04/16/2026
AGEISM AND THE STIGMA OF SENIOR S*XUALITY
Recently, I attended a workshop about s*xual well-being for seniors, and it was a real eye-opener. Although my practice specializes in human s*xuality, I was surprised to learn just how much the healthcare system fails older folks when it comes to s*x. Neglect in attending to their s*xual needs increases their risk of both physical and emotional disorders. . Here are some things to think about:
Senior Citizens: A Growing Population
For those who wonder why be concerned about seniors, it is important to understand that their population is growing. Currently, almost 1 in 5 are over 65 and 1 in 4 is over 60. In terms of numbers, there are over 86 million Americans aged 65 or older. Get the Facts on Older Americans. Given this trend, the number of folks affected by the problem will only increase
AGEISM
Let's face it, our youth-oriented culture is ageist, especially when it comes to s*x. Ageism is a stereotypical discrimination toward individuals based solely on advanced age. For example, seniors are often believed to be as*xual, because they're "just "too old.
Ageism also involves more than individual discrimination. It also affects physician education and institutional structures. Indeed, many medical school curricula often make learning about the s*xual well-being of older folks optional.
Even worse, Institutions fail to provide policies or structures that allow or promote physical intimacy for their residents. Many assisted living facilities do not recognize the s*xual rights of their older residents and actively discourage any s*xual behaviors by separating residents who pair off.
Sadly, many nursing homes do not provide basic safe-s*x information or encourage them to get help with s*x-related problems. Not surprisingly, senior citizen facilities report high rates of HIV and other s*xually transmitted infections.
S*xual Stigma
S*xual stigma is another aspect of ageism. While many folks feel embarrassed about s*x, what seniors experience goes way beyond embarrassment. To be clear, stigma is a profound, unfair mark of disapproval or shame imposed on individuals by society due to specific attributes like health conditions, behaviors, or appearance.
This stigma permeates not only younger people's attitudes but also healthcare professionals' as well. Not only are doctors poorly trained regarding geriatric s*xuality but many express emotional discomfort with the subject and thus are not emotionally supportive to their older patients, Don’t ask, don’t tell: Silence in the medical encounter when s*xual problems, aging, and health conditions meet | British Geriatrics Society
Sadly, ageism and s*xual stigma not only affect seniors' healthcare, but also their sense of their s*xual legitimacy. Often, disapproval and shaming from others result in an internalized guilt and disgust about their natural wants and desires. As a result, many older folks fail to seek help for s*xual issues, and, often, health care providers don't inquire about s*x-related concerns during regular check-ups.
For example, less than 40% of elderly women talk to their doctors about s*xual concerns and less than 25% of men do. Studies reveal that s*xual stigma even occurs in the doctor's office, Bottom line: many suffer in silence and go without effective treatment.
The Historical Context of S*xual Stigma
For those who wonder where all of this negativity came from, the answer is obvious. Most Americans of whatever age have always had a problem with s*x. Frankly, Christianity was a major factor in creating what has been called our culture's erotophobia. Erotophobia
From its inception, the church struggled with s*x. Early Christians believed that Christ's Second Coming would spiritualize life and eliminate all of the problems of the flesh. ( "In Christ there is no male or female" Gal. 3.28,) But that didn't happen, and early church leaders, who lived in a time of Roman s*xual depravity, did not know what to do with s*x, specifically s*xual pleasure.
Unfortunately, the dominant church leader, the Bishop of Hippo, St Augustine, declared s*xual pleasure (lust) sinful. Of the Good of Marriage (De bono coniugali, c. 401) and On Marriage and Concupiscence (De nuptiis et concupiscentia, c. 419). **
Although the church accepted s*x, it was only under strict limitations, i.e., between husband and wife, and for the purpose of having a child. The implications for the elderly are obvious and explain why the church ignored the s*xual issues of the elderly.
What Needs to be Done
Raise Public Awareness about S*xual Ageism
Much of the ageist attitudes toward seniors and s*x stem from the persistent myth that s*xual feelings fade away with age. In fact, given good emotional, physical, and relational health, it doesn't. Accurate information can push out false ideas and beliefs.
75% of couples aged 64 report having regular s*x. Likewise, 55% at 74 and 25% at age 85. Health, more than age, determines one's experience of s*x. In fact, given good health, s*x is a lifelong entitlement. Of course, the physical effects of aging influence s*xual experience but they do not eliminate it. S*xuality and Intimacy in Older Adults | National Institute on Aging
Going forward, we need to provide accurate information by expanding s*x education programs to include aging issues.
Update our Understanding of S*x and S*xuality
Another crucial update is to change how we understand s*x. It is more than something we do; s*xuality is also part of who we are. Rather than viewing s*x as a peripheral aspect of life, s*xuality needs to be understood as an integral part of one's identity. Likewise, the lifelong aspect of s*xual desire needs to be emphasized.
Ussuage Guilt/Shame and Endorse S*x Positivity
Most s*xual guilt and shame can be overcome by reminding folks that s*xual feelings are normal and nothing to feel bad about. Guilt and shame need to be explained as the consequence of false and abusive negative beliefs and undeserved condemnation. Folks need to know that thoughts and behaviors, like fantasies and ma********on, are completely normal and healthy. S*X & SHAME | Pastoral Counseling Syracuse NY
Advocate for Mandatory S*x and Aging Training for All Healthcare Professionals
Professional health organizations, as well as state and federal licensing agencies, need to step up their requirements to include adequate training in the areas of s*x and aging.
Advocate for Senior S*xual Rights
Seniors need reassurance about the legitimacy of their s*xuality and their right to express it. Likewise, they need to be encouraged to assert their s*xual needs and seek help when they are having problems.S*xual Rights For Seniors | American S*xual Health Association
Finally, senior living facilities need to change and accept that their residents are s*xual people. They need to abandon puritanical attitudes that allow s*x only between married couples.
To end on a positive note, change is slow, but it can happen. Over 30 years ago, in 1995, the Hebrew Home in Riverdale, New York, established what’s recognized as the nation’s first S*xual Expression policy for residents of a retirement community. Let's keep the ball rolling.
Rev. Michael Heath, LMHC, Fellow, AAPC 4 15 2026
www.revmichaelheath.com