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Time to make room for sex in our care homes

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We need to open up to the significance of love and sexuality in later life

The persistence of romantic love in long-term relationships is, unsurprisingly, associated with higher levels of relationship satisfaction.

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Although Valentine’s Day is often criticised as a cynical creation by florists and the greeting cards industry, it is a useful focal point for considering love and sexuality as elements of human wellbeing that often escape attention in healthcare.

This neglect is most marked in later life, when popular discourse on late life romance is dominated by simple notions of asexuality or by ribald jokes

There are many reasons why healthcare professionals need to learn more about human love and sexuality, not least of which is a fuller understanding of the nature and meaning of ageing.

exuality is a core element of human nature, encompassing a wide range of aspects over and above those related to genital functions, and the medical literature has rightly been criticised for taking too narrow a vision of sexuality.

We need to open up to the continuing significance of love and sexuality into later life

This narrow vision is paralleled by a steady trend in the neurosciences of “neuroreductionism”, an over-simplistic analysis of which parts of the brain light up in sophisticated scanners on viewing photos of a loved one.

We need to open up to the continuing significance of love and sexuality into later life, understanding that sexuality includes a broad range of attributes, including intimacy, appearance, desirability, physical contact and new possibilities.

Studies

Numerous studies affirm sexual engagement into the extremes of life, with emerging research on the continuing importance of romantic love into late life. There is also reassuring data on the persistence of romantic love in long-term relationships, unsurprisingly associated with higher levels of relationship satisfaction.

A growing literature sheds light on developing new relationships in later life, with a fascinating Australian study on online dating which subverts two clichés – that older people are asexual and computer illiterate.

The challenge in ageing is best reflected in the extent to which we enable and support intimacy and sexuality in nursing homes. Although for many this is their new home, the interaction of institutional life (medication rounds, meals), issues of staff training and lack of attention to design of spaces that foster intimacy can check the ability to foster relationships and express sexuality.

For example, is the resident’s room large enough for a sofa or domestic furnishings that reflects one’s style, personality and sense of the romantic? Are sitting spaces small and domestic rather than large day rooms? Do care routines allow for privacy and intimacy? Is there access to a selection of personal clothes, make-up and hairdressing?

Granted, there can also be complicated issues when residents with dementia enter new relationships and the need to ensure consent in a sensitive manner, but these should be manageable with due training and expertise in gerontological nursing and appropriate specialist advice.

Supports

A medical humanities approach can provide useful supports in education from many sources, ranging from literature ( Love in the Time of Cholera), film ( 45 Years or the remarkable and explicit Cloud 9 from 2009) or opera (Janácek’s Cunning Little Vixen, a musical reflection of the septuagenarian composer’s passion for the younger Kamila Stösslová).

We, as present and future older Irish people, also need to take a step back and consider if we are comfortable with a longer view on romance and sexuality.

The Abbey Theatre did us considerable service in 2015 with a wonderful version of A Midsummer Night’s Dream set in a nursing home. We were struck by a vivid sense of the inner vitality of these older people, suffused with desire, passion and romance.

This contemporary understanding of companionship and sexuality in later life was enhanced by casting Egeus as a son exercised about his mother’s romantic choices instead of a father at odds with his daughter.

We can also take heart from an early pioneer of ageing and sexuality, the late Alex Comfort. Best known for his ground-breaking The Joy of Sex, he was also a gerontologist of distinction, and wrote knowledgeably about the intersection of both subjects with characteristic humour.

He wrote that the things that stop you having sex with age are exactly the same as those that stop you riding a bicycle: bad health, thinking it looks silly or having no bicycle, with the difference being that they happen later for sex than for the bicycle.

His openness and encouragement for our future mirror Thomas Kinsella’s gritty poem on love in later life, Legendary Figures in Old Age, which ends with the line: ‘We cannot renew the Gift but we can drain it to the last drop.’

Complete Article HERE!

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Multiple Orgasms for Men?

