Let's Talk About Sex: The Stigma, Sexuality, and Sex Lives of the Aging in America, Part 2

Indeed, older people are stigmatized for their sexuality when they do not stay within the lines of society's expectations (Gott & Hinchliff, 2003). Later-in-life sexuality is viewed as deviant, according to the literature, and those who engage in it are often mocked in the media and viewed with disgust. A study by Levy (2019) found that sexually active older adults are more stigmatized than their sexually inactive peers. Sexually active older men were perceived more negatively than sexually active older women, supporting the concept that sociocultural climate influences ageism and explicit attitudes (Levy, 2019). 

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Nonetheless, older adults are living longer and healthier lives; thus, cultural norms should shift to mitigate the stigma surrounding later-in-life sexuality. Currently, beliefs about age are increasingly negative while the older population continues to grow. Interventions and policies are needed to decrease the stigmatization of sexually active older adults, including further research, education, and interventions that provide meaningful change and a new vision of older people as not only healthy but sexy (Levy, 2019). 

Joan Price, an 81-year-old author, speaker, and advocate for ageless sexuality, is a leading senior sexpert, as well as the voice behind the award-winning blog about sex and aging, Naked at Our Age. Price has a graphic that says, "Old people have sex. Get over it." While Price maintains her humor, she says thoughtfully, "There's no expiration date on sexuality, but many people let it go because their bodies don't work the way they did before. Instead, we can adapt, invent, and recreate exciting sex, and relax into it in a whole new way" (Bonvissuto, n.d.).

Sexual activity is a significant aspect of one's overall well-being. The desire for intimacy, or closeness and connectedness, can happen with or without a physical component and has no age threshold. Aging brings new phases in life that allow older adults to redefine their sexuality and intimacy. Many older adults find renewed satisfaction and improvement in their sex lives compared to when they were younger. This may be due to having fewer distractions (i.e., more time privacy), no concerns about pregnancy, and a better ability to express their sexual wants and needs (National Institute on Aging, 2022). 

Older adults do experience physiological changes, as discussed before (chronic illness, arthritis, etc.), which may cause them to modify their sexual activities. Today, there is a wide range of drugs and devices to enhance sexual functioning; therefore, providers must be prepared and willing to talk to their older patients routinely about their sexual health and concerns (Steckenrider, 2023). The aging process causes changes in our weight, skin, and muscle tone, creating discomfort for people in their older bodies.

Our sex organs can change as we age, too. For women, the vagina can shorten and narrow, its walls becoming thinner and stiffer, and vaginal dryness increasing. For men, erectile dysfunction (E.D.), or impotence, is the loss of the ability to have and/or keep an erection, and the erection may not be as firm or large as it used to be.

Menopause, which can last for several years, can cause many unpleasant symptoms, such as hot flashes, trouble falling asleep and staying asleep, and mood changes. A woman's desire for sex during menopause may increase or decrease. If a woman is using hormone therapy to treat menopausal symptoms, she will likely experience an increase in her sex drive. While there are many issues related to aging, from side effects of medications to diabetes to stroke and even dementia, there are also many approaches that older adults can take to enjoy an active and healthy sex life (National Institute on Aging, 2022).

If an older adult has a partner, it is essential to talk openly about changes and refrain from self-blame. Taking time to understand the changes both partners may be going through will further build intimacy and create a bond that allows both partners to explore their sexual relationship in new ways. It may be a good idea to visit with a therapist, especially one with special training in helping people with sexual problems, either alone or with a partner. Many changes in an older adult's sex life can be rectified through communication and understanding with their partner. Being open with healthcare providers goes a long way toward improving sexual activities, as well. 

LGBTQ older adults are more likely than their heterosexual counterparts to experience conditions that interfere with sex, such as increased mental health stressors and higher rates of chronic illness. This population is much less likely to disclose their orientation in long-term care facilities due to mistreatment, as well as the reported adverse reactions from their healthcare providers. Years of hiding their identity combined with other stress factors make it exponentially more difficult for this community to receive help for their sexual needs and issues; therefore, communication between partners and healthcare providers is critical to maintaining their active sex life (National Institute on Aging, 2022).

