reach towards a binary endpoint. The best they could offer me was tissue expander placement at the time of mastectomy, with the promise of flexibility (changing size, adding or removing implants, adjusting as we go) down the line. I decided to go with this plan.
Waking up in the hospital after surgery, drains snaking out of my chest, I stumbled to the bathroom and parted my hospital gown to take a look. I had deflated tissue expanders in place, lumpy under the skin, and an otherwise smooth landscape: two nipples framed by the edges of the expanders. I made a map of my chest with my fingers. Where did sensation begin and end; where did I meet the prosthetic as it protruded at my borders? I could feel more than I thought I would, though the nerve grafting I had would not, I was told, have any effect for months. To my surprise, propped up in the bathroom, I felt a dawning sense of relief as I looked across the terrain of my chest. The cancer was gone, and in its place was some ease: I was becoming something new. Amid a haze of pain, I opened towards a beginning I hadn’t known to expect.
I met with my plastic surgeon in the weeks that followed. I told her how I felt pulled between the two gendered poles—familiarity on one end, freedom on the other—and she agreed to go slow with reconstruction. One week, we added a little saline to the expanders; the next week, we added a little more. We looked over the charts the implant companies offer to dictate the specifications of a reconstructed chest (the options are limited and mostly too oversized for my liking). In the next surgery, we plan to swap out tissue expanders for “the smallest possible implants” and fat grafting. As the date approaches, I feel a sense of ambivalence, but also openness to what my body is becoming and will become. Along with those who have kept me company in these past months—real and fictional—I am trying to stay alive to the porous edges of my own becoming. Like July’s protagonist, I’ve parked myself close to home, but I’m still drifting; following the contours of a body that no longer promises clarity, but invites attention.
Featured image: “The Transformation of Daphne” by Ary Ernest Renan
