Aging sexual stereotypes and sexual expression in mid- and later life: examining the stereotype matching effect

Psychometric Properties and Gender Invariance of the Portuguese (European) Version of the Aging Sexual Knowledge and Attitudes Scale

The sexuality of older people was understood as non-existent or as something outside the prevailing norm. In this sense, analysing people's sexual knowledge and attitudes towards older people is a challenge for theory and practice. The aim of this study is to translate and validate the Aging Sexual Knowledge and Attitudes Scale (ASKAS) for the Portuguese population. A sample of 994 Portuguese adults (70.9% women, n = 705) completed the ASKAS-PT along with a series of self-report measures. Confirmatory factor analysis and the psychometric properties of the Portuguese (European) version of ASKAS-PT were investigated, particularly reliability, temporal stability, and convergent and critical validity. This study also examined the gender measurement invariance of the ASKAS-PT. After confirmatory factor analysis, a two-factor model fit the Portuguese version best. Reliability and validity results also showed good results, and the ASKAS-PT appears to be a gender-invariant measure. Overall, the Portuguese version of the ASKAS showed good psychometric properties and appears to be a valid and reliable measure for assessing knowledge and attitudes about aging.

Factors Associated with Erectile Dysfunction Among Older Gay Men

Erectile dysfunction (ED) is a common issue that aging men encounter, but whether internalized gay ageism (i.e., the internalization of ageist messages within the context of aging as a gay man) is related to ED among older gay men is unknown. A cross-sectional web-based survey explored the relationship between internalized gay ageism, health-related and social factors, and ED among older gay men who resided in the Midwest United States (N = 181). Internalized gay ageism was not significantly associated with ED. However, hierarchical regression analysis found that age (β = .224, t = 2.70, p = .008) and overall health (β = -.247, t = -3.05, p = .003) were significantly associated with ED among older gay men, suggesting that older gay men share similar risk factors for ED as the general male population. Future research should continue to explore other factors that are unique to gay men that may be associated with ED.

Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men

The internalization of ageist stereotypes or messages based on the framework of an aging gay man is known as internalized gay ageism. Internalized gay ageism may influence an older gay man's sexual satisfaction. The aim of this study was to examine the relationship between internalized gay ageism and sexual satisfaction and determine if body image was a potential mediator. A cross-sectional online survey collected data on sexual satisfaction and other variables related to sexual health and well-being among older gay men. Inclusion criteria included: aged 50 or older, identified as gay, identified as male, assigned male at birth, and resided in the Midwestern region of the United States. Descriptive, bivariate, and mediation analyses were conducted. A complete mediation effect was found between internalized gay ageism and sexual satisfaction when mediated by body image. Older gay men who were in open relationships were more sexually satisfied than single/widowed older gay men. Future research should continue to explore internalized gay ageism, relationship status, body image, and sexual satisfaction among older gay men.

[Sexuality among the elderly: understanding the weight of stereotypes]

Sexuality is an integral part of health and accompanies human beings throughout their lives. It contributes to well-being and improves quality of life. The social representations conveyed by Western society modulate sexuality and can play a decisive role in the expression of seniors' sexuality.

The Role of Ageist Sexual Stereotypes in the Network of Sexual Difficulties, Sex and Relationship Satisfaction Among Adults Aged 50

As people age, their sexual activity, including sexual and relationship satisfaction, may change due to the onset of health and sexual difficulties and the activation of internalized ageist sexual stereotypes. We studied whether ageist sexual stereotypes were relevant for the importance of sex for people aged 50+ and how sexual and relationship satisfaction are interlinked with health and sexual difficulties when ageist sexual stereotypes are considered. Data for the network analysis were collected from a sample of 897 Czechs and Slovaks aged 50-96 (52% men, mean age = 62.01). Two models were analyzed - with and without the inclusion of ageist sexual stereotypes. The findings indicated that ageist sexual stereotypes play an important role in the sexuality of women and men aged 50 + .The fewer ageist sexual stereotypes people had, the less sexual difficulties they reported and the more they perceived sex as important. The inclusion of stereotypes into the models, however, weakened the negative link between sexual difficulties and the importance of sex for both women and men. These findings show that the effect of ageist sexual stereotypes are likely complex in the sexual lives of people aged 50 +.

