Analysis Sheet: Research Article 1
Title: “Sexual Expression in Old Age: How Older Adults from Different Cultures Express
Sexually?”
Author(s): Sofia von Humboldt, José Alberto Ribeiro-Gonçalves, Andrea Costa, Gail
Low, Isabel Leal
Publication: Springer Science+Business Media, LLC, part of Springer Nature 2020
Objective: The study aims to analyze how older adults express themselves sexually
across different cultures.
Methodology:
Participants: 495 older adults aged 65 to 98 from Portugal, England, and Brazil.
Data Collection: In home face to face semistructured interviews done between
June 2018 and January 2019.
Findings:
1. Tenderness and Care: Rediscovering affection and its benefits, such as
combating depression and increasing happiness.
2. Altruism and Gratitude: Acts of kindness and gratitude positively influencing
sexual well-being.
3. Attractiveness: Physical, emotional, and psychological characteristics that evoke
interest or desire.
4. Positive Communication: Effective communication, including verbal and nonverbal cues, essential for sexual intimacy.
5. Sexual Activity: Frequency and quality of sexual activity influenced by
physiological and psychological changes.
6. Good Health and Physical Condition: Physical exercise and good health
positively impacting sexual expression.
7. Supportive Relationship: Emotional, physical, and spiritual support from partners
enhancing sexual expression.
8. Eroticism: Continued eroticism and sexual life in old age, despite societal
prejudices.
9. Feeling Active and Alive: Physical activity and sexual expression contributing to a
sense of vitality and enthusiasm.
Key discoveries:
Cultural Differences: Variability in sexual expression across the different cultures.
Psychosocial Factors: Factors such as altruism, gratitude, and attractiveness can play
significant roles in sexual expression.
Health and Well-being: Good health and physical condition are crucial for maintaining
sexual activity and expression in old age.
Reference:
Humboldt von Sofia et al, May 12, 2020. “Sexual Expression in Old Age: How Older
Adults from Different Cultures Express Sexually?” Sexual Expression in Old Age: How
Older Adults from Different Cultures Express Sexually? | Sexuality Research and Social
Policy
Sexuality in older people: A brief discussion of the barriers
Team 3
Sexual health is a fundamental aspect of overall well being across all stages of life.
However,
older adults often encounter significant challenges in expressing their sexuality and
addressing sexual health concerns. Despite evidence demonstrating that a considerable
proportion of older adults remain sexually active well into later life, a range of social,
cultural, and institutional barriers often prevent them from fully expressing or seeking
support for their sexual health needs. Cultural misconceptions about aging and sexuality
persist strongly. Research shows that 86% of men and 60% of women aged 60–69
years, and
even 31% of men and 14% of women aged 80 years or older, remain sexually active
(Steckenrider, 2023). Nevertheless, dominant societal narratives portray older adults as
asexual, leading to their exclusion from sexual health discussions and services (Ezhova
et al.,
2020).
When speaking about old age and sexuality, a large number of myths arise that limit
both older adults and health professionals in their interactions, as they are surrounded
by
prejudices that divert the natural forms of sexual expression (Fajardo, 2017). These
myths not
only inhibit older adults themselves but also discourage healthcare providers from
initiating
conversations about sexual health. Leyva (2008) says that “la población general (e
incluso los
profesionales de la salud) considera que el sexo entre los ancianos es anormal (y
desagradable
para algunos) asumiendo en ocasiones, la idea de que el anciano es un ser asexual o
que
cualquier manifestación sexual entre ancianos es improcedente”1 (Leyva, 2008, en
Fajardo,
2017).
Societal misconceptions further narrow the definition of sexual activity, limiting it to
penetrative intercourse and ignoring alternative expressions of intimacy such as kissing,
fondling, and solo sex (Steckenrider, 2023). Such a limited view marginalizes those
older
adults who adapt their sexual behaviors due to physical changes like erectile
dysfunction,
arthritis, or chronic illnesses. Psychologically, older adults are influenced by the social
conditions around them, adopting the prevailing prejudices and preferring not to talk
about
1Text translation: "The general population (and even health professionals) considers
sex between
elderly individuals to be abnormal (and unpleasant for some), at times assuming that
older adults are
asexual beings or that any sexual expression among the elderly is inappropriate”
(Leyva, 2008, en
Fajardo, 2017).the subject, which distances them from this dimension of life. Although it
is clear that some
elderly individuals choose to end their sexual lives voluntarily, there is a large number
who
do not wish to do so (Fajardo, 2017).
Healthcare providers often feel uncomfortable addressing sexual issues with older
adults, which reinforces the stigma and silence surrounding sexuality in later life.
Studies
show that only 17% of older adults reported having discussed sexual issues with a
physician
in the past two years, and most of these conversations were initiated by the patient
(Steckenrider, 2023). Furthermore, the social dimension of sexuality, as described by
Leyva
(2008), is shaped by various social factors that restrict the intimate lives of older adults.
