Changing norms of older men’s sexuality in the sexological discourse during Czechoslovak socialism: Dementia as an interpretative lens to make sense of sexual expressions in later life

Introduction

There is a long tradition of discussion highlighting the desexualisation of older bodies (Clarke and Griffin, 2008; Gonzales, 2007; Gott, 2005). Simpson (2021: 37) points out the existence of ageist erotophobia as a specific form of anxiety about older people as sexual beings. This expression of ageist attitudes is also materialised in the failure even to recognise older adults as individuals with sexual needs and in the discomfort that is often associated with the idea of older people’s sexual activity. However, simultaneously, the medicalisation of sexual (dis)function in later life has brought an unprecedented interest in sexual practices in older age (Marshall, 2010, 2011, 2012). The assumption that sexual decline in both men and women represents an integral part of growing older has been replaced by the inclusion of sexual activity in the representation of healthy ageing. Changing sexual capacities in later life are seen through this prism as a medical problem that should be monitored, treated and solved (Marshall, 2010). This change of perspective is illustrated in, for example, the results of the review of studies focusing on sexual functioning in older adults conducted by DeLamater (2012). The review highlights that older adults remain sexually active into their 70s and 80s and that physical ageing is not necessarily associated with a decline in sexual functioning. Furthermore, regular sexual expression is associated with good mental and physical health (DeLamater, 2012). The ability to demonstrate one’s sexual activity has become an integral part of the idealised images of the third age (Marshall, 2011), while the ability to remain sexually active across the lifespan has become part of the project of healthy and active ageing (Marshall, 2012; Marshall and Katz, 2013; Sandberg, 2013). Sexual activity in later life has become not only an option but almost an imperative (Calasanti and King, 2005).

The increasing emphasis on the re-sexualisation of old age is often linked to the development of new pharmaceutical products (Marshall and Katz, 2013; Wentzell, 2017) and/or interpreted as a consequence of the rise of consumerism and the cultures of the third age that creates new expectations and representations of sexually active later life (Gilleard and Higgs, 2014). The new emphasis on the importance of sexual activity and intimacy for the process of ageing well is situated mainly in the mid-1990s and associated with the cohort of baby boomers. There is often an (unspoken) notion of the relative uniformity of discourses of sexuality and ageing prior to this period stressing the taken-for-granted image of desexualized later life.

(Post-)socialist countries have been stereotypically presented as particularly backward and prudish regarding sexuality issues (Funk and Mueller, 1993; Takásc, 2015). However, an increasing amount of research emphasises that human sexuality and family issues were not left out of the socialist modernisation project in East–Central Europe (Jarska, 2019, 2021; Kościańska, 2020; Klich-Kluczewska, 2017; Lišková, 2018; Lišková and Szegedi, 2021). Despite the growing attention that has been paid to the study of discourses of sexuality in the Eastern Bloc (i.e. Lišková 2016, 2018; Sokolová 2012, 2021; Takács 2015), the studies exploring such discourses in the context of later life are still missing. The study by Bělehradová and Lišková (2021) represents one of the exceptions by demonstrating how Czechoslovak medical experts gradually discussed and liberalised climacteric women and their sexuality from the end of the 1950s until the mid-1970s. The authors, however, do not say much about the sexuality of older men during socialism. Our study seeks to fill this gap by focusing on the expert discourses regarding older men’s sexuality in socialist Czechoslovakia between the 1940s and the 1980s. We want to further elaborate on the discussion regarding sexuality as an integral part of the socialist modernisation project. Our study shows that even people in post-reproductive age were not seen as asexual in socialist Czechoslovakia. With this research, we stress the need to broaden existing knowledge about the modern history of older persons’ sexuality to take into account societies outside the prevailing Western history with its dominant narratives. Older men’s sexuality was the subject of discussion among medical experts (primarily sexologists and psy-experts) in Czechoslovakia during socialism. Lišková (2018) demonstrates that sexologists were the main experts who held jurisdiction over human sexuality in Czechoslovakia. The foundations of modern medical sexology were laid in Czechoslovakia in the interwar period, but its most significant developments date to the socialist era. At the beginning of the 1950s, there was only a small circle of experts gathered around the founder of Czechoslovak sexology, Josef Hynie. However, sexology was growing rapidly, and sexologists gradually gained the power to shape ideas about gender, sexuality and family relationships in Czechoslovakia (Lišková, 2018). When homosexuality was decriminalised in Czechoslovakia in 1961, ¹ sexologists played a key role in the process (Davison, 2021: 94–103; Seidl, 2012: 265–295; Sokolová 2012: 31–32). Sexology solidified its position through cooperation with the state (in promoting pro-population policies) in the 1970s and was successfully institutionalised in the same decade (Lišková, 2018: 15–16).

