Body image and general health are important for the sexual health of older gay men, according to new studies

According to a national survey on Healthy Aging, 93% of people ages 50 to 80 in the United States report experiencing at least one form of ageism from other people. Internalized ageism occurs when a person holds age-discriminatory beliefs about themselves, such as believing they have experienced a “senior moment” or are too old to learn new technology. Internalizing age-discriminatory stereotypes can impact older adults’ mental and physical health, including sexual health. Various aspects of older adults’ sexual health have been extensively studied; however, studies of older gay men, who often face disproportionate health disparities, are limited.

New research from Lucas R. Prieto, assistant professor in the department of social work at George Mason University’s College of Public Health, finds that internalized gay ageism affects some aspects of older gay men’s sexual health, but not all. Internalized gay ageism negatively affects older gay men’s sexual satisfaction when mediated through body image. However, internalized gay ageism does not affect their erectile dysfunction. Internalized gay ageism (IGA) is the combination of internalized homophobia and ageism that describes the unique experiences of older gay men, such as feeling invisible when they are around other gay men.

“A full mediation effect was found, meaning that older gay men who internalize negative feelings about aging as a gay man (e.g., IGA) report poorer body image and sexual satisfaction,” said Prieto, the lead researcher. “Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men” was published online in the Magazine for Homosexuality in May 2024.

“Research shows that older adults who are sexually satisfied have higher life satisfaction and quality of life. Therefore, studies examining sexual satisfaction among marginalized older adult groups such as older gay men are needed. It is critical that providers understand the uniqueness of aging as a gay man in order to provide competent care,” Prieto said. The research also showed that older gay men in open relationships were more likely to be sexually satisfied compared to single or widowed men.

“Limiting our understanding of sexual satisfaction to older heterosexual populations may have adverse health consequences for sexual minority groups. Our findings demonstrate the need for health-promoting interventions tailored to the cultural differences and experiences of older gay men,” Prieto said.

In addition, Prieto examined the relationship between internalized ageism in gay men and erectile dysfunction (ED). Prieto found that age and general health were factors that predicted ED in older gay men, but internalized ageism in gay men did not. These findings were published separately as “Factors Associated with Erectile Dysfunction in Older Gay Men,” which is available online at Archives of sexual behavior in June 2024.

The results of both papers come from a cross-sectional study called the Study of Aging and Sexual Satisfaction Among Gay Men (SASSY) in which gay men were surveyed online about sexual health and well-being. The initial research for this study was conducted at Michigan State University, Prieto’s former university. Deirdre A. Shires and Yuan Xiong of Michigan State University are co-authors of both papers.