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Multiple Orgasms for Men? The Fascinating Technique That Might Open Up Whole New Sexual Experience

 

Women aren’t the only ones capable of a multi-orgasmic experience

By Carrie Weisman

As a society we carry a lot of entrenched ideas about sex. Perhaps one of the most deeply ingrained assumptions is that women can have multiple orgasms, and that men can’t. But is that really true?

In 1986, sex therapists William Hartman and Marilyn Fithian put together the book, Any Man Can. They describe that by withholding ejaculation, men can experience “a number of sexual peaks.”

“The multi-orgasmic men we have studied have chosen to develop that capacity (stopping ejaculation using learned techniques)… The behavior itself (interrupting orgasm via such techniques) appears to be at least four thousand years old,” they wrote,

More than a decade later, sex educator Jack Johnston came out with a training program to help men work towards this experience. Johnston told me over the phone that he’s made it his life’s work to dispel the myth that only women are capable of experiencing multiple orgasms.

“Men and women are physiologically a lot more similar than people realize. Vive la différence, of course, but in terms of the neurological capacity for experiencing the orgasmic impulses, we’re wired in quite a similar manner.”

He added, “I try to help reacquaint people with the idea that orgasm is an energetic event, and that for men, it’s not automatically linked to ejaculation. They’re two separate events. Two separate reflexes.”

In contrast to other “experts,” Johnston avoids conventional “squeeze techniques” that encourage men to stop just short of “the point of no return.” These techniques typically require that men clench pelvic floor muscles, slow their breathing and allow the urge to ejaculate to pass.

As Johnston explained, “That’s not really a whole lot of fun for anybody. You’re constantly monitoring, it’s like ‘Am I there yet? Maybe I can go a little further. Oh shucks, I went too far.’”

“My working hypothesis was that there’s got to be a better way than that. I don’t think our creator was sadistic in that way.”

Johnston’s program is known as The Key Sound Multiple Orgasm (KSMO) training. The “Key Sound” refers to a particular sound one can make while engaging in some light stimulation during solo (or partnered) practice sessions, separate from the act of intercourse. He insists the vibrations brought on by the sound can help “unlock” the key to multiple orgasms.

One satisfied client writes, “As the sensations became stronger, my vocal expressions became deeper and louder. I continued until I was so overwhelmed by this feeling I literally could not move anymore – pleasantly paralyzed by orgasm with no urge to ejaculate.”

But while most men believe penile stimulation to be the primary means by which to experience orgasm, Johnston recommends  guys bypass the penis and head for the perineum (the area between the scrotum and anus) during their solo sessions.

Johnston’s refers to the perineal area as the “the male G-spot.” Part of his training revolves around “helping men locate that area of their body, and then, as part of the ‘Multiple Orgasm Trigger,’ practice to gently massage [the perineal] area just enough to get a little tingle, or a little rush.” Johnston calls these sensations “Echo Effects.”

“How does one increase arousal to orgasmic intensity without using lots and lots of stimulation? For men in particular, more and more stimulation tends to trigger the ejaculation reflex. So the idea is, in a sense, how do you learn to sneak up on the orgasm?”

“Very often, orgasm is centered right in the genital area, whereas the method that I teach tends to occur throughout ones body. One experiences arousal throughout one’s body. Neurologically, it’s all connected throughout the body, so the idea is to become aware of that. To become aware that when someone becomes aroused it’s not just in the genital area, those waves of energy start flowing throughout one’s entire body.”

On the official forum, one of Johnston’s clients reports, “As I am doing my sessions, I am really getting new sensations each time. Presently, I am feeling my prostate pumping (for lack of a better word) and this is causing me to get a slight erection. When my prostate pumps, it is sending pre-cum and I am beginning to leak a little. I have to stay relaxed because I feel that I could cross over and ejaculate. This pumping of my prostate are mini orgasms (I assume) and they feel great. My entire body is hot, shaking, and feeling really amazing. I can do this for about an hour and maybe a little longer.”