Kościańska (2020: 7), who studied Polish sexology during socialism, notes that ‘the history of expert knowledge of sexuality is also the history of sexuality’. Accordingly, we study the development of ideas about ageing sexuality during Czechoslovak socialism by analysing medical (primarily sexological) discourse. Our research is based on medical texts published between 1948 and 1989. Specifically, we focus on the medical journals Časopis lékařů českých (Journal of Czech Physicians), Československá gynekologie (Czechoslovak Gynaecology), Československá psychiatrie (Czechoslovak Psychiatry) and Praktický lékař (General Practitioner), which represented a space for sharing knowledge among the medical community during socialism, and the criminological journals Československá kriminalistika (Czechoslovak Criminology) and Kriminalistický sborník (Criminal Proceedings). We analyse the official Czechoslovak sexology textbooks from the founder of Czechoslovak sexology, Josef Hynie, which came out in 1940, 1968 and 1980. We also examine the popular-science magazine Zdraví (Health) and the first book about ageing sexuality, Stárnutí: osobnost a sexualita (Ageing: Personality and Sexuality), which was written for a lay audience by psychologist and sexologist Pondělíček (1981, 1987). We collected all available medical texts devoted to the ageing male sexuality published in Czechoslovakia during socialism. The fact that we present examples of non-harmful sexuality of older men only from the late 1970s onwards does not mean that we have missed some data. On the contrary, until the late 1970s, Czechoslovak experts neglected the possibility of normal ageing male sexuality and focused exclusively on the paedophilic behaviour of older demented men. Our analysis reflects this disparity.

Inspired by Hacking’s (1986, 1995) theory of making up people, we claim that ‘new kinds of people come into being’ through the changes in expert knowledge. Hacking emphasises that it is especially psychiatrists and medical experts who are constantly trying to refine descriptions and medical categories. When the experts create new classifications of categories, new kinds of people are created hand in hand. The changes in Czechoslovak experts’ descriptions of older men’s sexuality and the related creation of new kinds of sexual beings are at the centre of our attention. Our intention is not to analyse how older men behaved sexually in their lived reality or how they perceived experts’ (re)classifications of ageing sexuality. We track how medical experts’ understanding of older men’s sexuality changed during socialism. More specifically, we analyse how medical experts rejected the stereotype of asexual older people and created a new ideal of sexually active older men.

Hacking (2003: 17) stressed that ‘[n]ames organise our thoughts’. Thus, the experts’ labels and vocabulary help us to understand their thinking about ageing sexuality during socialism. To capture the discourse and to be historically accurate, we try to preserve the experts’ expressions of the time as precisely as possible. We are aware that some terms might sound offensive to contemporary readers, but we want to maintain the authenticity of the data.

Our research begins in 1940, when Josef Hynie published the founding text of modern Czechoslovak sexology, Introduction to Medical Sexology. In this book, Hynie (1940) spoke about asexual older people and connected the sexual behaviour of older men with dementia and paedophilic delinquency. We analyse the transformations of experts’ ideas about older man’s sexuality up to the 1980s, when Czechoslovak sexologists presented sexual activity as a normal part of healthy ageing and omitted dementia from the discourse accordingly. Following Hacking’s insight, we claim that the kind of older men with dementia with pathological sexuality implemented in Czechoslovak sexology by Hynie in 1940 was replaced in the medical discourse by a new kind of healthy older men with active sexuality in the early 1980s. We explain that this shift in medical discourse was linked to new ideas about active ageing as well as changes in the Czechoslovak classification of (ageing) paedophilic delinquents.

We argue that the definition of normal/pathological sexuality in later life reflected the prevailing discourses regarding ageing. Furthermore, we point out the essential role of the representation of dementia in the process of the construction of normal/pathological sexual expressions in later life. Reference to dementia played an essential role in defining the boundary between both normal/pathological ageing and normal/pathological sexuality in later life. In all the studied periods, dementia functioned as a cultural signifier for the monstrous sexual self (Grigorovich, 2020) that was mobilised to make sense of ageing sexualities. However, we simultaneously point out that the ways in which – and the intensity with which – dementia was mobilised as an interpretative lens for sexuality in later life varied over time, and these variations mirrored the changes in meanings attributed to ageing and old age. Our analysis of the way in which the idea of pathology/normality regarding ageing sexualities in socialist Czechoslovakia was constructed is, therefore, primarily an analysis of how the idea of what constitutes healthy and normal ageing became established in expert discourses.