Humans have a natural desire for intimacy and physical connection. Physical intimacy such as hugging, cuddling, hand-holding, and sexual activities are no less desirable in older age and are associated with real health benefits such as lower stress levels, better healing after surgery, healthier behavior, and even a longer lifespan. Lower resting blood pressure and higher levels of oxytocin, a feel-good hormone, are associated with physical affection. Older adults who lack physical and emotional intimacy have an increased chance of loneliness and a poor sense of self-worth (National Institute on Aging, 2022).

Sexuality and its expression, therefore, can be positive, empowering, and life-affirming. Though later-in-life sexuality frequently focuses on dysfunction rather than gratification, well-being, and improved quality of life, the evidence is growing that older people are increasingly aware that they are capable of having great sex and improved health (Heath, 2019). 

As an older adult, sexual experience has accumulated over time. With this experience may come improved self-confidence and self-awareness combined with fewer unrealistic standards and biases from decades before. With two experiences, children and career, less prevalent from day to day, personal relationships can take on more significance, especially the sex within those relationships.

Sex has many benefits, including but not limited to: 

·        burning fat, causing the brain to release endorphins, and drastically reducing anxiety

·        increasing lifespan through its health-improving benefits

·        improving relationships through the expression of your closest and most profound feelings and activities

·        escaping from the world through the refuge of sex (Better Sex as You Age - HelpGuide.org, 2018).

Later-in-life sex may not be the same as it was in one's youth; however, it can be even better. Embracing an older identity may increase independence and self-confidence, which many partners find attractive. Older adults also tend to know their bodies better, including what feels good and what excites them during sex. This makes for more passionate sexual encounters. Maintaining a positive attitude and letting go of expectations as an older adult can open one's mind toward improving sex. For instance, if an active sex life was enjoyed in younger years, it does not mean one needs to allow age to slow them down. Accepting the body changes that come with aging can garner greater sex appeal and sexual certainty (Better Sex as You Age - HelpGuide.org, 2018).

Older adults may feel uncomfortable talking about their thoughts, fears, and desires regarding sex with their partner; however, careful communication can bring sexual partners closer and make sex more pleasurable. Just talking about sex can be a turn-on.

Conversation starters can include:

·        playfulness (humor, gentle teasing, tickling)

·        honesty (fosters trust)

·        discussing new ideas and listening to your partner's ideas (creativity and passion)

·        modernize (sex is no longer taboo, so express your needs, desires, and concerns)  

Older adults can take pressure off of themselves by putting aside old ideas of what sex "should be" and focusing on the importance of intimacy such as extended foreplay (erotic literature, romantic dinner), holding hands and giving massages, telling your partner what you love about them, sharing new ideas about sexual experiences, and relaxing together (taking a bath can help with E.D. and vaginal dryness) (Better Sex as You Age - HelpGuide.org, 2018).

For many older people, sex toys are an essential part of their sexual activities. Sometimes, aging can make achieving orgasm more difficult. If achieving orgasm is a necessary part of sex for an individual, a sex toy is a must-have for play and pleasure! A good sex toy for older adults should be able to build in intensity as well as work for a long time without losing charge. Additionally, it should be made of body-safe materials, be comfortable to hold for extended periods, and frequently need to be slim if it is for a woman's vagina (remember, aging vaginas are narrower). Along those lines, older people may be less flexible physically, and their go-to positions may not feel as good as they once did. But, there is nothing preventing partners from trying new positions. Older people can have fun exploring new positions that are comfortable and provide pleasurable sensations without any aches or pains.