Another writes, “Tonight, after doing my 20 minutes and then sort of absent mindedly continuing, I do believe I had my first full body, non-ejaculatory orgasm. It just sort of came on as I was massaging the base of my penis, from out of nowhere–NOT like it came from within my body. It felt like a heat throughout my body, and a sort of giddiness, almost like the light, first rush of MDMA (er…or so I’ve read…).

“And the crazy thing was, instead of feeling like the orgasm was in me, it felt like I was in the orgasm–like it was surrounding and suffusing my whole body like a field of energy. Pretty wild.”

Johnston recommends that his clients practice the technique for 20 minutes every other day. He notes that ejaculation should be avoided on days devoted to practice.

He explained that in contrast to the “traditional” male ejaculatory orgasm, multiple orgasms typically arrive in “waves.” And since they aren’t linked to ejaculation, one’s energy doesn’t dissipate as it does when one ejaculates. He added that after having mastered the technique, most men come to prefer these kind of orgasms.

He continued, “It lasts so much longer. The after glow lasts so much longer too. It’s the kind of energy that can infuse your whole being.” He also notes that, after having completed the training, many men report experiencing more intense ejaculatory orgasms as well.

But mastering the physical technique is only half the battle. As Johnston explained, a good part of his training revolves around teaching men to expand their understanding of sexual pleasure, and open themselves up to the different means by which it can be attained.

He tells me, “There are a lot of people who think that it’s important for intellectual integrity to be really, really skeptical. I think it’s appropriate to have some skepticism, but it’s also really essential not to just be attached to being a skeptic. In the face of evidence to the contrary, one needs to have the intellectual integrity to consider it.”

“Once we learn the facts about our physiology, and what’s really possible. That’s a whole new world.”

Some people have years of sexual experience under their belt. Some don’t. But no matter where you land on the path of sexual self-exploration, it’s never too late to rewrite certain standards, and never too soon to start experimenting with different points of pleasure, no matter how obscure they may seem.

Complete Article HERE!

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Lust, sex and the middle-aged woman

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Women’s sexuality doesn’t die with age, but the level of their desire is diverse.

By Margaret Jennings

She seemed to have it all: a loving family, successful career and beautiful home.

Then Yvonne Carmichael jeopardised everything by having a torrid affair with a random stranger, ripping apart the cosy trajectory of her life.

Yvonne is the lead character in a BBC1 mini-series currently steaming up our TV screens, called Apple Tree Yard.

And while the storyline takes us from the joys of lust to the darkness of rape, it’s rare to see a 50-something female take centre stage in such scenes.

Midlife affairs are usually the reserve of testosterone-driven, crisis-ridden males — as if females have no such needs — or so the media world would have us believe.

Apple Tree Yard, a dramatised version of a novel by Amanda Coe, challenges pre-conceived ideas about middle-age sex.

It not only affirms that it’s OK for older women to be sexually expressive, it annihilates the myth that we become “invisible” and asexual just because we are ageing.

The four-part psychological thriller has prompted a lively debate on this issue and 50-year — old actress Emily Watson, who plays Yvonne, has commented: “Your sexuality doesn’t die with your age. You don’t have to apologise for it.”

The idea that our sexuality can be compartmentalised as non-existent, especially as we are living longer more vital lives, seems absurd.

While Yvonne’s torrid affair illustrates this explicitly, it also raises the issue of how our latent sexual urges are perfectly ripe to be reignited at this stage of life, depending on our circumstances and responses.

“Many women of 50 and beyond succumb to a flagging libido, more difficult arousal and maybe a stale, longtime relationship, by retreating from sex.

“Then they meet someone new and — bam — they feel the excitement that they thought they had left far behind,” says Joan Price, a US author and blogger on senior sexuality.

“They feel on fire. Their sex drive — which they thought was dormant — goes into overdrive. It can be quite an amazing and delicious experience. It can also be bewildering and guilt-filled, if a woman has an affair when she’s in a committed, monogamous relationship.”

Price, now 72, has first- hand experience of this herself: “I was 57 when I met the man who would become my husband and great love. I had been single for decades, with occasional relationships that didn’t go anywhere — and long dry spells.