Asexual ageing as normal ageing: Dementia as a way of making sense of sexual expression in later life (the 1940s–1950s)

The topic of ageing sexuality in the Czechoslovak modern medical discourse was addressed for the first time by the founder of Czechoslovak sexology, Josef Hynie, in the book Introduction to Medical Sexology, published in 1940. This expert captured contemporary knowledge about normal and aberrant sexual phenomena, building on information from various disciplines. The sexologist summarised that while sexual lust might be increased at the beginning of the male and female climacteric ² (at approximately the age of 50), sooner or later there comes ‘a period of reduced sexual demand, when one’s own sex drive falls asleep’ (Hynie, 1940: 464). In short, Hynie presented asexual ageing as the norm. However, he stressed at the same time that older men have paedophilic tendencies often, when brain changes disrupt their mental functions. According to Hynie, ‘[t]he sexual function of ageing men loses its natural goal; only its individual components are involved, not harmonised, disordered. . . . Often, we find paedophilic tendencies, also incest, and various other indiscretions as well if the person [the object of a man’s sexual interest] can only be a source of pleasant feelings in the genital area. . . . Similar attacks are also related to the amorality of the elderly when arteriosclerotic, or other changes in the brain, cause a gradual disruption of mental functions and weakening of intelligence. It can be a cause of sexual indiscretion’ (Hynie, 1940: 469–470). The sexologist expected that when mental functions decrease during ageing and men suffer from cognitive impairment, they can easily begin to exhibit pathological sexual behaviour. Hynie even marked older men as the prime offenders in paedophilic crimes: ‘Paedophilia comes most often in the cases of ageing people and people with somatic or psychosexual infantilism. . . . Genuinely independent primary sexual inclinations to children occur less often; rather more in people burdened by different signs of mental aberrations’ (Hynie, 1940: 152). Thus, in the founding text of modern Czechoslovak sexology, sexual manifestations of older men were portrayed as uncontrolled, pathological and potentially dangerous.

In the following years, medical experts’ attention regarding sexuality in older age focused more intensively on women. Bělehradová and Lišková (2021) show that Czechoslovak gynaecologists were the first to challenge the stereotype about the asexuality of (post-)climacteric women. As more and more women confided in their gynaecologists about concerns regarding their (upcoming) climacteric and anticipated negative changes in their (sexual) lives, from the early 1960s, doctors started to reflect on the prevailing myth connecting post-reproductive age with asexuality and its negative effects on older women. The gynaecological debates gradually resulted in the rejection of the stereotypical image of fading women’s sexuality. Instead, since the turn of the 1960s, experts have begun classifying older women as sexual beings and emphasised the importance of satisfying sexuality for their well-being (Bělehradová and Lišková, 2021). The debates regarding post-reproductive women’s sexuality contrasted with the lack of attention that had been paid to older men’s sexuality. For a very long period, Hynie’s book remained the only reference point regarding older men’s sexuality in Czechoslovak expert discourse. In accordance with Hynie’s conception, expected and normal older men’s sexuality was depicted as passive and absent, and male sexual expressions in later life were addressed only in the context of pathology.

The stereotype of older men with dementia as frequent sexual offenders persisted in the following two decades. While Czechoslovak gynaecologists started to study and liberalise climacteric women and their sexuality (Bělehradová and Lišková, 2021), older men’s sexuality was either omitted in the expert discussions or associated with pathological behaviour explained by dementia. This is also reflected in the published articles and textbooks – while there was some information about older paedophilic delinquents, there were no mentions of normal sexual expressions of elderly men. During the 1950s, information about older men’s sexuality was only present in texts devoted to the forensic assessment and treatment of sexual offenders. Ferdinand Knobloch and Jiřina Knoblochová briefly described pathological manifestations of older men’s sexuality in the book Forensic Psychiatry for Lawyers and Medical Doctors, published in 1957. The psychiatrists stressed that ‘[i]n dementia, inhibitions fall away, and here the sexual urge may manifest itself as morbidly heightened. The vague desire is not directed toward a definite goal, but manifests itself, for example, in exhibitionism, stimulating the genitals of small children, etc’ (Knobloch and Knoblochová, 1957: 55). To support this claim, Knobloch and Knoblochová added a case report about a 68-year-old man who suddenly ‘sexually assaulted’ his 35-year-old married daughter. Until the incident, the family did not observe the man’s dementia manifestations or any alterations in his behaviour and personality. However, when experts diagnosed him with dementia after the assault, ‘only then did [the family] remember that he had recently changed in character’ (Knobloch and Knoblochová, 1957: 55). According to the forensic experts, the man’s sexual expressions suggested that there was something mentally wrong with him, leading them to diagnose him with dementia. We argue that because the experts still perpetuated the stereotype of asexual older men, they understood the older man’s (unconventional) sexual behaviour as an indicator of his diminished intellectual capacities. Thus, the dementia diagnosis served not only to explain (or justify) the older man’s disordered sexual act but also to reframe his past behaviour.

