How do older people discuss their own sexuality? A systematic review of qualitative research studies

Abstract

This study captured older people's attitudes and concerns about sex and sexuality in later life by synthesising qualitative research published on this issue. The systematic review was conducted between November 2015 and June 2016 based on a pre-determined protocol. Key words were used to ensure a precise search strategy. Empirically based, qualitative literature from 18 databases was found. Twenty studies met the inclusion criteria. Thomas and Harden's thematic synthesis was used to generate 'analytical themes' which summarise this body of literature. Three main themes were identified: (a) social legitimacy for sexuality in later life; (b) health, not age, is what truly impacts sexuality, and (c) the hegemony of penetrative sex. The themes illustrate the complex and delicate relation between ageing and sexuality. Older adults facing health issues that affect sexual function adopt broader definitions of sexuality and sexual activity.

“Shades of Grey”: Exploring Public Opinion about Later-Life Sexuality

“…Finally, the last theme, "With maturity comes satisfaction", reflects participants' perception that sex becomes better as people age. This is consistent with previous studies conducted among older people who report that the quality of their sex improved with age (Gewirtz-Meydan et al, 2019;Stahl, Gale, Lewis, & Kleiber, 2019). The reasons given for improvements in sexual relationships and pleasures were increasing knowledge of one's body and the ability to get pleasure from it (both alone and partnered), feeling more comfortable with partners, knowing their partner's body and sexual preferences better, an increased level of maturity, a lack of stress from raising children, and an increase in the stability and emotional intimacy of the relationship (Mannila, 2012;Vares et al, 2007).…”

“…Older people who do engage in sexual activity might be viewed as ridiculous (Gatling, Mills, & Lindsay, 2016), and/or disgusting and inappropriate (Vares, 2009). Negative attitudes towards later-life sexuality and about older people's sex lives are prevalent among the general population (e.g., Floyd & Weiss, 2001), health care professionals (e.g., Bouman & Arcelus, 2001;Gewirtz-Meydan & Ayalon, 2017), the media (Gatling et al, 2016;Wada, Hurd Clarke, & Rozanova, 2015), and even older people themselves (Estill, Mock, Schryer, & Eibach, 2018;Gewirtz-Meydan et al, 2019;Heywood et al, 2019).…”

“…Older people also report being exposed to ageist perceptions by professionals (MacRae, 2018) and by the general population (Gewirtz-Meydan et al, 2019), which they describe as negatively impacting their sexual activity and interest (Heywood et al, 2019), and interfering with the process of seeking health care (Chrisler, Barney, & Palatino, 2016;Gott & Hinchliff, 2003a;Hinchliff & Gott, 2011). Taken together, these studies suggest that societal views regarding later-life sexuality are based in part on ageist stereotypes and are quite widespread yet difficult to identify.…”

Sexually Transmitted Infection Knowledge among Older Adults: Psychometrics and Test–Retest Reliability

“…Additionally, the STD-KQ was developed for evaluating knowledge of STIs in younger populations. Therefore, it may not include topics that are important for sexuality and have implications for STI risk in later life, such as intimacy, communication, companionship, changes in sexual functioning, and sexual consent in the absence or presence of cognitive decline [36,[53][54][55][56]. The instrument also included some topics that may not be as relevant to an older demographic, including childbirth-related HIV transmission and HPV [based on Pap test and vaccination standards]).…”

“…The instrument also included some topics that may not be as relevant to an older demographic, including childbirth-related HIV transmission and HPV [based on Pap test and vaccination standards]). Adaptions to the STD-KQ may be warranted to take into account contextual factors influencing sexuality among older adults [36,[53][54][55][56]. Lastly, while the instrument included a sexual identity item developed by the research team, this item may not have fully captured the possible range of responses.…”