Aging Perceptions in Older Gay and Bisexual Men in Portugal: A Qualitative Study

Sexual well-being among partnered adults and couples over 60: a scoping review

INTRODUCTION

Although society still holds age-related stereotypes dismissing the sexuality of aging individuals, older adults remain sexually active and find sexuality to be an important part of their quality of life. Primarily oriented toward a biomedical and dysfunctional lens, prior research neglected the subjective well-being of elderly individuals, especially partnered adults and couples aged 60 years or more. Shedding a more positive light on this area of life could promote older individuals' and couples' sexual well-being.

OBJECTIVES

This scoping review aimed to synthetize the studies including community samples of partnered adults or couples over 60 who reported on various indicators of subjective sexual well-being including sexual satisfaction, distress, and function using validated measures.

METHODS

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMAScR), the electronic literature search was conducted using PubMed, PsycINFO, Medline, and CINAHL for peer-reviewed journal articles published before July 2023.

RESULTS

Results showed how relational variables such as relationship satisfaction and intimacy emerge as important correlates of older adults' sexual well-being.

CONCLUSION

Avenues for future research arising from gaps in the studies identified thorough this scoping review, including the underrepresentation of sexual/gender diverse individuals and the use of single and/or non-validated items to assess sexual well-being, are discussed.

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.

An Intersectional Perspective on Age Stereotypes: Bisexual and Gay Men are Stereotyped as Younger than Heterosexual Men Even When Aging

We analyzed the age stereotypes of heterosexual, gay, and bisexual men and the implications of such stereotypes for the conceptualization of older gay and bisexual men, specifically. In Study 1a (N = 158) and 1b (N = 155), we found that compared to heterosexual men, participants stereotyped gay men more on young- than elderly-stereotypical traits. Participants represented bisexual men not as "somewhere in between" the stereotypes about heterosexual and gay men, but were characterized more by young- than elderly-stereotypical traits. In Study 2 (N = 106), we reasoned that because of their sexual orientation, both older gay and bisexual men would be viewed as atypical subtypes of older men, considered to be heterosexual by default. As atypical subtypes, both older gay and bisexual men may be stereotyped less on traits associated with elderly men and more on traits associated with their sexual orientation membership, namely young-stereotypical traits. Consistently, compared with older heterosexual men, both older gay and bisexual men were perceived as less typical of older men, and their perceived atypicality accounted for them being stereotyped less as older and more as younger men. The results have been examined for intersectional stereotyping research and practical implications are discussed.

Predictors of Loneliness Among Older Lesbian and Gay People

This study sought to understand the social and individual factors that predict loneliness among older lesbian and gay people in Australia. A sample of 508 gay men and 241 lesbian women, aged 60 and over, completed a survey including measures of loneliness, internalized homonegativity, sexual orientation discrimination, and connectedness to lesbian and gay communities. A multivariable linear regression predicting loneliness was conducted. Not being in an intimate relationship and having less connection to lesbian and gay communities were significant predictors of loneliness for both older lesbian women and gay men. For the men, younger age, internalized homonegativity and more frequent lifetime experiences of sexual orientation discrimination also appeared to predict greater likelihood of loneliness. More frequent recent experiences of sexual orientation discrimination predicted loneliness for the women. The findings confirmed loneliness as an issue of concern among older lesbian and gay people and identified factors amenable to intervention to address loneliness.

The impacts of sexual stigma on the mental health of older sexual minority men

OBJECTIVES

The purpose of this study was to explore the impacts of sexual stigma experiences on the mental health of older gay and bisexual men in Portugal.

METHODS

Self-identified older gay and bisexual men (n = 210) between 50 and 80 years old (mean age = 60.03; SD = 6.33) participated in this study. Measurement instruments included a sociodemographic questionnaire, the Brief Symptom Inventory-18, measures of suicidal ideation and intention, and the Sexual Stigma Scale.