The prevailing view of the 1950s that older men with dementia were frequent perpetrators of sexual offences (mainly paedophilic delicts) is mirrored in the only publicly available medical statistics for sexual delinquency from Czechoslovakia. The statistics were included in a sexological article devoted to ‘The Question of Sane and Corrective Measures for Sexual Delinquents’ and showed the total number of cases of men who had committed sexual delict that all Czechoslovak sexologists forensically assessed in 1958 (Nedoma and Freund, 1959). The article’s authors, Karel Nedoma and Kurt Freund, presented rather simple information in the statistics: the age and marital status of the delinquents, the types of sexual delicts, the psychiatric diagnoses and recidivism. Moreover, they did not suggest any relationships between the variables. Out of 24 men, there were ten men older than 50, who constituted almost half of the cases. Paedophilic delicts were the most represented in the sample (16 cases), while other forms of sexual crimes were present only sporadically (Nedoma and Freund, 1959: 264). The experts explained the sample composition as follows: ‘It is very reasonable from the legal point of view that the most common occurrence in our forensic assessments were paedophilic activities, whose severe social dangerousness is evident and also reflected in the length of the penalty. . . . From the expert point of view, it is not possible to anticipate that sexual abuse or other sexual delicts could be committed by an individual who is fully healthy mentally and adequately developed sexually’ (Nedoma and Freund, 1959: 265). We assert that as older men personified the image of the paedophilic offender – the idea that Hynie rooted in the Czechoslovak discourse in the early 1940s – younger perpetrators may have been more difficult for Czechoslovak experts to classify, detect and prosecute as paedophilic delinquents during the 1950s. Therefore, in this sample, where most of the offences were paedophilic, the group of men over 50 was the largest. These statistical results retrogressively consolidated the notion of sexually perverse older men whose uncontrolled sexual behaviour was caused by arteriosclerosis or other mental pathologies.

Rejecting the stereotype about older men as prime paedophilic delinquents (the 1960s)

Older men’s sexual expressions continued to be associated with pathology and explained by dementia in the 1960s. The only shift in the discourse happened in the second half of the 1960s when Czechoslovak experts disproved the current stereotype about older men as primary offenders of paedophilic crimes. Sexologists gradually became interested in sexual delinquency issues during the 1960s (Lišková, 2016, 2018; Lišková and Bělehradová, 2019). They were mainly concerned with paedophilic delinquency, as this was the most frequent crime of a sexual nature in Czechoslovakia (Nedoma et al., 1968a, 1968b: 171). The sexologists extensively researched 100 paedophilic delinquents to understand the whole issue better between 1964 and 1967 (Nedoma et al., 1969; Pondělíčková et al., 1969). Many articles in medical journals presented the research results in the second half of the 1960s. The researchers repeatedly highlighted one conclusion in particular. After comparing the offenders’ age, the experts found that ‘[t]he usual notion that paedophilic delinquency is more common for old or ageing men is not valid. The delinquency occurrence concerning the offender’s age at the time of the crime was the same in all 10-year age groups from adulthood [age 18] to the age of 59. The average age of the delinquents was 37; just 28% were older than 50’ (Nedoma et al., 1968a: 393). Thus, the authors refuted the stereotype of older men as the primary perpetrators of paedophilic crimes. However, they did not focus any more attention on the group of older sexual delinquents and the possible causes of their pathological sexual behaviour. Although Czechoslovak sexologists rejected the stereotype, they continued to see paedophilic delinquency as the most common crime of older men, and dementia remained the most likely explanation for their pathological sexual behaviour during the 1960s and the first half of the 1970s. This was also the only representation of older men’s sexuality present in the Czechoslovak medical discourse until the mid-1970s.

Rejecting the asexual stereotype (the late 1970s)