“It was distressing, because I knew I was a vibrant, sexual being, but after menopause I seemed invisible to the men I met. Many women report that they feel the same. How glorious it is then, when we meet the right person and that person is as electrified as we are!”

The on-screen electricity between research scientist and grandmother-to-be Yvonne, and her handsome lover, Mark Costley (played by Ben Chaplin), is an endorsement of this passionate potential, but is there something missing in our relationship if we yearn to seek those sparks elsewhere?

Sex in relationships is not just about sex, but about the connect between a woman and her partner, says Lisa O’Hara, a couple counsellor with Dublin-based clinic Mind and Body Works.

“If lack of libido is an issue for a couple attending for counselling, it can be part of a wider discontent than just the sexual connection. There may be a loss of closeness in general and resentments by the woman towards the partner that have built up over years, which have gone unaddressed.

“If these are addressed in therapy and things improve, sex may be back once again.”

However, some of her midlife female clients do develop a stronger curiosity about their own desires and fantasies, once free of fear of pregnancy or of other lifestyle issues that had got in the way, says O’Hara.

“Some say ‘I’m out of here’. It totally depends on their unique circumstances and how they feel about themselves.”

The myth that we become less sexual as we age was recently explored in research among women aged 55 to 81, titled Sex, Desire and Pleasure: Considering the experiences of older Australian Women.

Research author Bianca Fileborn, a lecturer in the School of Social Sciences at the University of New South Wales, tells Feelgood: “One of the key findings from our research was that women are really diverse — there’s certainly not one way that older women are ‘doing’ sexuality and sexual desire in mid to later life.

Emily Watson’s as character Yvonne Carmichael in the BBC production of ‘Apple Tree Yard’.

“In fact quantitative research carried out in western countries pretty consistently shows that a significant number of older people remain sexually active — usually a majority — at least until they reach ‘deep’ old age, in their 80s and 90s. But even then, a large minority still have sex.

“Another key finding for us was that women’s desire for sex didn’t depend necessarily on how older they were, but what else was going on their lives that influenced them.”

Irish sexologist Emily Power Smith says she knows women of all ages who, although they’re living with chronic illness and pain, are “determined to find ways to feel sexual”.

“Women who enjoy sex will have sexual desire right to the end of their lives and will find creative ways to keep that spark. But I also work with a number of women in their 50s and above, who want to know what all the fuss is about, because they could quite easily never have sex again.

“Inevitably it transpires that they have never really enjoyed sex. As they begin to discover their ability to feel sexual pleasure and arousal, their drives tend to increase.”

ONCE we are leading healthy lives low libido seems more related to the kind of sex we are having, rather than our age, she says.

“I know many young fertile women who hate sex and many older women, post menopause, who love it. Increasingly, there is research to show that older women embarking on new relationships report no reduction whatsoever in their sexual desire.”

Whatever about the complex rich reality of older women’s everyday sex lives, the screening of Apple Tree Yard may nudge the film and media world towards a more rounded representation of the mature female in all her sensual glory.

And perhaps even encourage women to explore their own sexuality more.

There is a growing posse of sexy women in their 50s and older decades, gracing the fashion and beauty world, in recent times, apart from the fact that some of the original supermodels of the ’90s, such as Cindy Crawford, Elle Macpherson and Linda Evangelista are already past the half century mark.

This year’s Pirelli calendar also sees photographer Peter Lindbergh tap into the zeitgeist, describing the make-up free portraits of his subjects as a “cry against perfection and youth”.

Some of the high-achieving women he chose to feature were actresses Julianne Moore, 56, Charlotte Rampling, 70, and Helen Mirren, 71.

However, despite this celebration of our vitality as we age, we still may have some catching up to do as individuals, says Power Smith.

“Women do a lot of self-policing when it comes to behaviour, dress and dating over a certain age. I think we are so conditioned to believe our lives are over once we’re 50 — though this is changing slowly — we get very troubled at the thought of our peers wearing short skirts, or dating younger people. But the rules don’t serve us. They never did.

