Aging Adults and Sexuality
Colorado State University
When examining mankind’s natural ability to notice patterns, it is no surprise that certain biases are formed toward groups of people. However, often time perception is wrong and one should never trust a stereotype at face value. Especially since stereotypes can lead to discrimination toward various groups simply based on uncontrollable characteristics, such as aging. Though overlooked, ageism, or discrimination against older adults has been occurring for generations and continues to impact aging populations. Older adults are stereotyped through a multitude of facets and it can be harmful to the aging population. One particular stereotype is that older adults have no desire to be sexually active. Aging and sexuality can both be considered taboo topics of discussion; thus, the belief is perpetuated that sexual activity does not occur among aging adults. I never thought twice about this notion until I began working in a skilled nursing facility and discovered the exact opposite. Knowing that my observations at one facility in Fort Collins is not representative of aging and sexuality, I consulted four empirical research articles to explore the evidence behind the stereotype.
The research articles suggest that there is not an abundance of research on the topic, but that it is studied in countries around the globe. In 2012, Palacios-Cena et al. conducted a study to evaluate sexual activity among Spaniards aged 65 years or older. The study was epidemiological in nature and examined data taken from The Spanish National Sexual Health Survey (SNSHS). Individuals were surveyed using two methods; an interviewer-administered questionnaire and a self-administered questionnaire. Both of which required participants to answer questions related to sexual experience and sexual relations occurring up to 12 months prior to the questionnaire. Researchers then evaluated data submitted by persons aged 65 years or older and whom identified as heterosexual. Participants consisted of 1,118 women with the average age being 74.5 and 821 men with the average age of 73.5. Analysis concluded that, overall, most men (62.3%) and about 38% of women are sexually active. In addition, it was found that rates of sexual inactivity increase significantly with age (Palacios-Cena et al., 2012). However, despite this fact, the article still supports the overarching idea that adults remain sexually active well into their 70’s in Spain.
Across the globe, researchers in Australia conducted their own study to evaluate this topic. Hyde et al. (2010) conducted a longitudinal study which examined sexual activity occurrence in men between the ages of 75 and 95. Data was collected at three different points in time between the mid 1990’s and 2009 via self-reported questionnaires. Questionnaires asked participants about their sexual activity as well as satisfaction. Many health-related topics such as current medical conditions, prescribed medications and a blood draw were included in data collection (Hyde et al., 2010). While longitudinal studies are excellent for evaluating change over time, one major drawback to this method is participant drop out. 12,203 men completed the initial survey but only 2,758 men had complete data collection following the final survey. After evaluation of the data, researchers found that 40% of men aged 75-79 were sexually active. Further, 54% of the men were satisfied with the frequency of their sexual encounters and 41% engaged in sex less often than they desired. Similar to the previous study referenced, researchers found that sexual activity decreased with age, but 11% of the men surveyed reported being sexually active into their 90’s (Hyde et al., 2010). In the discussion section, potential reasons for decreased sexual activity was explored, the majority of which were related to medication or physical limitations, not a lack of desire.
Meanwhile, in the United States, while a lack of desire may have been the common thought among younger cohorts, the Center for Disease Control (CDC) had a much different perspective. The CDC had noticed an increasing trend in HIV diagnoses among Americans age 50 and older, specifically between the years of 2000 and 2010, with African Americans being diagnosed at rates 10.7 times higher than rates of other races (Gedin & Resnick, 2014). Shortly thereafter, Gedin and Resnick (2014) launched a study with the goal of discovering the best way to educate older adults regarding safe sex practices. They believed that the increasing prevalence of the disease was due to the fact that some older adults had never received education regarding sexually transmitted diseases (STD). Researchers facilitated two educational workshops which utilized a variety of teaching methods to formulate an effective program. Teaching methods ranged from lecture to demonstration and even role-play. There were a total of 21 participants from both workshops, who all reported being generally pleased with the program (Gedin & Resnick, 2014). While this study was not a direct evaluation of older adult sexual activity, it is still important for two reasons. For one, it confirms that older adults are indeed still engaging in sexual activity as supported by increasing HIV prevalence. Additionally, it illustrates some of the negative ramifications that occur when a stereotype leads to a society denying that an activity is occurring.
In an effort to reverse the common denial, a study was conducted in New York in 2007 to evaluate sexual activity among older adults simply because it is a less common topic of study (Smith, Mulhall, Deveci, Monaghan & Reid). Smith et al. (2007) conducted a total of 47 face-to-face interviews with people aged 70 years or older to evaluate sexuality. Interviews consisted of two parts. The first inquired about a person’s demographic and medical information. Next, a survey was conducted which asked participants about sexual activity. The participants were offered the choice of completing this portion of the survey on their own or through the interviewer. As stated previously, there were a total of 47 participants, 27 women and 20 men, with the mean age of all participants being 81 years old. Overall, 18% of the women and 41% of the men were sexually active. The rates of sexually active men were in congruent with the Australian study. In addition, both studies reported that the most common reason for older adults to abstain from sexual activity was due to physical limitations and not a lack of desire. In fact, Smith et al. (2007) found that of those who were sexually inactive, 85% of men and 35% of women reported a desire to be sexually active.
Following the evaluation of all four research articles, I feel confident in my intuition that older adults do, in fact, engage in regular sexual activity. This idea is supported by several valid studies conducted both inside and outside of the United States. Further, the US and Australia both reported similar values for the number of sexually active males which increases both studies’ reliability. Unfortunately, because sexuality is a sensitive topic the only way to evaluate it is through self-reporting, which is not the most reliable method. However, the fact that the CDC has seen an increase in HIV diagnosis in older adults supports the supposition that this cohort is engaging in sexual activity, even if the precise values are being reported inaccurately. It appears evident that the stereotype that aging people do not engage in sexual activities is erroneous on multiple levels. Evidence shows that older adults are not only engaging in sexual activity, but that those who are not sexually active are likely limited due to medication, by not having a partner or by physical restrictions. Stereotypes have the power to hurt the cohort that they are directed at, as shown by increased HIV diagnosis, but in my opinion, we, as a society, are doing much more damage to ourselves by undermining and underestimating our older generations. The only thing that sets them apart is that they have much more life experience, a characteristic which should lend more value, not invite discrimination.
Gedin, T. C., & Resnick, B. (2014). Increasing risk awareness and facilitating safe sexual activity among older adults in senior housing. Journal of Community Health Nursing, 31(4), 187-197. doi: 10.1080/07370016.2014.958390
Hyde, Z., L. Flicker, Gj Hankey, Op Almeida, Ka Mccaul, Sap Chubb, and Bb Yeap. “Prevalence of Sexual Activity and Associated Factors in Men Aged 75 to 95 Years A Cohort Study.” Annals of Internal Medicine 153.11 (2010): 693-702. doi: 10.1059/0003-4819-153-11-201012070-00002
Palacios‐Ceña, D., Carrasco‐Garrido, P., Hernández‐Barrera, V., Alonso‐Blanco, C., Jiménez‐García, R., & Fernández‐de‐las‐Peñas, C. (2012). Sexual behaviors among older adults in Spain: Results from a population‐based national sexual health survey. Journal of Sexual Medicine, 9(1), 121-129. doi: 10.1111/j.1743-6109.2011.02511.x
Smith, L. J., Mulhall, J. P., Deveci, S., Monaghan, N., & Reid, M. C. (2007). Sex after seventy: A pilot study of sexual function in older persons. Journal of Sexual Medicine, 4(5), 1247-1253. doi: 10.1111/j.1743-6109.2007.00568.x