Stigma experiences among young and middle-aged testicular cancer survivors in China: A phenomenological study

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Objective: To explore the lived experiences and core structures of stigma among young and middle-aged Chinese testicular cancer (TC) survivors using a phenomenological approach. Methods: A qualitative phenomenological study was conducted with 15 TC survivors aged 18-45 years, purposively recruited from a tertiary hospital in Beijing. In-depth semi-structured interviews were conducted, with data collection continuing until thematic saturation was reached. All interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi's seven-step method to extract significant statements, formulate meanings, and generate themes. Results: Four overarching themes and 11 subthemes emerged, situated within a social-ecological framework. (1) Internalized and Embodied Stigma (Individual Level): Shame-driven self-blame, hypervigilance toward bodily changes, and intergenerational transmission of stigma. (2) Relational Diplomacy and "Face" Management (Interpersonal Level): The ambivalence of family secrecy, strategic management of social capital, and contraction of social networks. (3) System-Driven Stigma (Community/Institutional Level): Cultural moralization of illness, clinical interactions inadvertently reinforcing stigma, and structural discrimination or neglect. (4) Confucian Ideology of the Body (Societal/Cultural Level): Moral weight of perceived lineage disruption and cultural expectations of bodily integrity. Conclusions: Stigma among young and middle-aged Chinese TC survivors is pervasive and shaped by the interplay of biological vulnerability, Confucian moral values, and institutional structures. A comprehensive, culturally grounded, multi-level stigma-reduction strategy-spanning the individual, family, community, and health care system-is urgently needed to support psychosocial adaptation and improve survivorship outcomes.

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