RESULTS

Older gay and bisexual men with higher levels of sexual stigma presented significantly higher anxiety, depression, somatization, and suicidal ideation scores. Correlational analyses showed significant correlations among mental health variables and sexual stigma variables. Regression analyses showed that sexual stigma explained 11% of anxiety symptoms, 10% of depression symptoms, and 9% of somatization symptoms.

DISCUSSION

Sexual stigma has a negative impact on older gay and bisexual men's mental health. Mental health professionals should be aware of how sexual stigma affects sexual minority men's quality of life and work toward the reduction/elimination of sexual stigma in society.

Loneliness Perceptions in Older Portuguese Gay and Bisexual Men

The purpose of this study was to explore the perceptions of loneliness among gay and bisexual men in Portugal over 60 years old. Despite the growth of the older population in Portugal, the social isolation and loneliness experiences in older gay and bisexual men is only beginning to be understood. A structured electronic inquiry with 35 gay and bisexual men over 60 years of age from Portugal (mean age was 66.45 years (SD = 4.45) was used, ranging from 60 to 77 years). Data were analyzed using thematic analysis, comparing self-perceived loneliness levels by sexual orientation and by levels of loneliness. The recurrent themes in the narratives of loneliness perception of the participants in the study were as follows: Mental Health, Support System, Dating and Relationships, Discrimination, Coping, Personal Characteristics, and Coming-out issues. Differences between sexual orientation and levels of loneliness were also found.

The Importance of Social Support, Positive Identity, and Resilience in the Successful Aging of Older Sexual Minority Men

The aim of this study was to assess the relationship between social support, positive identity, and resilience and the successful aging of older sexual minority men. The study involved having 210 self-identified gay and bisexual men aged between 50 and 80 years complete a cross-sectional online survey comprised of sociodemographic information; the Portuguese version of the Multidimensional Scale of Perceived Social Support; the Lesbian, Gay, and multifactor Bisexual Positive Identity Measure; the Connor–Davidson Resilience Scale 10; and the Successful Aging Perceptions Scale. The results showed that self-identified gay participants showed higher levels of positive identity, while bisexual participants scored higher for resilience, mental health, and successful aging. Higher levels of social support, resilience, and positive identity were significant predictors of mental health (28%), physical health (18%), and successful aging (10%) in our sample. These results offer similarities with the growing body of literature on the positive factors of successful aging in the gay and bisexual men communities, which is an important step in the development of aging and health preventive initiatives among this population.

Male Sex Workers Selling Physical Sex during the COVID-19 Pandemic in Portugal: Motives, Safer Sex Practices, and Social Vulnerabilities

The purpose of this research was to assess the motives, safer sex practices, and vulnerabilities of male sex workers who sold physical sex during the COVID-19 pandemic. This study used a mixed strategy, utilizing purposive sampling techniques to conduct 13 online surveys with male sex workers working in Portugal during the COVID-19 pandemic. Participants were aged between 23 and 47 years old and mostly provided their services to other men. Additionally, half of the participants were immigrants. Participants mentioned paying for essential expenses (rent, food, phone, etc.), having money for day-to-day expenses, wanting to, and enjoying it, as their main motives for engaging in sex work. Regarding sexual practices, 3 to 11 participants did not always or did not consistently use condoms during penetrative sex with their clients. Thematic analysis was used to identify the following repeated patterns of meaning regarding COVID-19-related vulnerabilities, encompassing a loss of clients and income, increased work availability, price reductions and negotiation difficulties, emotional functioning, health care access, safer sex negotiations, age, and immigration status. The findings serve as a basis for recommendations regarding social policies aimed at male sex workers who sell physical sex in Portugal.

