Healthy sexual aging: A qualitative exploration of the sexuality and sexual health of older adults in the UK

Western society experienced a ‘sexual revolution’ in the previous century which has uncoupled sex from marriage and reproduction, and increased research into sexuality. However, stigma around sex in later life still persists, and our conceptualisation of sexual aging still remains centred around biomedical narratives of disease and decline. Researchers have also begun to build more multifaceted constructions of sexuality which do not solely focus on sexual frequency and function, instead including interpersonal and socio-cultural aspects such as intimacy and freedom of sexual expression. The aim of this thesis was to enrich our knowledge of sexual wellbeing in later life and to provide insight which may aid in building a more positive and inclusive sexual rights framework for older adults. In a systematic review of the qualitative literature on the sexuality of older adults aged 60+, 69 articles met the inclusion criteria. The articles were analysed thematically in order to identify gaps in the literature base. Notably, comparatively little is known about male sexual desire and pleasure beyond sexual performance, and LGBTQ+ experiences. Many older adults seem to rationalise sexual problems as a ‘natural’ part of the aging process. I conducted in depth, semi-structured interviews with 31 older British adults aged 65+ and analysed using reflexive thematic analysis. Participants felt that they are seen as ‘past it’ and irrelevant in the eyes of society and the media, and that the media only represents ‘overly glamourous’ older people. Many participants had internalised narratives which construct aging as a time of decline, and aging ‘well’ meant retaining youthful characteristics. Our participants often rationalised and accepted sexual changes as part of the natural aging process. Sex was the ‘icing on the cake’ of high-quality romantic relationships, built on foundations of intimacy, connection, and companionship, and wellbeing and sexual connection can be maintained through shared experiences, emotional closeness, and support. The results break down stigma around sex in later life and suggest that ‘successful aging’ narratives which focus on resisting decline and maintaining sexual function may not be beneficial to wellbeing. The findings provide insight into how definitions of sex and its importance shift in later life, and how later life can be seen as a time of difference. More holistic and multidimensional approaches to sexual wellbeing are required which encompass intimacy, emotional support, and freedom from stereotypes