Moreover, including role-play and fantasy may be more important to the older adult as it enhances what they are already doing. If one partner is not comfortable with this idea, the other partner can role-play or fantasize in their mind. Lastly, age-appropriate erotica is available such as books, porn, magazines, and websites. Older adults can enjoy and celebrate themselves by consuming erotica reflective of their mature bodies (Bonvissuto, n.d.). A willingness to modify for any challenges an aging body or mind may present brings renewed experiences to one's sex life. 

Sexual exploration and improved sexual satisfaction can continue throughout the lifespan. Relationships become taxing when day-to-day patterns become routine, especially sexual activities. Thus, sexual communication is vital in creating and growing intimacy over time (Scheel, 2024). Older adults, just like their younger counterparts, can be intimate and sexy without intercourse through activities such as caressing, hugging, kissing, and manual or oral stimulation. Solo sex, AKA masturbation, is an excellent way for partnerless people to enjoy the health benefits of sex (i.e., lower blood pressure, decreased pain, relaxation, etc.) (https://www.facebook.com/WebMD, 2019). Everyone deserves agency over their own sexual experience and sexuality. 

Though our bodies' needs and desires may change as we grow older, long-lasting sexuality comes from being flexible with these changes (We Need to Talk about Sex and Aging, 2024). According to an American Association of Retired Persons (AARP) national survey of adults ages 40 plus, older Americans are expressing more positive attitudes towards sex. Sixty-one percent of individuals in this survey believed that sexual activity is critical to a good relationship. Nearly half of those surveyed were satisfied with their current sex life, and 17% surveyed believed their sex life is better now than a decade ago. This survey found that four out of five respondents described their relationships as physically pleasurable and emotionally satisfying.  Therefore, the happiest respondents had a sexual partner and frequent sexual encounters, proving that sex really can improve with age (Brittne Kakulla AARP Research, 2023). 

Despite increasing evidence of the importance of sexuality across a person's lifespan, sex among the aging continues to be the target of societal stigma and sexual stereotypes. Myths are perpetuated that older adults are asexual and undesirable or simply incapable of having sex. These negative perceptions not only cause internalized feelings of shame and guilt, causing older people to reject their own sexual needs and desires, but perpetuate outdated, harmful Western ideals that youth is equated with beauty—and sex. This belief affects healthcare services and results in an undereducated medical community under implicit and explicit biases. This further alienates older adults from addressing their sexual health needs while increasing rates of sexually transmitted infections such as HIV. 

While research is sparse, some studies indicate a positive shift in attitude toward sexuality in older adults. According to one study, 4,246 men and women ages 50-93 expressed positive attitudes towards aging and sexuality. Furthermore, as Baby Boomers are replacing the previous generation, they bring with them more liberal views concerning sexuality and place higher importance on sexual well-being (Syme & Cohn, 2015). Curley & Johnson (2022) suggest changing "successful aging" to the "aging experience" to incorporate better sexual wisdom, sexual experience, and the sexual diversity that accompanies older adults.

Accordingly, some older adults refer to their sexual identity as an openness to sexual experiences, sexual variety, and sexual behaviors outside of the norm.  Furthermore, it is suggested that "sexy" is newly defined to mean confident, self-assured, and authentic (Curley & Johnson, 2022). Educating and advocating for increased visibility for aging adults' sexuality and pleasure-focused sex may be contrary to popular belief, social norms, or media portrayals; however, it is necessary to combat the adverse effects of ageism on sexual health and well-being, to break down negative, harmful stereotypes, and to advance the sexuality of older adults. 

*This is a 2-part article.

Warm Regards,

Bryan Hutchison

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Bryan Hutchinson is a licensed professional counselor and Certified Clinical Anxiety Treatment Professional (CCATP) who recognizes the privilege to partner with individuals and families struggling with anxiety, depression, stress management, life transitions, and self-esteem. She understands the complexity of LGBTQiA issues, and also provides affirmative counseling that recognizes all parts of your identities and experience. Bryan uses an integrative approach to therapy that includes Cognitive Behavioral Therapy, Motivational Interviewing, Acceptance and Commitment Therapy, and mindfulness.