Sexual dilemma among elderly men living with HIV/AIDS: a cross-sectional survey of the sexual needs and behaviours among HIV-positive men aged ≥50 years

OBJECTIVES

This study aimed to explore the factors associated with the sexual needs and behaviours among elderly men living with HIV/AIDS in Chongqing, China.

STUDY DESIGN

The study used a cross-sectional design.

METHODS

Data were collected through face-to-face interviews using a structured questionnaire by convenience sampling from July to December 2021. The chi-squared test and logistic regression were conducted to identify factors associated with sexual needs and behaviours.

RESULTS

In total, 63.70% of participants (493/774) reported having sexual needs. Individuals aged 50-59 years (odds ratio [OR] = 7.257, 95% confidence interval [CI]: 4.620, 11.401) and those who were married or cohabiting (OR = 1.595, 95% CI: 1.133, 2.246) reported high sexual needs. Among those with sexual needs, 69.17% (341/493) reported having sex in the past year. In total, 11.37% (40/341) and 9.68% (33/341) reported having commercial and casual sex, respectively. Participants aged 60-69 years (OR = 2.175, 95% CI: 1.128, 4.193), those who were married or cohabiting (OR = 3.371, 95% CI: 2.192, 5.184) and individuals who were employed (OR = 2.301, 95% CI: 1.339, 3.954) had higher odds of engaging in sexual behaviour, while participants with an awareness of AIDS-related knowledge (OR = 0.504, 95% CI: 0.307, 0.829) and those who had ≥1 year of antiretroviral therapy (ART) (ART 1-2 years: OR = 0.374, 95% CI: 0.176, 0.795; ART ≥3 years: OR = 0.429, 95% CI: 0.218, 0.846) had a lower likelihood of engaging in sexual behaviour.

CONCLUSIONS

The sexual needs and behaviours of elderly men living with HIV/AIDS in Chongqing, China, remain at a high level. There was a discrepancy between sexual needs and behaviours among elderly men living with HIV/AIDS. Continuous dissemination of sexual health education and the promotion of condom use are necessary.

Differences and Disparities in Ageism Affecting Older US Adults: A Review

Purpose of Review

This review summarizes findings from quantitative research studies published between 2010 and 2022 providing insight on sociodemographic differences and disparities in ageism among US adults ages 50 and older.

Findings

Across 21 studies, disparities in ageism were more consistently found such that those who were older (57% of studies), with less education (64%), and of lower socioeconomic status (100%) reported more ageism than their counterparts. Amount of ageism did not differ by sex in the majority (71%) of studies. Findings regarding race/ethnicity were mixed. Other possible differences in ageism, assessed in a small number of studies, were patterned by employment characteristics, geographic residence, religiosity, and political affiliation but not by marital or employment status.

Summary

Given that ageism is both common and associated with poor health outcomes, identifying disproportionately affected segments of the older adult population is a necessary prerequisite for developing targeted interventions to reduce negative outcomes linked to ageism and associated health disparities. Evidence within this review suggests that the patterning of ageism may deviate from that typically documented for other social and structural disadvantages. Some groups traditionally considered to be socially marginalized were found to report more ageism while others did not.

Mediating effects of ageism and knowledge on the relationship between contact with older adults and attitudes toward older adults' sexuality among nursing students

BACKGROUND

Healthcare professionals often ignore sexuality in aging and avoid discussing related topics, especially in China. Nursing students, as future professionals, can address the sexuality of older adults encountered in clinical practice by establishing positive attitudes toward aging sexuality. Previous studies have demonstrated that contact has positive impacts on nursing students' attitudes toward aging sexuality. However, little is known about the mechanism underlying this relationship between contact and attitudes.

OBJECTIVES

To explore the mediating effects of ageism and knowledge on the relationship between contact and nursing students' attitudes toward aging sexuality.

DESIGN

This was a cross-sectional study.

SETTINGS

The study was conducted at a nursing school in Hefei city, China.

PARTICIPANTS AND METHODS

614 nursing students completed online-administered questionnaires measuring the level of contact with older adults, ageism, knowledge, and attitudes toward aging sexuality. Data were analyzed using SPSS and AMOS.