The discourse changed rapidly in the second half of the 1970s when Czechoslovak experts pointed out the normality of older men’s sexuality. Recognising the normality of ageing male sexuality, experts gradually liberalised the conventional and non-harmful sexuality of older men. For example, sexologist Topiář (1977a: 882) stressed the following: ‘There are many misconceptions and myths about the sexuality of the elderly. In this context, there is talk about negative variations of sexual behaviour; in these ways, their sexual behaviour is considered undesirable. . . . Sexuality does not expire at 60, and doctors should be prepared to discuss sexual issues with their older patients. Relatively little attention has thus far been paid to sexuality in geriatric age groups. . . . The need for eroticism and sex does not vanish with increasing age’. Older men’s sexuality was no longer discussed solely in the context of sexual delinquency. Sexual issues of older men after a heart attack received experts’ attention within a new state-supported rehabilitation care programme for cardiac patients (Bělehradová, 2022). When the experts dealt with the sexual troubles (mainly psychological and erectile problems) of men suffering from cardiac disease, they normalised older men’s sexuality and stressed its benefits for the physical and mental health of people. The interdisciplinary Pilsen team (consisting of a cardiologist, sexologist, psychiatrist, rehabilitation doctor, etc.), which was the first to focus on the sexual activity of cardiac patients within the rehabilitation programme, even highlighted that ‘[w]e should see coital activity as physical therapy sui generis’ (Kotál et al., 1978a: 199). The experts recognised that the lack of information about older people’s sexuality and the sexuality of people with (cardiovascular) disease worried the patients and their sexual partners. Men recovering from a heart attack suffered from ‘psychological inhibitions’ during intercourse because of the fear of possible health complications. They had tendencies to ‘anxiously monitor their subjective states during foreplay, intercourse and after ejaculation’ (Kotál et al., 1977: 138). Pilsen experts thus highlighted that ‘[t]he task of the psychologist and sexologist is to help the patient after a myocardial infarction to overcome the blocking anxiety and the dampening role of self-consciousness’ (Kotál et al., 1978b: 559). Accordingly, they stressed that in general, ‘[p]roper sex education is needed to change our culture’s rejection of the sexual needs of the elderly and the sick’ (Kotál et al., 1978b: 561). From then on, Czechoslovak experts highlighted that myths about asexual older people must be abandoned, and sexual activity in older age should be freed from the stereotypes.

When the sexual behaviour of older men started to be recognised as normal in Czechoslovak medical discourse, the ideas about older sexual offenders transformed accordingly. The new space opened in relation to cardiac patients prompted a broader reconsideration of received wisdom. Dementia was no longer used as the only explanation for the pathological behaviour of older men. Instead, the experts shifted attention to loneliness and helplessness instigated by sexual frustration, pointing out that asexual myths still prevail in society and negatively affect and inhibit the normal and healthy sexuality of older people. As Topiář explained, ‘[s]ocial norms require abstinence, whereas the ageing individual is neither prepared nor biologically compelled to adapt to it. . . . The myth of sexless old age is harmful; it interferes with the health and well-being of many old people. Considerable ignorance in matters of sex and considerable restrictions in matters of behaviour that might lead to satisfaction and relief of sexual tension make sexual problems one of the causes of feelings of helplessness among the elderly. Inappropriate quests for relief from the tension and seeking ways to reduce these feelings of helplessness lead to quite unsatisfactory relationships and to conflicts with the public interest. . . . The socially non-conventional sexual activities such as precipitous access to women, paedophilia, exhibitionist, and voyeuristic activities often develop through the search for new ways to relieve sexual desires’ (Topiář, 1977a: 882–883).

In 1977, Topiář published a study based on data from 20 men aged 61–88 years who had committed paedophilic delicts. Topiář (with his colleagues from a psychiatric hospital in Opava) had forensically examined the men after they had committed their crimes over the previous 10 years. The experts identified ‘elements of senility and arteriosclerotic dementia’ in half of the men (Topiář, 1977b: 235). Although they thought dementia to be a ‘rich medium for social non-conventional sexual activities’ (Topiář, 1977b: 235), they focused much more on the marital and social situations of the perpetrators. According to the presented data, half of the men had lived alone without a relationship for at least 2 years before their sexual delinquency. Out of ten married men, one man did not live with his wife, and two men had chronically ill, bedridden wives (in other words, the women were not willing or able to have sex with their husbands). Overall, one-third of the men had not had sexual intercourse with ‘age-appropriate women’ for two to 14 years prior to their sexual ‘contact’ with children (Topiář, 1977b: 235). Topiář concluded that the men were socially isolated and sexually frustrated. Moreover, as the author stressed, the sexual contact involved girls between ten and 14 years old, and ‘full three-quarters’ of the children ‘reacted to sexual contacts with the elderly men in both suggestive and provocative ways, actively cooperating or displaying elements of prostitution behaviour’ (Topiář, 1977b: 235). The description of children’s initiating behaviour was based solely on the testimony of the men examined. It seems, however, that the expert did not question it in any way and even labelled it as prostitution.

