This is the plenary presentation of Caitlin Littleton of HelpAge International Asia Pacific, which took place as part of Seventh session of 10th Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSHR10) Virtual, on 14th September 2020, on the theme of "Population ageing and sexual and reproductive health and rights (SRHR) in Asia and the Pacific". CHAIR: Sono Aibe PLENARY SPEAKERS * Caitlin Littleton, Regional Programme Adviser, HelpAge International, Asia Pacific | "Sexual health of older people: an overview" * Sai Jyothirmai Racherla, Deputy Executive Director, ARROW | "Reclaiming and Redefining Rights -Older Women's Health and Well-Being in Asia and the Pacific Region at ICPD+25" * Krishna Gautam, founder and Chair of Ageing Nepal | "Not Leaving Older Adults Behind in the process of achieving SDG-2030" A B S T R A C T P R E S E N T A T I O N S * Dr Tey Nai Peng | Understanding the Sexual Behaviour of Older Men and Women in Malaysia * Prof Xiaoming Sun | Unmet Needs on Sexual and Reproductive Health among Women Aged 50-64 in Rural China For more information on this session go to www.bit.ly/apcrshr10virtual7 #SRHR #sexualhealth #reproductiverights #familyplanning #womenshealth #LGBT #genderequality #SDGs #ageing #elderly #olderpeople #IDOP2020 #InternationalDayOfOlderPersons

1. Caitlin Littleton
Regional Programme Adviser-Care and Health
HelpAge International
Asia Pacific Regional Office
Sexual health of
older people: An overview

2. Presentation overview
1) Four key false beliefs about
sexuality among older adults
2) The impact of ageism on sexual and
reproductive health and rights of older
people

3. Belief #1- Older people
aren’t able to have sex
Inability to have
sexual intercourse is
linked with health
issues rather than
age.
Sexual intercourse
isn’t the only means
for sexual, physical
and emotional
intimacy.
• Erectile dysfunction and
underlying conditions of
diabetes, hypertension and
use of medications are
more common with age
but doesn’t effect all older
men
• Urinary incontinence and
prostate issues more
common with age
• Mental health (e.g.
depression) and cognitive
health (e.g. dementia)

4. Belief #2- Older people
don’t want to have sex
Many older people
continue to desire
sex for the same
reasons younger
age groups do:
pleasure, closer
relationships,
reducing stress and
increased
wellbeing.
• Older women are more
likely to report reduced
desire for sex (but why?)
• Chronic health issues play
a role in reduced desire
• Desire affected, but not
necessarily to the degree
thought (e.g. English
Longitudinal Study of
Ageing data has 11% older
women and 15% of older
men listing low sexual
desire as a sexual health
concern)

5. Belief #3- Older people
shouldn’t have sex.
Every adult should
be able to safely
and fully express
their sexuality with
respect to the
rights of others.
• This is a largely an
external viewpoint-
strongly reinforced by
media and societal norms
• Some older people
internalize this message.
• Similar to the issues faced
by other groups notably
women and youth with
‘shoulds and shouldn’ts” of
sexual behaviours

6. Belief #4: Older people
don’t have sex
• Just as with any age, there is a large variety in sexual
frequency, activities, satisfaction, etc.
• Cultural beliefs and norms, marital status,
gender/sex, sexual orientation, physical and mental
health- all influence sexual practice
(Global Survey of Sexual Behavior, 26 countries, 2009)
– 69% of Indian respondents agreed that sex is beneficial for
general health and wellbeing compared to 30% of Japanese
and 28% of Thai respondents (all ages)
– 61% of Indian respondents reported full satisfaction with their
sex life while only 15% of Japanese, and 35% Thai and
Singapore respondents did (all ages)
• A sizeable minority of older people remain sexually
active throughout their life, particularly when you
consider sexual activities other than intercourse.

7. © HelpAge International

8. Ageism
• Ageism is “the stereotyping, prejudice, and
discrimination against people on the basis of
their age”. (WHO)
– Throughout society, people make assumptions about
older people and older age which do not reflect reality.
– This results in prejudice, and discrimination, and
means that individual experiences of ageing are
ignored.
• Ageism intersects with sexism and rigid
gender roles; homophobia; ableism, etc.
• Ageism says ‘older people are no longer
sexual beings’

9. Sexual health definition
The World Health Organization (WHO) defines
sexual health as a state of physical, mental and
social well-being in the sphere of sexuality.
Intrinsic to the right to sexual health are a positive
and respectful approach to sexuality and sexual
relationships, as well as the possibility of having
sexual experiences that are pleasurable and safe,
free from coercion, discrimination, violence and
disease.

10. © BBC.com

11. Ageism is a barrier to sexual
health for older people
Negative societal messages may
detract from individual
enjoyment of sexuality
• Only young people can be
attractive;
• Inappropriate/disgusting/shameful
for older people to have or express
sexual desire;
• Focus on sexual intercourse (and
often male sexual pleasure) only
Social and health services
aimed towards older
people ignore sexual
health
• Those receiving care esp.
in residential care settings
• Social welfare residential
homes
Sexual health issues are ignored
by research on ageing and health
Older people are excluded from
SRHR research on sexual health;
LGBTQI; STIs; sexual violence and
abuse (especially older olds)
Upper age limits are used in the
SDG for gender equality:
• Proportion of women age 15-49 who
make their own informed decisions
regarding sexual relations,
contraceptive use and reproductive
health
• Number of countries with laws and
regulations that guarantee women
aged 15-49 access to sexual and
reproductive health care, information
and education
Older people are
excluded from sexual
health programming:
• Sexual health education
• Distribution of protection
from STIs
• Screening and check-ups
• Efforts to improve
primary health care
(training of health staff)

13. Two essential takeaways
• Older people are not a homogenous group and
assumptions mean that individual needs are
ignored
• Dismantling ageist views and discriminatory
practices regarding sexual health are essential
in achieving progress on:
– sexual health across the population
– right to health
– women’s rights
– LGBTQI rights
– older people’s rights

14. For more details: www.helpage.org