RESULTS

The mean scores for knowledge and attitudes toward aging sexuality were 85.70 (SD = 16.39) and 104.91 (SD = 14.88), respectively. Overall, our findings confirmed that these hypotheses were accepted. Ageism (β = -0.079, P = 0.007) and knowledge (β = -0.070, P < 0.001) mediated the relationship between contact and attitude.

CONCLUSION

Given the mediating role of ageism and knowledge in the relationship between contact and attitude, reducing ageism and enhancing knowledge are vital to changing students' attitudes, including integrating ageism and aging sexuality knowledge learning into the nursing curriculum and creating opportunities for contact with older adults. The frequency and quality of contact between nursing students and older adults can be improved by rationalizing the internship duration, tasks, and assessment objectives of placements on geriatric wards and by the role of clinical faculty role models in cultivating positive attitudes toward aging sexuality.

Retirement and Sexual Satisfaction

BACKGROUND AND OBJECTIVES

Although interest in sexuality in older age has increased over the last decades, few studies have focused on longitudinal change in sexual satisfaction around retirement age. In the present study, we studied change in sexual satisfaction across retirement in a sample of Swedish older adults with a partner.

RESEARCH DESIGN AND METHODS

Our analyses were based on n = 759 participants (359 male, 400 female) from the longitudinal Health, Aging, and Retirement Transitions in Sweden study. For this study, we used 5 waves spanning over a period of 4 years.

RESULTS

On average, sexual satisfaction did not change significantly before retirement, but decreased after retirement. Interestingly, women showed higher sexual satisfaction than men, as well as a more positive development of both pre- and postretirement sexual satisfaction. Individuals with higher relationship satisfaction had a higher sexual satisfaction until retirement, but their sexual satisfaction also decreased faster after retirement, whereas those with lower relationship satisfaction showed a stable but lower sexual satisfaction.

DISCUSSION AND IMPLICATIONS

Sexual satisfaction can change in the retirement transition in several important ways and further studies on the impact of retirement and other late-life stage transitions are warranted.

"I'm Too Old for That": The Role of Ageism and Sexual Dysfunctional Beliefs in Sexual Health in a Sample of Heterosexual and LGB Older Adults: A Pilot Study

The role of ageism (i.e., discrimination against individuals or groups on the basis of their age), in particular toward the sexuality of the elderly, remains, to date, an overlooked issue. A few studies have suggested that ageistic stereotypes can negatively affect older adults' sexual health. No data are available, in particular, about differences among heterosexual and LGB (lesbian, gay, and bisexual) populations. The present study aimed to investigate differences in perceived ageism and related dysfunctional beliefs in a sample of heterosexual (n = 104) and LGB (n = 103) older adults (aged 55 or older; mean age 66.5) and their impact on sexual health and satisfaction. LGB individuals reported higher rates of masturbation and sexual intercourse and an increased quality of sexual activity as compared to heterosexuals. In addition, no differences between the groups emerged as regards perceived ageism and dysfunctional beliefs toward ageing. In conclusion, LGB individuals perceived more ageism toward sexuality than their counterparts; however, heterosexuals were more likely to have dysfunctional beliefs toward sexuality in ageing. The study findings highlight the significance of examining sexual orientation to understand experiences of sexuality in ageing of the growing older population. Renewed socio-educational efforts based on these data are clearly needed.

Understanding the Role of Virtual Outreach and Programming for LGBT Individuals in Later Life

Due to health disparities LGBT older adults may have more health care needs, but they are likely to have less informal sources of support. While efforts have been made to serve LGBT older adults, traditional forms of in person outreach and service may still be inaccessible to those living in rural areas, with restricted mobility, due to lack of transportation, during inclement weather, or in public health situations as the Covid-19 pandemic. We conducted focus group discussions to understand the role of virtual outreach in serving LGBT individuals' needs in their later years of life. Study participants expressed a desire for dating, community, aging in place, and affirming health care. However, their experience of internalized and institutional homophobia and ageism may act as barriers in fulfilling those needs. A dedicated virtual space has the potential to overcome these barriers by facilitating online get-togethers, support groups, dating events, having coming out resources, and exchanging information on LGBT friendly health services. Having a space to express their generativity may make such virtual services more empowering. Lack of technological access and privacy concerns may hinder the use of virtual services but can be overcome with training and education.

