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Human sexuality requires complex frames of understanding because of the multiplicity of factors influencing how it is constructed and expressed. One of these factors lies in the capacity to promote and the actual generation of sexual desire traditionally associated with the notion of sensuality.

In this chapter, we reflect on how narratives and social practices contribute to shaping understandings of later life (Iacub, 2006), taking later life not as some life-stage with fixed and ‘objective’ chronological boundaries but as a cultural concept, which enables classification of certain people as ‘older’. In turn, such understandings have an impact on eroticism in older age. Such narratives and practices are also responsible for enabling certain cognitive, affective and behavioural responses (both explicit and implicit) concerning the acceptance or rejection of later life and older persons as subjects and objects of sexual desire.

As will be seen, estrangement appears as one of the reactions to an ageing body, including, for instance, the feeling that one’s (inner self) is separate from one’s own ageing body. We will review how bodily estrangement has its roots in some historic accounts, as well as how it is expressed in stories told by older people themselves. Focusing on this sense of estrangement is important in helping us understand how individuals relate to older adults and how older adults relate to their own bodies. It appears as a reason for rejection, not always explicit and socially understood, but one strongly associated with emotions like shame, embarrassment, disgust, or ridicule, which, in turn, naturalise ageist cultural interpretations and limit critical and political thinking about sexuality, eroticism and desire in later life.

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Author: Jane Youell

Sexuality and intimacy have largely been seen as a domain of the young and attractive in contemporary society (White, 2011). Assumptions persist that the over-65s should be, or are, sexually retired (Bauer et al, 2007). Ageing has traditionally been associated with decline, frailty, unattractiveness, disability and illness, and wrinkly and withered bodies (through a western cultural lens, at least), so it is easy to dispel any notion that older people would enjoy a full sexual life, and by dispelling it we fail to support and encourage it. When adding to this the sense of distaste, disgust and taboo that older age sex seems to elicit, it is easy to see why there is a dearth of research, policy and good (pro-sex) practice (Bouman et al, 2006). Increasingly, the benefits of a full sexual and intimate life are being recognised across the lifespan, although research seems to focus mostly on ageing and heterosexual sex (Sinković and Towler, 2019).

For those who are older and identify as LGBTI+, there is significantly less evidence of good practice, and greater invisibility, particularly around supporting sexuality and intimacy (McGovern, 2014; Sinković and Towler, 2019). To ignore the importance of sexuality, intimacy and relational needs does older people, especially those already marginalised, a great disservice. The physical, psychological, social and emotional benefits of intimate relationships arguably result in greater pleasure and liberation with age (Rowntree, 2014). Sex, intimacy and relational needs are fundamental to wellbeing, and with the advent of the recent Care Quality Commission (CQC) guidance, health and social care services will be required to show evidence of how they support relationships and sexuality within their services (CQC, 2019), including the LGBTI+ community.

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Much of the conceptual architecture of the chapter on physical disability (Chapter 6) is relevant to this chapter on intellectual disabilities: intersectional subjectivities; the impairment/disability dichotomy; the social construction of disability; the heteronormative and genito-centric conception of sexual intimacy; the radicalism of crip/queer theorising; and the necessity of critical deconstructions of normative and normalising discourses that produce desexualising impacts upon disabled people. Similarly, there are important issues to explore at policy and interpersonal levels. The intersection of age and intellectual disability is composed by both the impact of ageing on forms of intellectual capacity – typically conditions such as Alzheimer’s and other types of dementia – and people who have intellectual disabilities, for whom ageing might exacerbate or provide added complications – such as people with Trisomy 21 (colloquially Down’s syndrome). Or put simply, intellectually disabled people growing old and older people growing into intellectual disability. Yet it would be a mistake to simply extend or map the conceptual framings and analysis of physical disabilities onto intellectual disabilities. There are important differences as well as similarities at the intersections of intellectual disabilities with sex and intimacy in later life.

Intellectual (as physical) disability and ageing both bring into question how human difference is categorised and understood according to conceptions of what is bodily or customarily normal. The notion of ‘normal’ dominates conventional understandings of ageing, disability and sex and intimacy, and is the discursive basis for the desexualisation of those people bearing these features. It is precisely the development of crip/queer critiques (and in this chapter, a neurodiverse equivalent), that has problematised and deconstructed these qualities and characteristics: dissembling reproduction; genito-centric and penetrative heteronormativities from sex and intimacy; dissembling ableism and the constitution of hierarchies of ability from disability; and dissembling life course developmental staging from age.