In this way, Topiář explained the men’s sexual delinquency through ‘the helplessness of old age’ and suggested ‘examining the factors that may create a potential delinquent situation from a victimological perspective’ (Topiář, 1977b: 234–235). In today’s perspective, we would say that the sexologists quite openly victim-blamed the children while making excuses for the elderly. Although the older men were still considered as having dementia in half of the cases, dementia no longer served as the main (or only) explanation for their pathological sexual behaviour, as had been the case in the previous decades. Czechoslovak experts recognised non-harmful sexual manifestations of an old man as healthy and vital. Therefore, according to the experts, it was not dementia itself but rather the lack of sexual opportunities that could lead to pathological sexual behaviour when a sexually (and socially) frustrated man came into contact with an ‘initiating’ child. The role of dementia as an explanatory factor for older men’s (pathological) sexual behaviour gradually diminished.

Active ageing and the transformation of dementia explanations (the 1980s)

In the second half of the 1970s, Czechoslovak experts discussed the issues of older men’s sexuality primarily within their medical community and journals. Since the turn of the 1970s, they have also increasingly informed the general public about the subject (e.g. in the popular-science magazine Health). In addition, the first book devoted to older people’s sexuality came out in 1981, targeting a lay audience (Pondělíček, 1981). The increase in the number of texts on sexuality in older age was related to the emphasis on an active life in older age, which gradually received attention in Czechoslovakia (see Bělehradová, 2022). Health magazine often informed its readers about the need to stay mentally as well as physically active (bc, 1980; Hlavová, 1982; Pacovský, 1980; Šimek, 1983; Šipr, 1983). At around the same time, U.S. experts (mainly sexologists and urologists) connected healthy and successful ageing with the need to stay sexually active (Katz and Marshall, 2003; Sandberg, 2015: 219).

It seems that Czechoslovak and Western experts had a similar idea(l)s. Writing for medical experts, psychologist Fukalová highlighted that ‘[a]n escape into passivity continues by escaping into illness, leading to numerous difficulties of a hypochondriacal nature. An ageing person’s body becomes sickly and incapable in every way. The rejection of sexuality as a symbol of life makes way for sickness, emptiness, and death’ (Fukalová, 1982: 184). Topiář summed up the situation similarly when he wrote the following: ‘In any case, a man must not avoid and give up sexual contact. . . . Any inhibition of loving and sexual activity is harmful under conditions of involution. . . . If men have lived their sexual lives fully and their sexuality has not been hampered by anxiety or convention, sexuality in old age becomes a positive orientation to life, a source of confidence and stability’ (Topiář, 1980b: 271). Experts spread the new norm of staying sexually active in old age among the general population. As psychologist and sexologist Pondělíček advised readers of the magazine Health, ‘[a]n ageing person ³ should not refuse to continue with his sex life! On the contrary, he should seek new and appropriate possibilities in his sexuality, just as he seeks new and appropriate “age” norms in other areas of his activity’ (Pondělíček, 1979: 19). He stressed the key role that sexual life has for happiness ‘in every relationship and every period of human life’ (Pondělíček, 1981: 179). Topiář, as the first of the Czechoslovak experts, noted in a journal devoted to medical professionals that sexual needs should be recognised and respected in residential care as well. The author criticised that in institutional care there still prevailed ‘a pragmatic restriction or even ignorance of the erotic–sexual needs of these people [older people living in institutional care]. The embarrassment prevailing so far has meant that the necessary discussion on these issues has not yet taken place, and there are no appropriate programs to address the socio-sexual frustration and emotional, sexual deprivation of these people’ (Topiář, 1980a: 492). He highlighted the need for change in institutional practice to ensure a more sensitive approach to the sexuality of its residents. The author envisaged possible solutions (regardless of gender) – to give the residents more privacy and provide them with erotic material or ‘concubinage’ (by which he probably meant providing sexual assistance to the elderly). The suggestions, however, remained only theoretical and no adjustments were implemented during socialism.

The new definition of older people’s sexuality was closely interlinked with the representation of what constitutes healthy and normal ageing. The norm of asexual older men established in the 1940s was replaced by the norm of an active sexual life in older age in Czechoslovakia. During the second half of the 1970s, sexologists expected that when a man was no longer sexually active, his sexual urge could surprise and overwhelm him during an interaction with a child. The experts viewed the child as a substitute for the man’s preferred adult woman and expected that the sudden sexual impulse could result in unexpected sexual delinquency (Topiář, 1977b). However, in the 1980s, experts expected a healthy man to have normal sexual needs, and when an older man presented himself as asexual, experts saw it as a sign that there should be something wrong with him sexually. When such a man was charged with paedophile delinquency, his proclaimed asexuality could newly signal to the experts that the man was not sexually normal and might suffer from a sexual deviation. For example, Jaroslav Zvěřina claimed in the magazine Health that ‘the basic characteristics of the sexual acts of ageing and old men include [among others, that] the perpetrator denies any sexual activity’ (Zvěřina, 1981: 18).