Older adults' perceptions and experiences of ageism during the COVID-19 pandemic

The current study investigates older adults' perceptions of ageism in the United States during the COVID-19 pandemic. Using tenets of Stereotype Embodiment Theory and the Behaviors from Intergroup Affect and Stereotypes Map framework, we sought to (a) examine whether older adults experienced ageism as self-relevant during the pandemic and (b) understand whether older adults experienced certain media messages and interpersonal behaviors during the pandemic and interpreted them as being motivated by potentialpaternalistic age stereotypes. Older adults aged 65 and older recruited from the community (n = 73) participated in a semi-structured interview about their perspectives on ageism toward older adults during the pandemic. Participants also completed an online survey about their experiences with a range of messages and interpersonal behaviors throughout the pandemic. We thematically analyzed interview data and identified three primary themes: self-relevance of age stereotypes; awareness of negative, overgeneralized portrayals of older adults; and defenses against self-relevance of age stereotypes. Survey responses were analyzed using descriptive statistics and frequency counts and suggest that participants attributed messages and behaviors potentially imbued with paternalistic ageism as motivated primarily by care and concern for older adults. The findings add to the field's understanding of older adults' experiences and perceptions of ageism in the media and in interpersonal behaviors in the context of COVID-19.

Sexuality and aging: Is it time for a new sexual revolution?

People in Western cultures live increasingly longer, and medical advancements, health care availability, and lifestyle changes have widened the possibilities of continued sexuality, sexual activity, and sexual diversity well into older adulthood. Yet, research studies have mainly eschewed discussions of sexual possibilities. Although studies have examined the benefits of sexual activity, often they focus purely on sexual function and sexual dysfunction, physical limitations, and the practicalities (such as finding a partner) of sex as persons age. This commentary posits that, in many instances, the social constraints around aging and sexuality inhibit sexuality in older adults in ways that may be more significant than functional or practical limitations. Portrayals in the media either reinforce social norms of the asexual older adult or portray images of the "sexy oldie" that may be unattainable for many older adults. We provide a brief review of sexuality research and prevailing sexual social norms. As Towler et al.'s (2021) elaborate study illustrates, many sexually active older adults struggle with ageism, stigma, and shame arising from the perceived social unacceptability of their sexuality. Studies of older adults from other Western countries reveal similar stories. Accordingly, achieving sexual well-being may be more dependent on changing social norms around sexuality and aging than on discovering new arousal medication to treat physical limitations. Moreover, we advocate for changing the social and academic dialogue from successful aging, which requires maintaining health and vitality-to the aging experience, which incorporates aspects of positive aging such as sexual wisdom, sexual experience, and the sexual diversity that comes with older adulthood. This "new sexual revolution" would elevate sexuality and aging as socially admirable and desirable.

Interest in Sex and Conversations About Sexual Health with Health Care Providers Among Older U.S. Adults

Objectives: Sexual health is an important component of overall health and well-being for older adults. Despite this, little is known about the importance of sex to quality of life, as part of romantic relationships for older adults, and potential drivers of interactions between healthcare providers and older adults about sexual health. In this study using a nationally representative population, we describe perceptions and experiences of sex among older adults.Methods: A nationally representative, cross-sectional sample of community-dwelling U.S. adults aged 65-80 was surveyed about their sexual health and interaction with their health care providers about sexual health.Results: The survey completion rate was 75% (N = 1,002). Overall, 50.9% of men and 30.8% of women reported being sexually active. In all, 17.3% of adults aged 65-80 reported speaking to their health care provider about sexual health in the past two years and of those, 60.5% of patients initiated the conversation. Multivariable logistic regression demonstrated that sexual activity (yes/no), interest in sex, and satisfaction with sex life are major drivers of sexual health conversations between patients and healthcare providers.Conclusions: Many adults aged 65-80 are interested in and engage in sexual activity. While the majority of older adults reported a willingness to discuss their sexual health with their health care providers, few had done so, and most conversations were initiated by patients. Iterest in sex and satisfaction with sex life may be targets for intervention and offer a segue for providers as they begin the conversation to engage with older adults about their sexual health.Clinical Implications: Providers may have conversations with older adults about sexual health and may need sexual health training to have effective discussions; age nor chronic conditions should preclude this essential conversation. Clinical gerontologists may be helpful in this training and in encouraging patients to bring up sexual health concerns during their medical appointments.