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Older people experience their sexual and intimate relations as intersectional agents. Their relationships are influenced not simply by age itself, but by gender, ethnicity, sexuality, class and other identarian differences. It is not necessary to subscribe fully to the benefits of intersectionality as a theoretical paradigm to recognise the impact of difference on how older people enjoy or endure the process of ageing (for relevant summaries of intersectionality, see Hancock, 2016; Hill Collins, 2019; May, 2015; Taylor, Hines and Casey, 2011). These differences extend to the sexual and intimate constraints and limitations that constitute desexualisation. This is particularly the case with the intersection of age and physical disability, which becomes more significant as the body ages and its functionality tends to decline. While the rate and form of that decline is differentiated dependent on variables such as robust physical health, income and resources and access to healthcare, the general proposition holds. Bérubé (cited in Gallop, 2019, p 7), commenting on this convergence, sagely observes: ‘[that] many of us will become disabled if we live long enough is perhaps the fundamental aspect of human embodiment’. These changes are exacerbated by the shared cultural prejudices and pathologies that dominate common perceptions of older people and disability. These perceptions produce material physical and regulatory constraints alongside ideological orthodoxies and internalised discursive framings by which older people’s sexual agency is diminished and subsumed beneath notions of ‘healthy’ and ‘normal’ sex and intimacy.

Both age and physical disability share common desexualising factors and impacts. Both are steeped in conventionally negative, normative characterisations of physical change across the life course, with changes measured by scientific-medical criteria with a culturally determined functional index.

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Author: Paul Simpson

It is impossible to talk about sex without talking about relationships or modes of relating, yet sexual relations are assumed to be the preserve of the young. So it seems when older people’s attempts to express sexuality or intimacy are commonly met with ridicule, condescension and infantilisation (Simpson et al, 2017). The quote in the chapter title, though fictional, is no less believable, but might seem incredible if not offensive to quite a few older people. Indeed, we can see the mockery of ageing and later life, and particularly of a presumed cognitive, aesthetic, physical and sexual decline, writ large in birthday cards for those aged 40 plus (Bytheway, 1995; Simpson et al, 2018b). This mockery reveals the casual, normalised nature of ageism in consumerist societies, where ageing can be seen as an individual pathology to be avoided (Biggs and Daatland, 2006). The anxieties occasioned by consumerist-driven ageism could well be responsible for the proliferation of sales of age-defying (denying?) cosmetics, as well as the increase in ‘rejuvenating’ cosmetic surgery, which Eagleton (2003) has theorised as an attempt to deny or stave off mortality.

Unlike many other forms of prejudice, ageism directed towards older people seems to be fair game. It also operates more under the radar of consciousness. It is worth noting that ageism can affect the young, who can be defined as insubstantial, inexperienced and the like, though, unlike later life, youth can be regarded as a transitory, experimental stage en route to maturity and usually experiences ageism less intensely (Bytheway, 1995; Simpson, 2015). In terms of ageism as applied to sex and intimacy, older people are stereotypically cast as prudish and beyond interest in such matters (Mahieu et al, 2014).

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Author: Paul Reynolds

Consent is generally regarded as a problem for the young and the inexperienced. The focus of academic literature, sexuality education and legal and cultural debate is upon those who are entering the sexual world, rather than those who are mature within it (selectively, Archard, 1998; Cowling and Reynolds, 2004; Moore and Reynolds, 2016; Popova, 2019; Stryker, 2017). In part, this is a product of the naturalised and normalised developmental model of sex that identifies sexual risk and danger primarily around the young (Moore and Reynolds, 2018, pp 24–26). It reflects a minimalist notion of sexual learning, regarded as a part of child social development that is adequately completed with maturity. For older people, consent is principally seen as an issue accompanying concerns about diminished capacity. This reflects the desexualisation of older people, where mainstream cultural representations and articulations of sex and sexuality involve stereotypes of youthful, ‘beautiful’, vigorous bodies and acute and rational minds. Older people do not conform to those dominant representations and its stereotypes (Moore and Reynolds, 2016; Hafford-Letchfield et al, 2020, passim; and this volume). Underlying this is a hetero- (and more recently homo-) normative sexuality that is focused on genito-centric, penetrative sexual functionality and in phallocentric vigour and fecundity (in respect of men) (selectively, Beasley, 2005; Jackson and Scott, 2011; Weeks, 2016). This normativity frames older sexual desires as risk and problem oriented, whether the focus is on desexualised older bodies or dysfunctionality, and discourages approaches to older sexual agency that emphasise sexual experimentation and creativity, which might provide different pleasures and alternative and new forms of sexual learning and knowledge.