“Only now some of us have the financial freedom, confidence and ability to create new norms. So come on! Let’s break some rules!”

Apple Tree Yard, BBC One, Sunday February 5, 9pm

10 ways to feel sexy

Senior sexpert, author and blogger, Joan Price, gives us these 10 tips for hot sex after 50:

1. Slo-o- o-w- w down. It takes longer for us to warm up, and this intensifies as we get older. Make the warm-up phase of sex play last hours… or days.

2. Appreciate, decorate, and celebrate your body. Jewellery, lingerie, feathers, fringe, silk, velvet, massage oil, candlelight — whatever looks good and feels good. If you know you look sexy, you’ll feel sexy.

3. Learn what you like. Explore, experiment. If you’re partnered, communicate what you like.

4. Do sexy things on your own to get in the mood long before you get naked. Work out. Swim. Dance. Fantasise a sexy scene. Spend some time humming with a vibrator, reading erotica, or watching porn — or all of these.

5. Have sex during high energy times, when your arousal is strongest, whether solo or partnered.

6. If you’re partnered, kiss and kiss. Kiss sweetly, passionately, quickly, slowly, contentedly, hungrily, lightly. All kinds of kisses help you bond with your partner, warm up, and enjoy the moment.

7. Explore sex toys and other erotic helpers, alone and/or with a partner. Lucky for us that sex toys are easy to find, fun to try, and wow, do they work!

8. Use a silky lubricant. There are many different lubricants made specifically for sex that feel great and enhance (or bring back) the joy of friction. Make applying lubricant an erotic part of sex play.

9. Enjoy the afterglow. If you’re partnered, indulge in quality snuggle time.

Solo, don’t get back to your daily life right away — bask in your feelings of wellbeing.

10. Laugh a lot. Laughter is joyful, ageless — and sexy.

Complete Article HERE!

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What your gynecologist wishes you would do

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By Linda S. Mihalov, MD, FACOG

No matter a woman’s age or how comfortable she is with her gynecologist, she may still be unsure about a few things — like which symptoms are worth mentioning, how often to make an appointment and how to prepare for an exam.

Based on my 30 years of providing gynecologic care to women of all ages, I thought it would be helpful to provide a few tips about how to make the most of your care visits.

Keep track of your menstrual cycle

Dr. Linda Mihalov

Menstruation is a monthly recurrence in women’s lives from early adolescence until around the age of 51, when menopause occurs. Because of the routine nature of this biological process, it’s easy to become complacent about tracking your periods. Thankfully, there are numerous smartphone apps that help make tracking periods easy.

Keeping track of your period is important for numerous health-related reasons. A missed period is usually the first sign of pregnancy. Determining the due date of a pregnancy starts from the date of the last menstrual period. Most forms of birth control are not 100 percent effective, and an unplanned pregnancy is best recognized as soon as possible.

Conversely, women attempting to get pregnant can use period tracking to learn when they are most fertile, which may greatly increase the chances of conception.

In addition, a menstrual cycle change can indicate a gynecologic problem, such as polycystic ovarian syndrome, or even uterine cancer. It is also often the first obvious symptom of health issues that have no obvious connection to the reproductive organs. When a regular menstrual cycle becomes irregular, it may indicate a hormonal or thyroid issue, liver function problems, diabetes or a variety of other health conditions. Women also often miss periods — or experience menstrual changes — when adopting a new exercise routine, gaining or losing a lot of weight or experiencing stress.

One late, early or missed period is not necessarily reason for alarm. But if menstrual irregularity is accompanied by other symptoms, a woman should schedule an appointment with her gynecologic care provider.

Get the HPV vaccine

Human papillomavirus, or HPV, is a very common virus. According to the Centers for Disease Control and Prevention, nearly 80 million Americans — about one in four — are currently infected. About 14 million people, including teens, become infected with HPV each year. Most people who contract the virus will clear it from their systems without treatment, but some will go on to develop precancerous or even cancerous conditions from the infection.

