Although findings from national surveys suggest that adults engage in a variety of sexual behaviors across the life span, social attitudes toward sexuality and aging range from permissive to restrictive. Among adults aged 50 and older their most commonly reported sexual problems include erectile dysfunction among men, and diminished interest and vaginal dryness among women. The use of systemic sex therapy is recommended with this population because it prompts clinicians to assess and examine the impact of a client’s biology (e.g., normative age-related changes, impact of drugs and illness), psychology (e.g., participation in high risk behavior), couple’s issues (e.g., availability and health of a partner), intergenerational issues (e.g., family by choice; adult children), sociocultural factors (internalized stereotypes; the medicalization of sexuality), and environmental factors (institutional settings; public policy) upon their sexuality. The impact of normative age-related changes, and both chronic and acute health problems including diabetes, heart disease, depression, breast cancer, and incontinence upon an older adult’s sexuality must also be acknowledged. Information about special populations (e.g., LGBT elders, hospice patients, institutionalized older adults), a clinical case study, and directions for future research and policy changes are provided.
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