Sexuality and Ageing provides a fascinating and clear response to questions that have been increasing in recent years about the sexual needs and expectations of older adults, particularly in relation to what older adults consider important to their sexuality and what we know about the sexual expression of older cohorts. Walter Bouman and Peggy Klienplatz, both longstanding experts in the field, edit a collection of articles from a special edition of Sexual and Relationship Therapy that builds a story for readers, with each chapter presenting differing aspects of sexuality and ageing. Although an anthology, the collection is a smooth and engaging read that brings new insights to the area. The broad nature of sexuality in everyday life means that authors have been able to include material pertinent to areas of study of many sexuality professionals, researchers and students alike.
Recognition of sexuality in older adults is slowly permeating into research, healthcare practice and society and the collection further develops this, challenging existing understandings through an endeavour to explore “the entire spectrum of sexual expression”, rejecting heteronormative expectations and accepting diversity. While particularly visible in Chapters 7, 9 and 10, which focus on non-exclusive relationships and older lesbian and gay people, this is an overarching theme throughout the book. Through increasing an inclusive approach to research from the perspectives of older adults themselves, and thus reducing potentially damaging assumptions, this demonstrates that understandings of older adults’ sexuality are evolving and becoming more reflective of everyday life.
From Chapter 4 onwards, relationships tend to be the main subject framed in relationship with one’s body (Chapter 11), with new partners (Chapter 10), with long-term partners (Chapters 4 and 11) or with friends and family (Chapter 9). While the importance of relationships to sexuality may seem obvious, the exploration of relational and emotional aspects within the articles included in this book speak to the inclusive and holistic perspective of sexuality that the editors are promoting and further demonstrate the authors’ desire to present a body of work that reflects the realities of what is relevant to sexuality for older adults.
One fresh perspective promoted by this book is on the many positive aspects of ageing. These aspects are seldom considered in research and society and yet the overriding sentiment that I came away with after reading this book was that negative discussions around ageing are being challenged, the most compelling of these arguments being presented in the optimal sexual experiences research undertaken in Chapter 6 and the sexual and erotic orientation of Chapter 7. Both these chapters demonstrate positivity within the research community, which counterbalances the negative discourse, and growing understanding that ageing is not intrinsically linked to a decline in sexuality. However, the negatives are also given consideration.
In line with the authors’ promotion of heterogeneous understandings, discrimination and intersections of age, gender and sexuality are explored and there is discussion around how various sections of ageing society – in this case, women and gay and lesbian people – may experience sexuality differently. One of the most emotive chapters in this book is Chapter 9 which details the devastating impact that discrimination continues to have on the lives of older lesbian and gay people, and the far-reaching impact that previous experiences of discrimination can have with regard to fear of accessing care services. An awareness of this may encourage increased sensitivity in health care professionals when dealing with older patients. In fact, throughout the book there are various practical considerations for healthcare professionals that make it relevant on both an academic and practical level.
After an eloquent introduction, and a reminder of the need for sexuality research from a phenomenological, human perspective, it was at first disappointing to see the first chapters focused primarily on biological and clinical aspects. However, once the book is read as a whole, the order makes perfect sense, moving from narrower to wider aspects of sexuality, thus facilitating readability.
It is also a pity that studies pertaining to the oldest old (adults over the age of 80) are almost completely absent. This lack of inclusion probably highlights a dearth of existing studies within this age group rather than a deficit on the part of the editors, as the authors themselves reject the consideration of older adults as “a single, older cohort”. It does, however, suggest that while the concept of “old” may have shifted, and it is now recognised that sexuality is important to adults in their 60 and 70’s, there may still be a reticence to accept the sexuality of the oldest old.
As Sexuality and Ageing presents wide-ranging and high-quality research in the area, it is relevant to a wide audience, not only through the inclusion of more commonly discussed topics in the field, such as sexual health and quality of life, but also rarely discussed issues such as dating. Despite my hesitance to review an anthology, it has been a compelling read and I believe that it presents readers with a comprehensive and current collection of literature by some of the most renowned researchers in the field, and is essential reading for all healthcare professionals, researchers and students who desire to broaden and deepen their knowledge in the area of sexuality and ageing.
By: Stephanie Ejegi-Memeh, PhD Candidate, School of Nursing and Midwifery, Sheffield University, Sheffield, UK.