Sex is one of human beings primary needs and can be categorized in the same group of other basic needs such as hunger, thirst, and avoiding pain (Langer, 2009). In a sense, we are all influenced by sexual impulses from the time we are born to the time of our death. Our sexuality is integral in the self-concept of being human (Hillman, 2008; Langer, 2009; Pangman & Seguire, 2000). Not only does sexuality play an important role in how we shape ourselves and view ourselves, but it influences how we relate to and perceive others (Pangman & Seguire, 2000).
Sexuality doesn’t only contribute to our self-concept and perception of others, but also is a key component in determining wellness throughout the lifespan. Despite the basic and natural needs and impulses of sex and sexuality, our society has seen these topics as taboo and therefore society has had difficulty with education, setting norms, and communicating across generations about these various topics (Langer, 2009).
Older adults, defined in this paper as individuals 65 and older (Hillman, 2008; Langer, 2009; Muzacz & Akinsulure-Smith, 2013; Pangman &Seguire, 2000), have received little attention and little respect in the realm of what it means to be a sexual being as an older adult. Myths and Societal Constructions Society has done a very poor job in supporting and perpetuating truths about sexuality in older adults (Hillman, 2008; Langer, 2009; Muzacz & Akinsulure-Smith, 2013; Pangman & Seguire, 2000; Thompson, O’Sullivan, Byers, & Shaughnessy, 2014).
Some common misconceptions include: older people don’t have sexual desires; they are not physically capable for sex even if they wanted to; older people are unattractive and undesirable; men who are sexually engaged are “creepy old men” and older women who are still seeking sexual encounters are seen as “oversexed” (Langer, 2009; Muzacz & Akinsulure-Smith, 2013; Pangman & Seguire, 2000). Pangman and Seguire (2000) coined the phrase sexual visibility and sexual invisibility; simply meaning that the negative ideologies, stigmas, and reactions around older adult sexuality has deemed their issues invisible or unseen by society.
Chronically ill and disabled older adults also suffer from “invisibility”, having feelings of rejection, denied from their sexuality, and marginalized from impactful relationships. Unfortunately, society seems to have a way of showing false depictions and sending misleading messages about older adults in our media (Hillman, 2008; Pangman & Seguire, 2000). Hillman (2008) uses the example of male performance enhancing drugs, such as Viagra, that can lead to blurred messages.
These advertisements seen on TV may be viewed as a tool that normalizes older adults engaging in sexual activity that takes shame away from getting proper diagnosis and treatment if they are unhappy with their level of sexual performance. However, this same message may limit the ways older adults believe they can express their sexual desires (e. g. , only through heterosexual penetration) and may marginalize other older adults who participate in other sexual acts or identify as LGBTQ (Hillman, 2008).
Ultimately, older adults should know that there is no ‘normal’ or proper behavior in the way sexuality presents itself in later life, it is solely dependent on the needs and perceptions of that individual. A study conducted by Thompson, O’Sullivan, Byers, and Shaughnessy (2014) examined the implicit and explicit attitudes of young adults on sex and the sexuality of older adults. They found that when young adults were asked about the sexuality of older adults they explicitly reported positive views, however their implicit feelings were negative.
Those who had more ageist attitudes were also more likely to have negative implicit and explicit views on sexuality in older adults. Interestingly, they found that men had a stronger bias against older people engaged in sexual activities than did women. This study exposes the issue of ageism that we are struggling with in our society’s younger population. The research also suggests that rather than focusing on shifting societal views on the sexuality of older adults, we should be shifting the views on aging itself.
Societal constructions and standards for beauty and gender also hinder the views on the sexuality of older adults (Hillman, 2008; Langer, 2009). As men age they are typically seen as “less masculine… and aging women are seen as moving away from youth and beauty” (Langer, 2009, p. 753). These factors contribute to the lessening of confidence in older adults and their willingness to express their sexual desires, therefore it leads to withdrawal from any sexual activities when there is no physiological reason. Despite these negative influences and constructions, society is able to change.
