The 21^st century has a higher population of older adults than any other century. With medical and quality-of-life advancements, humans now have the opportunity to live long, healthy, and happy lives. Many people see older adults as a fountain of wisdom, and that extends beyond life advice – it includes insights into sexuality and sexual health.

Public views of sexuality in older adults may be influenced by a variety of factors, like social expectations of behavior and effects of the aging body. Recent research has found that these factors appear to differ between genders and sexual identities. Some studies say that older adults from sexual minority populations (lesbian, gay, bisexual) may have lower levels of physical and mental health than their heterosexual counterparts. This may be because of differences in healthcare access and social expectations, or challenges with different sexual activities becoming more pronounced with age.

A Portuguese study that finished in 2021 surveyed 643 cisgender older adults (60+ years old) who did not live in an elderly care home. Using the female sexual function survey (FSFI), the international index for erectile function (IIEF-5), and the sexual pleasure scale (SPS), researchers compared the sexual function and sexual pleasure of heterosexual men and women, and lesbian, gay, and bisexual men and women. The goal of these comparisons was to see how sexuality interacts with social and sexual stigma in aging populations.

• Heterosexual women reported the lowest sexual function (SF) and sexual pleasure scores.
• Heterosexual men reported the highest SF and sexual pleasure scores.
• Lesbian and bisexual women reported higher SF levels than heterosexual women.

Researchers suggested this may have to do with generational expectations of reproduction and pleasure. Meaning, older adults may still be influenced by expectations of prioritizing men’s sexual pleasure and having children over women’s sexual pleasure.

• Gay and bisexual men reported lower SF and pleasure scores than heterosexual men.

Researchers said this may relate to internalized homophobia and ageism, as well as a history of discrimination in both social and medical settings when they were younger. This may have led to a lack of access to sexual health assistance or even hesitation surrounding medical visits and open conversations about sexual health problems.

Each group’s average sexual pleasure score was above the medical threshold for sexual pleasure. This means that older adults, on average, still have pleasurable sex. However, SF appeared to worsen with age, which means older adults may struggle more with sexual dysfunction.

Key Takeaways:

• Being a heterosexual woman may have more negative effects on SF and sexual pleasure.
• The sex lives of older adults may depend on both psychosocial factors and sexual identity.
• More research is needed to expand the information available about sexual health in aging populations.
• Older adults may want to speak with a sexual health professional if they are experiencing sexual dysfunction or are unhappy with their sex life.

Resources:

• Ribeiro-Gonçalves, J. A., Rodrigues, N., Carvalheira, A., Costa, P. A., & Leal, I. (2026). Sexual function and pleasure among Portuguese older adults: An approach based on sexual orientation and gender. The Journal of Sexual Medicine, 23(2). https://doi.org/10.1093/jsxmed/qdaf355