Aging sexual stereotypes and sexual expression in mid- and later life: examining the stereotype matching effect.

OBJECTIVES: Ageist sexual stereotypes may prohibit midlife and older adults from achieving sexual wellness when stereotypical beliefs about aging, sex, and intimacy become internalized over the life course (i.e. stereotype embodiment). Though there are several studies examining the application of stereotype embodiment theory to various health behaviors, it has not been applied to sexual and intimate health across the life course. The current study examined sexual stereotype embodiment by assessing the impact of aging-sexual-stigma on sexual and intimate activity among midlife and older adults. METHOD: In this cross sectional study, a convenience sample of 972 adults aged 50 and older was recruited via a crowdsourcing platform. Participants completed an online survey assessing attitudes about aging sexuality and their participation in a spectrum of sexual and intimate behaviors. Hierarchical linear regression was used to examine the study hypotheses related to sexual and intimate behaviors among middle age and older adults. RESULTS: Results of this exploratory study suggest that embodiment of sexual stereotypes effects both midlife and older adults, with endorsement of aging sexual stigma predicting lower engagement in both sexual and intimate activities. Sexual embodiment had similar effects across age cohort and gender. CONCLUSION: In addition to pervasive societal impact, ageist sexual stereotypes appear to affect individual sexual health and wellness via internalized beliefs. This provides preliminary evidence for stereotype embodiment in a novel domain, sexual health. Future research should explore potential age and cohort effects across the life course in longitudinal studies with robust measures of aging sexual stigma.

Social Cognitive Theory as a Theoretical Framework to Predict Sexual Risk Behaviors among Older Adults.

OBJECTIVES: Older adults vary in their safe and unsafe sexual behaviors. While researchers are beginning to understand more about the sexual and intimate expression of older adults, only recently are they beginning to understand how older adults make decisions about sexual risk. Bandura's social cognitive theory offers a frame for understanding how self-efficacy, environmental factors, and goal motivation are related to sexual risk behaviors for older adults, including the interplay between these variables. METHODS: Using a diverse sample of older adults (n = 720) age 50+ years, social cognitive theory was modeled to determine the relationship between environment variables (age, gender, and sexual health conversations with practitioners), behavioral variables (self-efficacy), and cognitive variables (importance of sexual wellness goals) with the outcome variable of sexual risk behaviors. RESULTS: Self-efficacy had an indirect effect on sexual risk via sexual wellness goal motivation. Healthcare provider conversations had both direct and indirect effects on older adults' sexual risk through sexual wellness goal motivation. Models were similarly predictive for older men and women. CONCLUSIONS: Sexual risk behaviors among older adults are more influenced by environmental factors in their healthcare settings and their perception and prioritization of sexual wellness goals. CLINICAL IMPLICATIONS: Providers play a key role in initiating and maintaining sexual health discussions with older patients, potentially mitigating sexual risk and bolstering self-efficacy.

Elder sexual abuse and implicit agism: examining the warm-incompetent bias among mock jurors.

Implicit ageist beliefs about the warmth and incompetence of older adults may influence jurors' perceptions and judgments of an older adult's competence in legal cases hinging on capacity and consent, including elder sexual abuse. However, little is known about the nuances of implicit agism in elder sexual abuse cases, and if it can be attenuated. The current study proposed to address these gaps via a randomized vignette design administered to a community sample of 391 US adults. Mock juror participants evaluated an elder sexual abuse case involving an older married couple, in which the victim had dementia. Results suggest that implicit agism was present among mock jurors, consistent with a warm-incompetence bias, and was predictive of mock jurors' guilt ratings. Age- and dementia-relevant jury instructions and mock juror gender were not found to be predictive of guilt ratings. Implicit agism among jurors should be addressed to reduce the potential for implicit age bias to affect elder sexual abuse cases.

"At My Age ": Defining Sexual Wellness in Mid- and Later Life.

