Sexual Obligation and Perceived Stress: A National Longitudinal Study of Older Adults

ABSTRACT

Objectives: This study examines the relationship between sexual obligation and perceived stress among older adults in the United States.

Methods: Using longitudinal data from three waves of the National Social Life, Health, and Aging Project (NSHAP), our sample included 1,477 partnered, sexually-active respondents aged 57 to 85 at the baseline survey. We estimated mixed-effects models to test how feelings of sexual obligation are related to changes in perceived stress score.

Results: Sexual obligation was positively associated with perceived stress score. The positive relationship between sexual obligation and perceived stress score became stronger over the study period among older men, although it remained relatively stable among older women. Relationship quality only partially explains this relationship.

Conclusions: Feeling more obligated to have sex had a significantly greater effect on older men’s perceived level of stress over time than older women’s. This association became marginally significant after relationship quality was controlled for, suggesting that relationship quality was a key explanatory factor for the gendered patterns in sexual obligation’s linkage to stress. These results highlight the importance of understanding gendered sexuality among aging older adults within the context of their relationship.

Clinical Implications: Older adults’ feelings of sexual obligation can manifest in their daily stress experience. Clinicians seeking to lower older adults’, in particular older men’s, stress levels should address the context of their sexual life and if they feel obligated to have sex, along with the positive and negative aspects of their relationship, as these could elevate their stress levels over time.

KEYWORDS:

• Aging
• older adults
• sexuality
• stress
• sexual obligation
• gender
• NSHAP
• relationship quality

Clinical implications

• Clinicians should inquire about the changing nature of older patients’ sexual experiences and if and how the partners are communicating with each other about their sexual desire.

• Because the relationship between higher sexual obligation and greater perceived stress increases over time, clinicians should be concerned earlier with the quality of their patients’ sexual relationship due to the harm that compounding high stress levels have on health.

• Clinicians wanting to lower older men’s stress levels in particular should address why they are feeling obligated to have sex, as this could elevate their stress levels as they age.

Disclosure statement

The authors have no conflict of interest to report

Notes

1. The original answer options for sexual obligation ranged from never (1) to always (5). The mean scores of sexual obligation for men and women based on this original scale was 1.59 for men and 1.91 for women at Wave 1, 1.58 for men and 2.10 for women at Wave 2, and 1.37 for men and 1.87 for women at Wave 3.

Additional information

Funding

This research was partly supported by the National Institute on Aging, Grants R01AG061118 and K01AG043417.