Welcome to It’s Complicated, stories on the sometimes frustrating, sometimes confusing, always engrossing subject of modern relationships. (Want to share yours? Email pitches to firstname.lastname@example.org.)
When my boyfriend gave me his version of the “It’s not you, it’s me” speech in the fall of 2014, I went through all the normal breakup reactions — anger, sadness, depression — with an added bonus: Worrying about reentering the dating world with a body that felt like a ticking time bomb.
I’ve known since my senior year of college that cancer was likely in my future. I’d done the genetic math: Based on my family history, there was a 50 percent chance that I carried a BRCA2 mutation, a hereditary gene mutation that carries up to an 80 percent lifetime chance of developing breast cancer. It also comes with an increased risk of ovarian, colon, and pancreatic cancers and melanomas.
They’re scary stats. But I didn’t know for sure that I had the gene, and more importantly, I didn’t want to know — at least, not until I was married. Or at the very least, until I was in a serious relationship. Dating is hard enough already, I told myself; what man would want to enter into a relationship with a woman who had the threat of cancer hanging over her head? And although I was ambivalent about whether I wanted kids, doctors recommend that BRCA mutation carriers have their ovaries removed by age 40, so I wanted to have a potential baby daddy lined up before I had to make any choices that would impact my fertility.
And so, a few years ago, comfortably settled into my relationship, I finally underwent genetic testing. When the results came back as positive, I took solace in the fact that I had my partner as a source of support — a feeling that quickly disappeared when we broke up soon afterward. I had a preventive double mastectomy at the end of that year, and spent my recovery time imagining what my future OKCupid profiles would look like: “Must love fake breasts and high odds of developing cancer.” It didn’t have the best ring to it.
* * *
Over the next several months, I struggled to decide if and when to tell dates about the surgery and my mutation status. What if I said something to soon and scared someone away? Or what if I waited too long and the person felt like I was lying by omission?
These issues are becoming increasingly common as more young women undergo genetic testing and counseling, says oncologist Susan Domchek, the executive director of the Basser Center for BRCA at the University of Pennsylvania. We’re seeing more and more patients who are undergoing genetic testing at age 25,” she says, “which means that many of them are not yet married and are struggling with how to balance learning that they have a BRCA mutation with decisions about when to disclose their status to a future partner.”
There’s not much advice to be found out there, either. “Although we’ve developed tools to assist individuals in communicating their status to family members,” Domchek says, “we don’t have one yet for telling a romantic partner.”
Initially, I decided that the best way to deal with my anxiety was to keep my status a secret. I had chosen to undergo a nipple-sparing mastectomy with silicone implants, which means that it’s hard to tell that my breasts are fake unless you search for the scar. Unfortunately, this also meant that the first few hookups involved my partner squeezing my implants too tightly, which was incredibly painful. There were also several dates who wanted to know why my last relationship ended, which led to me awkwardly fumbling to think of a good cover story so I could avoid telling the truth.
So after quickly learning that “pretend you haven’t undergone life-changing surgery” was not a sound strategy, I took a hiatus from dating to evaluate things. At the time, I was realizing that my picture of the ideal partner had begun to radically shift. Before, I hadn’t given much thought to what I wanted from marriage, besides being able to say that I was married. But going through a significant health ordeal had forced me to think about what I really needed from a life partner. And what I needed was someone solid — someone I could picture standing at my bedside if I found myself in the hospital.
At the same time, I was also becoming more active as an advocate for BRCA screening, and concealing my status from potential partners felt less and less necessary. I knew that when my dating hiatus ended, I needed to reverse course on my approach. And sure enough, when a friend set me up on a blind date, my BRCA status was out in the open from the beginning — he’d already read some of the writing I had done online about BRCA, we had an easy entry point to discuss things.
And you know what? It felt great — it felt like the opposite of what I’d imagined it would be like to talk about my health with a man I liked. In a 2010 study, researchers found that although most women reported fear and anxiety around disclosing their BRCA mutation status to a partner, sharing that information generally had a positive effect on the relationship, facilitating a greater degree of intimacy.
That’s certainly how it played out for me. Maybe it was just the right person at the right time, but I like to believe the reason that we’ve been able to make things work for the past year is that I’ve learned to be up-front — about my needs as well as my fears. Even if this winds up not being my last relationship, I’ve finally reached a point where I can be comfortable with myself, mutated genes and all.