Assessing the Impact of COVID-19 on Work-Related Quality of Life through the Lens of Sexual Orientation

In the face of the COVID-19 pandemic and the exceptional situation that has been experienced on a global scale since 2020, it is essential to assess the impact of COVID-19 in several areas and domains. Therefore, this research seeks to evaluate the impact of COVID-19 on work-related quality of life (WRQoL) in a Portuguese-speaking sample, through the lens of sexual orientation. One thousand, five hundred and seventy-seven individuals participated in this study, of which 1396 (88.5%) self-identified as heterosexual, 95 (6.0%) as gay or lesbian, and 87 (5.5%) as bisexual. Participants responded to the "Work-Related Quality of Life" scale, the "Fear of COVID-19" scale, and the "Negative Impact of COVID-19" scale. Bisexuals scored higher on "Fear of COVID-19" and "Negative Impact of COVID-19" than heterosexual, and gay, or lesbian participants. Differences between sexual orientations for all dimensions of WRQoL were found: heterosexual participants scored higher on general well-being, home-work interface, career satisfaction, working conditions, and lower on stress at work, compared to bisexual, and gay, or lesbian participants. Gay or lesbian participants scored lower than heterosexual and bisexual participants on career satisfaction and working conditions. Sexual orientation, the fear of COVID-19, and the negative impact of COVID-19 were significant predictors of overall WRQoL (explaining 13% of variance). Moderation analysis also showed that sexual orientation is a significant moderator of the association between the fear of COVID-19, the negative impact of COVID-19, and WRQoL. LGB people (especially bisexuals) suffer more severe impacts of COVID-19 and have lower WRQoL than heterosexual people. Inevitably, this has consequences in terms of mental health and overall quality of life for sexual minorities, thus reinforcing the need to adopt inclusive policies in organizations and companies to improve their WRQoL.

Loneliness, social dislocation and invisibility experienced by older men who are single or living alone: accounting for differences across sexual identity and social context

Across literature on loneliness and ageing, little attention is given to the intersection of ageing, sexuality and masculinities, and how this shapes the social connections of older men. We report findings from a qualitative study of older men's experiences of loneliness and social participation, focusing on perspectives from two groups who are single and/or living alone: men identifying as (a) heterosexual and (b) gay (not bisexual). We present findings generated from semi-structured interviews with 72 men residing in England (65–95 years). We discuss three prominent themes: (a) loneliness, loss and social dislocation; (b) diverging life-events that trigger loneliness; and (c) variations in visibility and exclusion across social settings. Embedded within men's descriptions of loneliness is a running theme of social dislocation that speaks to a wider sense of social separation and estrangement. Unique to gay men's accounts are the ways in which experiences of loneliness and social isolation are compounded by living in heteronormative social environments and their encounters with ageism in gay social settings. Older men's accounts convey anxieties about visibility and anticipated exclusion across social settings shared with other men that vary according to sexual identity and context. We discuss how sexuality and being single and/or living alone impact on older men's social participation as we seek to move beyond a heterocentric understanding of loneliness.

The State of Theory in LGBTQ Aging: Implications for Gerontological Scholarship

Social research in lesbian, gay, bisexual, transgender, and queer (LGBTQ) aging is a rapidly growing field, but an examination of the use of theory has not yet been conducted for its impact on the field's direction. We conducted a systematic review of empirical articles published in LGBTQ aging in the years 2009-2017 ( N = 102). Using a typology of theory use in scholarly articles, we analyzed these articles for the types of theories being used, the degree to which theories were used in each article, and the analytical function they served. We found that 52% of articles consistently applied theory, 23% implied or partially applied theory, and 25% presented as atheoretical. A wide range of theories were used and served multiple analytical functions such as concept development and explanation of findings. We discuss the strengths and weaknesses of theory use in this body of literature, especially with respect to implications for future knowledge development in the field.

Growing Older Out of the Closet: A Descriptive Study of Older LGB Persons Living in Lisbon, Portugal

There is a paucity of information regarding the needs of older Lesbian, Gay, and Bisexual (LGB) adults in Portugal; to help address this imbalance, this article describes a sample of Portuguese LGB older adults living in the large, urban center of Lisbon. Specifically, the article describes (a) the broad sociodemographic characteristics of LGB 60 years of age or older; (b) the type and level of social support and the nature of interpersonal relationships of these older LGB persons; (c) their physical and sexual health; and (d) the experiences and concerns when accessing social and health-care services, including disclosing their identity to social and health professionals. Across these areas, we further seek to evaluate any differences attributable to gender and compare our results to those in the literature, largely derived from North American studies.