The HPV vaccine is important because it protects against cancers caused by the infection. It can reduce the rate of cervical, vaginal and vulvar cancers in women; penile cancer in men; and anal cancer, cancer of the back of the throat (oropharynx), and genital warts in both women and men.

This vaccine has been thoroughly studied and is extremely safe. Also, scientific research has not shown that young people who receive the vaccine are more prone to be sexually active at an earlier age.

The HPV vaccine is recommended for preteen girls and boys at age 11 or 12 so they are protected before ever being exposed to the virus. HPV vaccine also produces a more robust immune response during the preteen years. If you or your teen have not gotten the vaccine yet, talk with your care provider about getting it as soon as possible.

The CDC now recommends that 11- to 12-year-old girls and boys receive two doses of HPV vaccine — rather than the previously recommended three doses — to protect against cancers caused by HPV. The second dose should be given six to 12 months after the first dose.

Teen girls and boys who did not start or finish the HPV vaccine series when they were younger, should get it now. People who received some doses in the past should only get doses that they missed. They do not need to start the series over again. Anyone older than 14 who is starting the HPV vaccine series needs the full three-dose regimen.

Young women can get the HPV vaccine through age 26, and young men can get vaccinated through age 21. Also, women who have been vaccinated should still have cervical cancer screenings (pap smears) according to the recommended schedule.

Do not put off having children

Fertility in women starts to decrease at age 32 and that decline becomes more rapid after age 37. Women become less fertile as they age because they begin life with a fixed number of eggs in their ovaries. This number decreases as they grow older. Eggs also are not as easily fertilized in older women as they are in younger women. In addition, problems that can affect fertility — such as endometriosis and uterine fibroids — become more common with increasing age.

Older women are more likely to have preexisting health problems that may affect their or their baby’s health during pregnancy. For example, high blood pressure and diabetes are more common in older women. If you are older than 35, you also are more likely to develop high blood pressure and related disorders for the first time during pregnancy. Miscarriages are more common in older pregnant women. Losing a pregnancy can be very distressing at any age, but perhaps even more so if it has been challenging to conceive.

So, women who are considering parenthood should not put off pursuing pregnancy for too long or it may become quite challenging.

See your gynecologist for an annual visit

For women to maintain good reproductive and sexual health, the American College of Obstetricians and Gynecologists recommends that they visit a gynecologist for an exam about once a year. Generally, women should have their first pap test at age 21, but there may be reasons to see a gynecologic care provider earlier than that if there is a need for birth control or periods are troublesome, for instance. Although pap tests are no longer recommended every year, women should still see their provider annually for a gynecologic health assessment. This may or may not involve a pelvic exam.

Other reasons to visit a gynecologist include seeking treatment for irregular periods, sexually transmitted diseases, vaginal infections and menopause. Women who are sexually active or considering it can also visit a gynecologist to learn more about contraceptives.

During each visit, the gynecologist usually asks about a woman’s sexual history and menstrual cycle. The gynecologist may also examine the woman’s breasts and genitals. Understandably, a visit like this can cause discomfort among some women. However, periodic gynecological exams are very important to sexual and reproductive health and should not be skipped. The patient’s anxiety can be significantly decreased if she knows what to expect from the visit. Prepared with the knowledge of what actually occurs during an annual exam, women often find it can be a straightforward, rewarding experience.

There are several things women should do to prepare for a gynecological exam, including:

  • Try to schedule your appointment between menstrual periods
  • Do not have intercourse for at least 24 hours before the exam
  • Prior to the appointment, prepare a list of questions and concerns for your gynecologist
  • Since the gynecologist will ask about your menstrual cycle, it will be helpful to know the date that your last period started and how long your periods usually last

The pelvic exam includes evaluation of the vulva, vagina, cervix and the internal organs including the uterus, fallopian tubes and ovaries. Appearance and function of the bowel and bladder will also be assessed.

The gynecologic provider will determine whether a pap test is indicated, and order other tests as necessary, including tests for sexually transmitted infections, mammograms and screening blood work or bone density studies. Even a woman who has previously undergone a hysterectomy and, as a result, no longer needs a pap test can still benefit from visiting her gynecologist.