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Although old age is still desexualised in many ways, there have increasingly been signs of more positive attitudes to sexuality in later life over the last two decades. Sexuality is increasingly positioned as significant to overall positive and healthy ageing (Gott, 2005; Sandberg, 2015). However, older people with illnesses and disabilities are still positioned as asexual, as pointed out in several other chapters of this volume. This is particularly true of the large group of older people living with dementia. Fifty million people worldwide are currently living with dementia, and this number is estimated to triple by 2050 (WHO, 2019).

Discourses on the sexuality of people with dementia are highly contradictory. On the one hand, pervasive discourses of dementia as a ‘loss of self’ also degender and desexualise people with dementia (Sandberg, 2018). Also, the degendering and desexualisation of people with dementia contributes further to the erosion of subjectivity in older people with dementia. On the other hand, there are discourses of sexuality and dementia as excessive, problematic and undesirable. These discourses are commonly reflected in the medical scientific literature, where sexuality among people with dementia is almost exclusively discussed in pathologising terms such as ‘hypersexuality’ or ‘inappropriate sexual behaviours’ (Sandberg et al, 2020). But the tendency to deem sexuality among people with dementia problematic is also reflected in the literature on nursing, which suggests that care staff tend to experience discomfort with, and try to suppress or redirect, sexual expressions among residents with dementia (Villar et al, 2015; Dupuis et al, 2012). Interestingly, intimacies such as kissing, sexual language and touching are sometimes considered challenging behaviour (Villar et al, 2019).

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The Limits of Sex and Intimacy

Despite evidence of a more sexually active ‘third age’, ageing and later life (50+) are still commonly represented as a process of desexualisation.

Challenging this assumption and ageist stereotypes, this interdisciplinary volume investigates the experiential and theoretical landscapes of older people’s sexual intimacies, practices and pleasures. Contributors explore the impact of desexualisation in various contexts and across different identities, orientations, relationships and practices.

This enlightening text, reflecting international scholarship, considers how we can distinguish the real challenges faced by older people from the prejudices imposed on them.

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Given that the desexualisation of older people emerged as a dominant theme in the first volume (addressing diversity) in this book series, this volume was created specifically to probe this subject further and, in doing so, provide a coherent and critical overview of it as a possible basis for critique and action.

This volume has showcased a variety of work by emerging and established scholars (based in Argentina, Britain, Sweden and Spain). As such, it has featured a mix of theoretical and theoretically-informed empirical work that reflects theorising from social gerontology, social psychology, structuralism, poststructuralism and feminism and some combinations thereof. In various ways, all contributors have addressed the intersecting influences that help to make up later life sexuality. If the first volume in the book series addressed influences of age combined with gender, sexual identification, race and class, this volume has focused a bit more on age as it enmeshes with gender (see the chapter by Clare Anderson), with sexual identification (see the chapter by Jane Youell) and with disability/ableism (see the chapters by Susan Gillen and Paul Reynolds and by Linn J. Sandberg).

Moreover, the main foci of this volume have concerned the cross-cutting physical/embodied, relational, cultural, structural and policy and practice-related constraints on older people’s intimate and sexual self-expression. Although such theorising indicates a fairly wide purview, this volume has presented key examples rather than a comprehensive survey of accounts of desexualisation. Nevertheless, it does provide considerable insight and critical reviews of the state of current scholarship on the subject of desexualisation in later life and prompts ideas for further research.

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Older people’s sexual and intimate lives represent an emerging field of study that fuels demands for change across public, private and voluntary services and holds some promise for representing age as positive change (see the volume edited by Barrett and Hinchliff, 2017). Yet, there remain significant constraints on older individuals’ sexual expression and limitations in knowledge on sexuality in later life (Reynolds et al, 2021). Constraint on sexual and intimate self-expression and practice, operating in diverse, intersectional modes, was a key motif that emerged in the first volume addressing diversity in this book series on Sex and Intimacy in Later Life. Older people (defined as aged 50 and over in the series introduction in this volume) remain the subject of stereotyping as non-sexual or ‘post-sexual’ (Simpson et al, 2018). Such a concept broadly refers to the process of desexualisation of older people that appears endemic in late modern societies and marks limits to who counts, age-wise, as a legitimate sexual being (Gatling et al, 2017).

Indeed, representations of age stress unsexy, sagging flesh, tarnished bodies, sexual dysfunction and absence of eroticism (Moore and Reynolds, 2016). More specifically, Gilleard and Higgs (2011) talk of how the leaky, less continent bodies of the oldest old are contrasted with the vital performances of younger adults, and Moore and Reynolds (2016) draw attention to a negative aesthetic that equates older people with ugliness and dearth, if not death, of desire. In light of such endemic pathologies and prejudices, it is tempting to believe that older people are generally not only thought of as no longer interested in engaging in sexual activity and pleasure but also are probably not even expected to think of it (Simpson et al, 2018; Bauer et al, 2016).

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