This has been seen in the shift in societal attitudes on sex in general, as compared to previous generations, sexuality is now known and accepted as something that is natural and pleasurable (Pangman & Seguire, 2000). Another example of societal shift is the acceptance of other sexual orientations and individuals identifying LGBTQ (Hillman, 2008). As society continues to evolve, the hope would be for more accurate research and personal accounts regarding the sex lives of older adults to be circulated throughout the population and for generations to come.
Truths on Sexuality and Older Adults The first basic truth is that older adults are in fact capable and actively having sex, however certain physiological processes may be slowed down and sex should be broadening to include various behaviors (e. g. , masturbation, non-penetrative sexual acts, etc. ) (Hillman, 2008; Langer, 2009; Muzacz & Akinsulure-Smith, 2013; Pangman & Seguire, 2000). It is important to also remember the importance of sexuality itself, Pangman & Sequire (2000) conveyed it beautifully:
Sexuality is central to the self-concept, self-esteem and body image. It includes qualities and values that make individuals who they are; the biological, psychological, social, cultural, and spiritual aspects of self. Sexuality is all that individuals have absorbed from their environment and refers to the totality of being, living harmoniously in relationships with self and other (p. 51) This basic human behavior and natural instinct should not be denied of anyone, especially because of their age.
Expressing sexuality is not only about satisfying physical needs, but is also a way for humans to maintain intimacy, express emotions, cultivate trust, and create closeness within relationships over one’s lifetime (Langer, 2009; Hillman, 2008; Pangman & Seguire, 2000). Older age, chronic ill ness, and disability can impact the ways in which sexuality and sexual health may be expressed, however they are still able to create and maintain stimulating relationships.
Data summarized by Hillman (2008) reported that “54% of men and 21% of women ages 70 to 80 had had sexual intercourse with in the past year, and one quarter of those men and women had intercourse more than once a week” (p. 291). Interestingly, the rate for female intercourse tends to be lower because partner availability decreases (e. g. , older nonmarried women and widows tend to outnumber older men) (Hillman, 2008). Both men and women share physiological obstacles regarding expression of sexuality as they age (Hillman, 2008; Langer, 2009; Muzacz & Akinsulure-Smith, 2013; Pangman & Seguire, 2000).
Women often deal with restrictions caused by menopause, a normal developmental phenomenon, that can result in the decrease of estrogen resulting in vaginal dryness that can cause sex to be seen as unpleasant (Hillman, 2008). However, there are accessible lubricants that can aid with this physiological issue; and rather than being seen as a negative developmental stage, menopause may be found to excite women merely for the fact that they no longer run the risk of becoming pregnant.
Men also commonly struggle with erectile dysfunction (ED) as they age. Hillman (2008) reports that by age 70, 67% of men are expected to experience mild to severe ED (p. 294). Prostate cancer is another concern for the aging male. It is currently the second most lethal form of cancer for men, specifically for African American men. For these reasons, it is extremely important to cultivate open conversations between healthcare professionals and patients about their sexual functioning and sexual history.
A higher use of prescription drugs with older populations may also aid or detract from healthy sexual functioning (Hillman, 2008). Even something as common as arthritis can create challenges for older adults, however usually there are solutions by using over the counter drugs or simply changing sexual positions. Actual use of possible remedies and solutions depend on the willingness and importance of the original issue itself (Hillman, 2008; Langer, 2009); meaning that if sexual intimacy is important to that individual, they will be more likely to seek solutions and remedies.
Sexual intimacy seems to have a form of plasticity in older adults such that if individuals sought out high levels of intimacy as a young person, they would be less likely to be impacted by the biological changes in aging as opposed to individual that sought less intimacy throughout their life (Langer, 2009). It is important to acknowledge that the need and desire for sexual intimacy is completely dependent on the beliefs of the individual; there is no right, wrong, or normal belief in the amount of sexual activity one wishes to have at any age across the lifespan.