Primary care providers, including family practitioners and nurse practitioners, internists and pediatricians can also provide gynecological care.

Menopause

Menopause can be a challenging time. Changes in your body can cause hot flashes, weight gain, difficulty sleeping and even memory loss. As you enter menopause, you may have many questions you want to discuss with your gynecologist. It is important that you trust your gynecologist so you can confide in them and ask them uncomfortable questions. The more open you are, the better they can guide you toward the right treatment.

Complete Article HERE!

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When You Are Old, Chinese, and Gay

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Gay, lesbian, and bisexual retirees seek companionship and acceptance in old age, but some find it harder than others.

 

By Fan Yiying

Zhang Guowei, a 76-year-old bisexual veteran, is relishing his twilight years. “I couldn’t be happier with my life post-retirement,” says Zhang, who was a doctor in the army until 1994.

As a former military officer, Zhang’s monthly pension is 10,000 yuan ($1,440) — five times the average pension in Changde, the small city in central China’s Hunan province where he lives with his boyfriend. Zhang divorced his wife in 2003 and met the love of his life — Wu, who is 40 years younger — a year later on the internet. “I expect him to accompany me through the remainder of my life,” Zhang tells Sixth Tone after finishing his daily exercise routine.

Zhang says he is bisexual but prefers men. He gained support and understanding from his ex-wife and two daughters when he came out to them in 2003. When he passes on, his assets will be divided equally among his daughters and his boyfriend. “My kids have no problem sharing with Wu because they know he is the one taking care of me in my final years,” he says.

The May-December couple have been living together since 2005 in an apartment provided by the government for retired army cadres and their families. The 10-story building houses a dozen veterans in their 60s through 90s, some living alone and others with their spouses.

When Wu first moved in, Zhang told his neighbors that Wu was his gan erzi, or adopted son, whom he met online. (The Chinese concept of gan erzi allows for a sort of informal adoption of adults, with no legal or religious implications.) “I had this vague idea that they might be gay,” says 74-year-old Lu Shize, who lives downstairs. “But it’s none of my business to ask about his private life,” Lu adds.

Last year, following in other veterans’ footsteps, Zhang wrote a 218-page autobiography — including his experiences of recognizing his sexuality — and shared it with his fellow cadres. His neighbors were very understanding. “Everyone knows about us, and no one gossips or gives us a hard time,” Zhang says.

Lu, who had never before met any out gay or bisexual men, says he admires Zhang’s courage. “Being gay or not, it doesn’t change the way I see him,” Lu says. “We are in our 70s; what’s more important than being happy and healthy?”

China’s population is rapidly aging. The proportion of the population aged 60 or older was more than 16 percent at the end of 2015, according to the Ministry of Civil Affairs, and that number is only set to increase. The nation’s changing demography brings with it challenges for managing welfare and health care, especially as fewer seniors are able to count on their families for support.

Two older men hold a symbolic wedding ceremony in Beijing, Jan. 30, 2013.

Decades of family-planning restrictions mean that even seniors who have children often must become self-reliant, as children born during the one-child policy can’t afford to support two parents and four grandparents. As a result, for many elders, being childless is no longer a major concern or an unusual occurrence.

Wen Xiaojun, 56, is single and childless. Immediately after he retired in November from working as a civil servant, he rented an apartment in Sanya, on the southern island of Hainan, where he is spending six months avoiding the cold of his hometown in the eastern province of Zhejiang. “I still feel young and restless,” Wen tells Sixth Tone. “Being childless makes it easy for me to travel after retirement.”

Like other older people, LGBT seniors want to have rich, fulfilling, and independent lives. They hope that retirement will give them the opportunity to focus on what they truly love.

Wen enjoys his slow-paced life in Sanya. He goes to exhibitions, takes walks along the beach, plays volleyball with locals, and sometimes meets up with men he contacts through Blued — a popular gay social app, on which he hopes to find a long-term boyfriend.

