Body image and overall health found important to the sexual health of older gay men, according to new studies

According to a National Poll on Healthy Aging, 93% of people in the U.S. between 50-80 years old report experiencing at least one form of ageism from other people. Internalized ageism is when a person believes ageist ideas about themselves, such as thinking they had a "senior moment" or thinking they are too old to learn new technology. Internalizing ageist stereotypes can impact older people's mental and physical health, including sexual health. Various aspects of older adults' sexual health have been studied widely; however, studies focusing on 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, found that internalized gay ageism affects some aspects of older gay men's sexual health, but not all. Internalized gay ageism negatively impacts older gay men's sexual satisfaction when mediated by body image. However, internalized gay ageism does not influence their erectile dysfunction. Internalized gay ageism (IGA) is the combination of internalized homophobia and ageism that captures the distinct experiences of older gay men, such as feeling invisible when they are with other gay men. 

"A complete mediation effect was found, meaning that older gay men who internalize negative feelings about aging as a gay man (e.g. IGA), report lower body image and sexual satisfaction," said Prieto, principal investigator. "Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men" was published online in the Journal of Homosexuality in May 2024. 

"Research shows that older adults who are sexually satisfied report better life satisfaction and quality of life; therefore, studies that explore sexual satisfaction among marginalized older adult populations, like older gay men, is needed. It is vital that providers understand the uniqueness of aging as a gay man to provide competent care," said Prieto. The research also showed that older gay men in open relationships compared to being single or widowed were more likely to be sexually satisfied. 

"Limiting our understanding of sexual satisfaction to older straight populations may lead to adverse health consequences for sexual minority groups. Our results indicate the need for health promoting interventions that are tailored to the cultural differences and experiences of older gay men," said Prieto. 

Additionally, Prieto explored the relationship between internalized gay ageism and erectile dysfunction (ED). Prieto found that age and overall health were factors that predicted ED in older gay men, but internalized gay ageism did not predict ED. These findings were published separately as "Factors Associated with Erectile Dysfunction Among Older Gay Men", which was published online in the Archives of Sexual Behavior in June 2024. 

Both papers' findings came from a cross-sectional study titled "Study on Aging and Sexual Satisfaction among Gay Men (SASSY)" that surveyed gay men online on the topic of sexual health and well-being. Initial research for this study was done at Michigan State University, Prieto's previous institution. Deirdre A. Shires and Yuan Xiong from Michigan State University are co-authors on both papers.