Where does the notion that sexuality holds the key to later life well-being come from? A fun­damental change has occurred in public health discourse in the past twenty years with the acknowledgment that sexual health is essential to overall health and well-being (Coleman 2010: 135). This development is linked to transformations in the concerns of sexuality researchers, which I briefly address here. In the first half of the twentieth century, reproduction was a central concern of both demographers and sexologists. They were interested in regulating sexual behaviour, often by establishing ‘scientific knowledge’ about sexual acts and seeking to identify patterns of deviance that obstruct biological and social reproduction.

In the 1960s, the focus of sexual health activists gradually moved away from reproduction — and related concerns such as contraception and abortion — towards sexual pleasure, well-being, and sexual rights. The feminist movements of the 1960s and lesbian and gay activism of the 1970s were influential in decoupling sexuality and reproduction and expanding what had been understood as ‘sexual’, drawing researchers’ attention to such things as sexual well-being, health, and sexual satisfaction. In 1975, the World Health Organisation defined sexual health as ‘the integration of the somatic, emotional, intellectual, and social aspects of sexual being, in ways that are positively enriching and enhance personality, communication, and love’ (WHO, cited in Coleman 2010: 137). The WHO document went on to explain that ‘the purpose of sexual healthcare should be the enhancement of life and personal relationships and not merely coun­selling and care related to procreation or sexually transmitted diseases’ (Coleman 2010: 137). This document had a significant impact on the international field of sexology.

In the 1990s, another shift occurred, away from a focus on sexual pleasure and toward making sexuality a human rights concern. An array of sexual rights were articulated by the World Association of Sexology (WAS 1999). For those of any adult age group, these rights include the right to enjoy the highest attainable standard of sexual health; the right to seek, receive, and impart information related to sexuality; the right to gain respect for one’s bodily integrity; the right to decide whether or not to be sexually active; the right to engage in consensual sexual relations; and the right to pursue a satisfying, safe, and pleasurable sex life. The process of articulating these sexual rights has influenced, and intersected with, social movements to promote the rights of older persons and to combat ageism (Butler 1989: 139; Bytheway 2005: 362). The discourse about older persons’ rights to sexual health and well-being links to these movements.

Conclusion

In this analysis of sexuality and aging in East Asia, I have explored a set of themes, logics, and concerns that prevail in discourses of sexual well-being in later life. One dominant theme is that the sexual attitudes of older persons need revision and updating. These studies of senior sexu­ality state that the older person can take initiative in embracing the unrealised health-giving potential of continued sexuality. Most of the authors mentioned here state that it is seniors themselves who need to free up their approach to and attitudes about sex. Araki (2004: 59—69, 2005: 480—86) is the only one who asserts that it is the institutions of care and caregivers who are responsible for changing their ways.

Most of these gerontologists and sexual health experts promote couple-based conjugal sexuality when in fact many older persons are single. The sexologists say that single older persons could benefit from finding partners and becoming couples. This is difficult, however, for many older singles, and the gerontologist’s model of sexual well-being implies that to be sexually satisfied an older person has to be in a coupled relationship. The result is that these ideas of married sexual well-being are exclusionary of the multiplicity of older persons who do not fit into that conjugal model of coupledom.

Further, these writers call for more liberated and expansive conceptions of sexuality, but the advice they provide to elders in realising their sexual potential serves to re-inscribe a heteronormative model of sexual relations. Many senior citizens may contest these views: this includes those who do not find themselves in that model of coupled relationship, or who do not want to be in that model, or who object to the notion that sexual activity should necessarily be paired up with well-being.

The sexologists’ advice also avoids engaging deeply with the patriarchal gender relations which appear to be deterring older persons, particularly older married women, from engaging in sexual activity. Various asymmetries in gender relations may make it unappealing for women and men to have sexual relationships; the tips from these sexologists do not address these gender asymmetries but instead feature simple techniques for complex social problems.

The study of later life sexuality is an emerging field. The tasks are to map how arguments and interventions about senior sexuality are being made by particular organisations and institutions and to analyse the assumptions that are being mobilised in these interventions. There is much more to analyse. I have addressed certain assumptions in this chapter. An implication arising from these discussions is that the social problem of aging becomes individualised. Well-being becomes reconfigured as an issue of whether and how individual older persons choose to cultivate their bodies, and to do so in a very specific way: by activating their sexual potential. The older person is considered to be individually responsible for his or her sexuality. Related to this is the notion that health in old age is a personal responsibility and choice. While readers need not overtly challenge these assumptions, it is important to remain aware of how they influence the lives of older persons.