But dating isn’t easy for older gay men. “Younger generations can build a relationship quickly by kissing or having sex soon after they meet offline,” Wen explains. “But we want something more spiritual and stable.”

Similarly, 62-year-old Ah Shan, as he’s called within the gay community, says that finding a partner is his biggest problem these days. His finances are secure, as he owns his apartment in Guangzhou — capital of southern China’s Guangdong province — and receives a monthly pension of about 5,000 yuan, but he has been single for four years and is ready for that to change. In the meantime, he is renting out one of his bedrooms to gay friends so he has some company at home.

Ah Shan poses for a picture in Guangzhou, Guangdong province, 2013.

Most gays, lesbians, and bisexuals of Ah Shan’s generation knew little about their sexual orientation until internet access became available at the turn of the millennium. Even when Ah Shan was working in the U.S. in the late 1980s, he refused to consider himself gay because the only information he’d heard about gay topics in China was AIDS-related or implied that homosexuality was shameful or immoral. “I think I was brainwashed,” Ah Shan laughs.

Over the last two years, Ah Shan has been working on a gay oral history project, recording the stories of older gay men in Guangzhou. He has talked to more than 60 gay men aged from 60 to 90, who have experienced some of China’s most critical historic moments, from the Cultural Revolution to the nation’s opening-up era. “If we don’t record them now, part of the important history of LGBT in China will be gone,” he says.

Many of the men are married and choose not to come out to their families. “They go to this particular park to chat with other gay men in the daytime to release their emotions, but when the sun goes down, they have to return home to bear their family responsibilities,” Ah Shan says with a sigh.

Ah Shan’s own parents passed away before he was brave enough to tell them the truth. His mother died in 2000, a year before homosexuality was declassified as a mental illness in China.

Compared with gay and bisexual men, older women find it even more difficult to disclose or discuss their sexual orientation. Since 2010, 45-year-old Yu Shi from Chengdu, the capital of Sichuan province, has been working on an oral history project for older same-sex-attracted women across China, but she says the process of locating participants and persuading them to share their stories is tough.

“Chinese women are in a weak position in the family, which doesn’t allow them to speak out for themselves,” Yu says, adding that of the 30 or so lesbians who have taken part in the project over the last six years, only one has come out to her family. Many won’t divorce their husbands even if they have female partners. “Chinese people are very concerned with saving face, and they think it’s a loss of face to get a divorce if you’re already a grandparent,” she says.

Yu and her 40-year-old girlfriend have lived together for over a decade, but despite their enduring, loving relationship, they can’t enjoy the security of a formal union, as same-sex marriage is not yet legal in China. Some issues can be resolved by making a will, but others — like legal or medical power of attorney — remain a problem.

According to Yu, some LGBT seniors who are single and childless have considered building their own retirement estate where they can live together and take care of one another. Although they aren’t opposed to regular nursing homes, Yu says “they prefer to live in a place where they can open their hearts and share their experiences with others in the same circumstances.”

A lesbian couple kiss each other during an event in Shanghai, Dec. 22, 2013.

As more and more seniors live separately from their children, retirement facilities in China have struggled to meet growing demand. The government encourages investment in privately owned nursing homes, but so far none have been established exclusively for members of sexual minority groups.

Little public attention is given to the needs of older LGBT people, but to Wang Anke, a 50-year-old bisexual woman from Beijing, these individuals don’t do enough to stand up for themselves, either. “We are almost invisible,” she says.

Wang married her husband in 1990 and plans to spend the rest of her life with him. Though Wang considers herself happy and fortunate, she says that most older lesbian and bisexual women she knows are pessimistic about their senior years. “They’re lonely and lack emotional care,” Wang says, adding that many would rather live alone than move into a nursing home where they fear they can’t be themselves. “Loneliness will go to the grave with them.”

But while some LGBT seniors advocate dedicated nursing homes, Ah Shan opposes the idea of separate services. “In the long run, LGBT people shouldn’t lock ourselves in a so-called safe place,” he says. “What we really need is for the overall environment to allow us to live comfortably in the community.”

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