Sexual health and well-being in older adults is a neglected topic. Here is my view on why we (academics, policy-makers, health professionals and educators) should pay more attention to it.
When compared to the research carried out with young adults, it is clear to see that sexual health and well-being in older adulthood is an under-researched area. There are a number of reasons for this: research funding has been prioritised in areas deemed to require an immediate response (e.g. unwanted pregnancy, and sexually transmitted infections which have the potential to impair fertility); assumptions about older people (e.g. that they are not sexually active); and assumptions about sexuality (e.g. that only younger people view sex as important). However, some academics and researchers have been carrying out work in this area for a number of years and there is general agreement that the societal changes observed in western societies over the past 50 years have had a significant influence on how later life sexuality is viewed and experienced today.
Take the UK for example, individuals of the post-war generation (or ‘baby boomers’ as they are also known) have grown up through a period of ‘rapid social change’, and witnessed the arrival of the National Health Service, the Divorce Reform Act and the Abortion Act as well as political movements such as feminism and gay rights. Changing relationship structures have meant that marriage rates have decreased and divorce rates increased, and there is evidence that people are increasingly rejecting re-marriage. Ideas about the appropriate context for sexual activity have also changed: rates of sex before marriage increased after the Second World War and a recent study identified that British people hold less strict attitudes towards premarital sex than they did 40 years ago. It has also been reported that, over a 10 year period (from 1990-2000), we have seen an increase in the numbers of partners – homosexual, concurrent and (lifetime) heterosexual – for people aged 16-44 years. Put together, all of this suggests that current and future older adults are likely to hold different ideas and expectations about sexual healthcare than their predecessors.
Other factors that directly or indirectly affect older adults, and will continue to affect all of us as we age, include resources like the Internet. A quick look around and it is easy to see that there is substantial information on sexual health aimed directly at older cohorts. The Internet also provides the opportunity to buy sexual aides thus overcoming the barriers of geographical location and physical ability associated with venturing to the shops. It also offers anonymity because facing a computer screen allows us to avoid facing other consumers and thus the stigma related to the asexual older age stereotype. There is a growing trend towards finding sexual partners online too, either for virtual or actual sexual contact, and one study found that people over 50 were using the Internet for this very reason.
Shifts in thinking about older people’s relationships and sexual activity have been influenced by a change in how ageing is viewed in western societies: from decline and passivity to health and activity. The positive ageing movement has helped to counter the negative stereotypes of ageing, including those that relate to sexuality. Changes in ideas about sexuality have also played a part. It has been argued that towards the end of the 20th century sexology and gerontology crossed paths, shaping the current cultural climate which promotes sexual activity in later life as part of an ageing well philosophy. But Merryn Gott has warned us about the myth of the ‘sexy oldie’. Breaking the asexual old age stereotype is a positive step, but care should be taken so that the stereotype that we must remain sexually active for physical and mental health isn’t created in its place.
In my view, the sexual health and well-being needs of older adults is an area that will continue to grow in significance, shaped by shifts in societal attitudes and approaches to healthcare. Future generations of older adults are likely to have had more sexual partners, and received more information about sexual health, than their predecessors. As a result, they may hold different expectations about the care they receive from health professionals and service providers.
I’d love to hear your thoughts on this topic so please add your comments below. If you’re interested in the editorial that I’ve taken this text from (which was aimed at clinical and health psychologists in recognition of the ageist bias in psychology-related sexual health research), get in touch.
It’s time to pay more attention to the sexual health and well-being of older adults