These factors include the absence of a partner, the deterioration of marital relationships
due to
sexual monotony and poor communication, domestic living conditions, difficulties
adjusting
to retirement, and religious beliefs that, in some cases, consider sex without
reproductive
purposes to be sinful (Leyva, 2008, in Fajardo, 2017).
Another critical issue is the lack of sexual health education and resources specifically
tailored to the needs of older adults. Many healthcare providers are unprepared to
address the
complex sexual health concerns of this population, including the specific needs of
LGBTQ+
elders (Ezhova et al., 2020). Although older adults may maintain high self-esteem, this
does
not necessarily translate into an active sexual life, because "se encontró que la
autoestima,
considerada un factor psicológico, no intervino en su percepción de mantener una vida
sexual
activa, ya que la mayoría de la población manifestó tener autoestima alta, aunque estos
no
tienen una vida sexual activa"2 (Can Valle et al., 2015).
Structural barriers in institutional settings also inhibit the sexual expression of older
adults. In many care homes, the lack of privacy, rigid regulations, and negative staff
attitudes
prevent residents from expressing their sexuality openly (Ezhova et al., 2020).
Additionally,
societal beliefs that aging inevitably leads to sexual decline have led to insufficient
attention
to the sexual wellbeing of older individuals: "la creencia de que la edad y el declinar de
la
actividad sexual están inexorablemente unidos, ha provocado que no se preste
atención
2 Text translation: "It was found that self-esteem, considered a psychological factor, did
not influence
individuals’ perception of maintaining an active sexual life, as most of the population
reported having
high self-esteem even though they did not have an active sexual life" (Can Valle et al.,
2015).suficiente a una de las actividades que provee mayor calidad de vida, la
sexualidad" 3(Can
Valle et al., 2015).
Gender disparities are also prominent in the sexual lives of older adults. Social
standards tend to more harshly judge the sexuality of older women compared to older
men.
"La autopercepción del atractivo sexual es un factor social muy importante. La
sociedad, en
general, cree que las ancianas son las que pierden más pronto su atractivo sexual,
posiblemente debido a que se produce una pérdida más precoz de la capacidad de
procreación
en comparación con el hombre"4 (Can Valle et al., 2015). Moreover, "la mayoría de los
hombres que participaron en el estudio tienen vida sexual activa, ya sea con sus
esposas o con
alguna mujer más joven. Las mujeres que mantienen una vida sexual activa solo tienen
relaciones con su esposo"5 (Can Valle et al., 2015), highlighting persistent gendered
dynamics
in later life sexual relationships.
Taking into consideration what has been established before, it's important to push
healthcare providers to normalize discussions about sexuality as part of routine care for
older
adults. Introducing brief, standardized sexual health screenings during medical visits
could
help identify sexual health concerns early and destigmatize these conversations
(Steckenrider,
2023). Providers must also receive comprehensive training on how to approach the
topic
sensitively and inclusively, particularly with LGBTQ+ older adults who may face
additional
layers of discrimination (Ezhova et al., 2020).
Public health campaigns should actively challenge the myths surrounding aging and
sexuality. These campaigns must portray older adults as sexual beings and promote
sexual
health as a lifelong component of wellness. Given the rising rates of sexually
transmitted
infections among adults aged 55 and older, education on safe sex practices should also
be
tailored to this population (Steckenrider, 2023).
5 Text translation: "The majority of the men who participated in the study have an active
sexual life,
either with their wives or with a younger woman. The women who maintain an active
sexual life have
relations only with their husbands" (Can Valle et al., 2015).
4 Text translation: "The self-perception of sexual attractiveness is a very important
social factor.
Society, in general, believes that older women lose their sexual attractiveness earlier,
possibly
because they experience an earlier loss of reproductive ability compared to men" (Can
Valle et al.,
2015).
3 Text translation: "The belief that age and the decline of sexual activity are inexorably
linked has led
to insufficient attention being given to one of the activities that provides the greatest
quality of life:
sexuality" (Can Valle et al., 2015).Furthermore, structural reforms are necessary within
institutions such as nursing
homes and assisted living facilities. Policies must support the sexual rights of residents,
provide opportunities for privacy, and train staff to respectfully manage and support the
sexual expression of older adults (Ezhova et al., 2020). Efforts should also empower
older
individuals themselves through education, workshops, and support groups that
encourage
open dialogue about sexual health and relationships.
Finally, it's important that we have in mind that persistent myths, societal stigma, and
institutional barriers continue to silence older adults and marginalize their sexual health
needs. However, through culturally sensitive healthcare practices, education reforms,
public
health advocacy, and structural changes, it is possible to create an environment where
older
adults can fully express and enjoy their sexuality.
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