Sexuality was recognised as an integral part of older age in the 1980s. This change of perspective also enabled the interpretation of sexual expressions in the context of an old person’s previous biography and not as an isolated expression of a pathology at a certain period of life. According to sexologists Zvěřina and Mellan (1982: 572), ‘[i]f a man suffers from sexual deviance, his ability to perform alternative conventional sex decreases with age. For this reason, many paedophilias are probably activated in old age’. Simultaneously, the role of dementia as the main interpretative lens for sexual ab/normality diminished. The experts considered that dementia somewhat loosened people’s existing restraints, thus revealing their true sexual desires that they had been able to suppress or cover up during their lives.

Sexologists even retrospectively questioned the diagnosis of dementia that used to be expected in ageing paedophilic delinquents and pointed out that not all paedophilic perpetrators diagnosed with dementia were truly demented. This breakthrough in understanding paedophilic older offenders followed after the foundation of in-patient sexological protective treatment. ⁴ The first sexological ward for treating sexual delinquents was founded in a psychiatric hospital in Horní Beřkovice in the mid-1970s (Lišková and Bělehradová, 2019; Singer et al., 1977). Under the conditions of the total institution (see Goffman, 1961), the experts had an opportunity to systematically work with the older delinquents and observe them for a long period of time. This was a crucial change in comparison to the previous decades. Until the early 1980s, all the data and medical (sexological and psychiatric) texts about older sexual delinquents were based on forensic evaluation of the men after they had committed a sexual crime. The assessment took only a few hours. The sexological protective treatment thus enabled the sexologists to systematically observe the delinquents for an extended period and reveal that the patients usually did not have dementia. A team of sexologists wrote the following after 10 years of working with older sexual delinquents at the first sexological department: ‘It cannot be assumed that if the cause of their sexually delinquent behaviour was indeed organic damage to the central nervous system (as the expert [forensic] opinion concluded for most), the psychotherapeutic component of the treatment would have strengthened the control mechanisms sufficiently to prevent relapse into sexually delinquent behaviour. Accepting the organic aetiology of the sexually delinquent behaviour, we would have to legitimately expect that as age progresses, the organic defect will deepen, leading to further deterioration of ability, judgement, and control and, in effect, to greater recidivism’ (Zimanová et al., 1986: 519). The experts thus revisited forensic evaluations of the older paedophilic delinquents and argued that the older men previously diagnosed with dementia did not, in fact, have dementia in most cases. Consequently, Czechoslovak experts concluded that the reason behind the sexual delinquency of older men was, in most cases, not dementia but his permanent deviant sexuality. To conclude, new attitudes towards sexual desire in old age – namely, that sexual desire was a normal phenomenon across the life span – enabled these clinical experts to critically revise earlier assumptions that all manifestations of sexuality in later life must indicate dementia. Czechoslovak experts began to think of ageing delinquents as potential (continuous) sexual deviants and not just demented (and helpless) old men.

Discussion

In her analysis of the discourse on sexuality and later life, Gott (2005) points out that over the second half of the 20th century, sex for pleasure was gradually transformed into behaviour positively associated with health. Expressing oneself sexuality (preferably through sexual intercourse) became an integral part of the representation of healthy ageing (i.e. Marshall, 2012). We have explored how the discourse on older men’s sexuality changed in the medical expert discourse in socialist Czechoslovakia between the 1940s and the late 1980s. Our analysis points out a shift in the 1970s from the image of asexualised old age to the expectation that a certain level of sexual activity is healthy in later life. Despite the stereotypical image of socialist countries as restricting liberal discussions regarding sexuality, our research suggests that sexological experts in socialist Czechoslovakia largely promoted the idea that sexual activity represents a desirable and expectable part of ageing. Older adults have been gradually included in the normative expectation regarding compulsory sexuality (Gupta, 2015).