Sexual wellness is integral to quality of life across the life span, despite ageist stereotypes suggesting sexual expression ends at midlife. However, conceptualizing sexual wellness in mid- and later life is complicated by a dysfunction-based narrative, lack of a sex-positive aging framework, and existing measures that are age irrelevant and limited in scope. This study aimed to address these limitations by providing a conceptualization of sexual wellness grounded in definitions from midlife and older adults. A sample of 373 midlife and older adults (M = 60, SD = 5.84) in the United States provided a definition of sexual wellness. Using thematic analysis, multiple researchers coded qualitative responses, and results suggested a biopsychosocial-cultural framework. Findings reflect that midlife and older adults provide multifaceted definitions inclusive of various behavioral experiences, including disengaging from sex. They are also keenly aware of physical and psychological limitations and strengths, and emphasize mutual experiences and synchronicity. Midlife and older adults also reflect on age, drawing comparisons to different phases of life and often displaying adaptability in adjusting expectations. When conceptualizing sexual wellness in this population it is imperative to capture this multidimensionality, include those who are not actively engaging in sex, and be aware of the influence of ageist and dys/function narratives.

A Comparison of Actual and Perceived Sexual Risk Among Older Adults.

Sexual risk among older adults (OAs) is prevalent, though little is known about the accuracy of sexual risk perceptions. Thus, the aim was to determine the accuracy of sexual risk perceptions among OAs by examining concordance between self-reported sexual risk behaviors and perceived risk. Data on OAs aged 50 to 92 were collected via Amazon.com's Mechanical Turk. Frequency of sexual risk behaviors (past six months) were reported along with perceived risk, namely, sexually transmitted infection (STI) susceptibility. Accuracy categories (accurate, underestimated, overestimated) were established based on dis/concordance between risk levels (low, moderate, high) and perceived risk (not susceptible, somewhat susceptible, very susceptible). Approximately half of the sample reported engaging in vaginal (49%) and/or oral sex (43%) without a condom in the past six months. However, approximately two-thirds of the sample indicated they were "not susceptible" to STIs. No relationship was found between risk behaviors and risk perceptions, and approximately half (48.1%) of OAs in the sample underestimated their risk. Accuracy was found to decrease as sexual risk level increased, with 93.1% of high-risk OAs underestimating their risk. Several sexual risk behaviors are prevalent among OAs, particularly men. However, perception of risk is often inaccurate and warrants attention.

Examining aging sexual stigma attitudes among adults by gender, age, and generational status.

OBJECTIVES: Stigma related to later life sexuality could produce detrimental effects for older adults, through individual concerns and limited sexual health care for older adults. Identifying groups at risk for aging sexual stigma will help to focus interventions to reduce it. Accordingly, the purpose of this study was to examine cross-sectional trends in aging sexual stigma attitudes by age group, generational status, and gender. METHOD: An online survey was administered to a national sample of adults via a crowdsourcing tool, in order to examine aging sexual stigma across age groups, generational status, and gender (N = 962; 47.0% male, 52.5% female, and .5% other; mean age = 45 years). An aging sexual stigma index was formulated from the attitudinal items of the Aging Sexual Knowledge and Attitudes Scale. RESULTS: This sample reported moderately permissive attitudes toward aging sexuality, indicating a low level of aging sexual stigma. Though descriptive data showed trends of stigma attitudes increasing with age and later generations, there were no significant differences between age groups or generations in terms of aging sexual stigma beliefs. Men, regardless of age and/or generation, were found to espouse significantly higher stigmatic beliefs than women or those reporting 'other' gender. CONCLUSIONS: Aging sexual stigma beliefs may not be prevalent among the general population as cohorts become more sexually liberal over time, though men appear more susceptible to these beliefs. However, in order to more comprehensively assess aging sexual stigma, future research may benefit from measuring explicit and implicit aging sexual stigma beliefs.

Resilience among rural lesbian youth.

Rural lesbian youth are encumbered with a number of obstacles in their development of a positive self-identify and self-worth. Youth may experience implied physical threats, abuse, and mental health concerns as they attempt to define themselves within a context that emphasizes the role of women as heterosexual caretakers of the community. A number of factors can serve to diminish or enhance the young rural lesbian's ability to cope with barriers and obstacles that she may face, including having a supportive family network, a larger network of friends, supportive mentors and teachers, and access to gay-straight alliances. The intent of this article is to examine the challenges that rural lesbian youth face in developing a positive self-identity including tools to enhance resilience.