As already pointed out by previous studies exploring the role of sexology in socialist Czechoslovakia (Bělehradová and Lišková, 2021; Lišková, 2016, 2018; Lišková and Bělehradová, 2019; Sokolová, 2012, 2021), sexology gained a prominent status among medical experts. Having jurisdiction over human sexuality, sexologists shaped public debates regarding, for example, gender roles, sexual relationships and family life (Lišková, 2018) and impacted the state policies and legislation in areas such as the decriminalisation of homosexuality (Davison, 2021; Seidl, 2012; Sokolová, 2014). Our analysis points out that sexologists also took part in debates on what constitutes normal/pathological ageing, as sexologists were the main experts who had the power to define and shape sexual norms in older age in Czechoslovakia. Borrowing from Hacking’s (1986, 1995) theory of making up people, we tracked how Czechoslovak experts created new kinds of ageing people. We show how the experts’ discourse on older men’s sexuality changed in line with new ideas about active ageing as well as the transformation of the classification of (older) paedophilic delinquents. More specifically, we demonstrate how the founder of Czechoslovak sexology, Josef Hynie, introduced the kind of older men with dementia with pathological sexuality in his pioneering book on Czechoslovak sexology in 1940, showing that this kind represented the main classification of older men’s sexuality until the second half of the 1970s. When medical knowledge about ageing and sexual delinquency changed, the experts accordingly made up a new kind of healthy older men with active sexuality. Older women’s sexuality was liberalised primarily by gynaecologists from the turn of the 1950s until the mid-1970s (Bělehradová and Lišková, 2021), while older men’s sexuality was discussed mainly by sexologists in Czechoslovakia. Thus, the explanation for why older men’s sexuality was long neglected in expert debates or discussed exclusively in the context of pathological sexuality lies in the different types of experts (gynaecologists vs sexologists) who paid attention to the topic of older people’s sexuality (Eyal, 2013).

Men’s sexual activity in older age was primarily addressed in the context of sexual delinquency until the second half of the 1970s, allowing no articulation of the representation of older men’s sexuality beyond the language of pathology. Our analysis points out the essential role of the representation of dementia in the process of construction of normal/pathological sexual expressions in later life. The reference to dementia was used in the expert discourse as an interpretative lens to make sense of older men’s sexualities. As pointed out by Sandberg (2018), the embodiment of dementia is associated with the inability to perform proper gendered subjectivities, producing forms of femininity and masculinity that threaten heteronormativity. The sexual expressions of people experiencing dementia are perceived as beyond their control and as threatening (Tzeng et al., 2009), reflecting the inability to present the authentic self. Dementia is represented as a disease that brings about a split between who a person was before (Higgs and Gilleard, 2016; Sweeting and Gilhooly, 1997) and thread to social order (Behuniak, 2011). Within discourses presenting old age as a period of asexuality, paedophilic expressions of older people became imaginable only as a major rupture in a life biography and not as a manifestation to be understood by exploring its roots in the context of a previous biography. Interpreting these acts as manifestations of dementia allowed for understanding these sexual expressions without having to redefine ideas of asexual old age as well.

Our analysis points out the essential role of the image of older men with dementia as a signifier for the abject and monstrous sexual self in the medical and forensic discourses in socialist Czechoslovakia. Unlike the sexuality of (post-)climacteric women, which was also discussed in the context of the social role of older women and the quality of health (Bělehradová and Lišková, 2021), older men’s sexuality was until the second half of the 1970s only addressed within the field of the study of sexual delinquency (as part of studies on sexual offenders). The image of older men with dementia symbolised the monstrous sexual self and embodied both a sexual pathology and a pathological way of ageing. The very presence of men’s sexual activity in older age challenged the discourse of passive and absent older men’s sexuality and strengthened the idea that such expression represented a break in the expected course of ageing. The idea that older men can experience sexual needs problematized the very conception of what normal ageing looks like. In this context, dementia became a means of making sense of the existence of sexual needs in older age – both as a sexual pathology and as a pathology within ageing. It enabled the idea of asexual ageing to be (re)constructed even within the evidence of sexual expressions in older age.

The representation of a new category of healthy older men with active sexuality, which appeared in the late 1970s, gradually integrated sexual activity into the representation of what constitutes normal ageing. Older men’s sexuality was newly addressed in the context of a discussion regarding well-being in later life. However until the late 1970s, the act of sexual offence represented a rupture in the expectations regarding both normal sexuality and normal ageing, from the early 1980s, the sexual delinquency of older men was addressed in the context of their previous biographies as an extension of long-lasting individual sexual urges. Simultaneously, dementia disappeared as the primary interpretative lens for understanding the causes of sexual offences perpetrated by older men.

Our paper contributes to the discussion concerning the means through which meanings of ageing and sexuality are communicated, pointing out, among others, the role of representations of dementia within sexological discourse in Czechoslovak sexology. Dementia represented not only a medical diagnosis but an interpretative framework that both reflected and reconstructed social expectations regarding ageing and sexuality. We show how a change in the idea of what constitutes healthy ageing has allowed sexuality to become a visible part of life in old age. This visibility translated, among other things, into the possibility of interpreting older men’s sexual delinquency differently. Thus, the change in discourses around healthy ageing brought about a change not only in the perception of what is ‘normal’ in sexuality in older age, but also in the interpretive frameworks used to explain the roots of pathological sexual behaviour in old age.