Does Sexual Communication Promote Partner Relationship among Older Adults? A Cross-Cultural Analysis

Abstract

This study examined age, gender, and ethnic differences in sexual communication satisfaction and relationship satisfaction among participants. Participants included 164 Caucasian Americans, 76 African Americans, and 112 Korean Americans residing in Northwest Ohio in the United States with 206 females (58.5%) and 146 males (41.5%) at the age range 40–84 years (mean = 55, SD = 10.45). Results identified significant differences in sexual communication satisfaction and relationship satisfaction based on age, gender, and ethnicity. Caucasian Americans and African Americans had significantly higher scores than Korean Americans in sexual communication satisfaction and/or relationship satisfaction. Age, gender, and ethnic specific programs to help older adults improve their quality of life through sexual communication are suggested.

Keywords

Sexual communication relationship satisfaction ethnicity gender age

A human developmental process is accompanied by sexual development, which is also progressing through the socially defined stages of childhood, adolescence, adulthood, and later life (DeLamater & Friedrich, 2002). Accordingly, each stage of life brings a unique set of characteristics and challenges related to sexuality. Late middle adulthood is the phase of life during which middle adults go through various physiological changes affecting their sexuality. For instance, women approach the onset of menopause, associated with a marked decline in the production of estrogen, while men experience a gradual decline in the production of testosterone, leading to a decrease in libido (Decaroli & Rochira, 2016). Despite the negative effects on sexual function due to age-related psychological changes, sexual maturation continues because human sexuality is an integral part of the whole person as lifelong process (Stuart & Sundeen, 1979).

Although older adults are the fastest growing segment of the population in the United States, little is known about sexuality in later life (DeLamater & Sill, 2004). Frequently, it is assumed that older adults are seldom interested in their sexuality due to a natural decrease in their sexual desire or sexual performance (Bradway & Beard, 2015). The media also provides many negative images of older adults, often portraying them as asexual or describing sexual activity as happening only among young people (Santos-Iglesias, Byers, & Moglia, 2016). These misunderstandings for sexual life of the aging population have negative influence on the decision of older couples to engage in sexual activities (Syme, 2014).

Regardless of this social stigma, sexuality of older adults becomes an undeniable social issue in the recent aged society with longer life expectancy. Many older Americans are sexually active in their 70 s and 80 s although the frequency of sexual behavior typically declined (DeLamater & Moorman, 2007). Notably, older adults continued to be interested in sexual activity as long as health conditions do not hinder their sexual activity because they believe that sex is important for a healthy relationship (Holden et al., 2005; Jung & Schill, 2004). Studies have also found that a healthy sexual life offers physical and mental health benefits, while sexual distress is associated with anxiety and depression (Trudel, Villeneuve, Préville, Boyer, & Fréchette, 2010). In addition, sexual satisfaction is positively related to the quality of relationship (Heiman et al., 2011; Scott, Sandberg, Harper, & Miller, 2012; Thomas, Hess, & Thurston, 2015; Woloski-Wruble, Oliel, Leefsma, & Hochner-Celnikier, 2010).

In this sense, an accurate understanding of sexuality issues in older adults is critical to improving their quality of life. Furthermore, exploring attitudes, experiences and knowledge regarding sexual health issues in older adults may provide insight into the development of tailored education programs for middle-aged adults because intimacy and relationship factors of older adults may have precursors which occur in middle age (Kalra, Subramanyam, & Pinto, 2011). However, studies regarding sexuality in older adults to date are limited due to a lack of diversity, excessively focusing on samples of White older adults, while there are few studies including perspectives of racial-ethnic minorities (Huang et al., 2009). Cultural factors should be considered as an important aspect when assessing the needs of older adults in the arena of sexual health (Orel & Watson, 2012; Tanga, Bensmana, & Hatfield, 2012). In this context, the current study examined whether age, gender, and ethnicity impact on sexual life related concerns, which include sexual communication satisfaction and relationship satisfaction among middle-aged and older Caucasian, African, and Korean Americans.

Relationship Satisfaction, Sexual Satisfaction, and Sexual Communication Satisfaction

Relationship satisfaction has been defined in many different ways. Rusbult and Buunk, (1993) defined it as an interpersonal evaluation of the positivity of feelings for one’s partner and attraction to the relationship. Meanwhile sexual satisfaction is more than experiencing orgasm or the frequency of sexual intercourse, which had sometimes been used as measures of sexual satisfaction (Byers, 1999). Lawrance and Byers (1995) defined sexual satisfaction as “an emotional response arising from one’s subjective evaluation of the positive and negative dimensions associated with one’s sexual relationship” (p. 268).

The association between relationship satisfaction and sexual satisfaction has been clearly identified in the literature. For example, a high relationship satisfaction with their significant other correlates greatly with sexual satisfaction (Dundon & Rellini, 2010; Sprecher, 2002). However, the interplay between sexual and relationship satisfaction is not unidirectional because communication plays a significant role in improving relationship satisfaction and sexual satisfaction of couples (MacNeil & Byers, 2005; Montesi, Fauber, Gordon, & Heimberg, 2011; Yoo, Bartle-Haring, Day, & Gangamma, 2013). Couples who were relationally satisfied were positively satisfied with their level of sexual communication and reversely, levels of sexual communication among couples influenced their relationship satisfaction (Scott et al., 2012). Sexual communication also gave impacts on sexual satisfaction; couples who communicated well about their sex lives were more satisfied with their sexual relationship (Dundon et al., 2010; La France, 2010). In this way, sexual communication plays as a strong indicator for relationship and sexual satisfaction within couples (Mark & Jozkowski, 2013).

Sexual communication may be more important for middle-aged or old adults because sexual communication must take place in a long-term committed relationship in order to make a unique contribution to sexual satisfaction (MacNeil & Byers, 1997). In this context, older couples are likely to communicate through problems in a healthier and more open way than younger couples (Scott et al., 2012). Additionally, Byers (2005) found that the higher quality of intimate communication enhanced sexual satisfaction and relationship satisfaction of individuals in long term relationships. Important indicators of sexual communication satisfaction include overall relationship satisfaction, age, the regularity of sexual activity, socioeconomic status, and sexual need (Chao et al., 2011). However, despite these findings, there is little research on sexual communication among older adults who have diverse ethnicity backgrounds with differences in the expectation and acceptance of sexuality (Huang et al., 2009).

Age and Gender Differences

Age has significant effects on the sexual lives of older adults due to decreasing sexual desire or sexual drive (Chao et al., 2011; Huang et al., 2009). Sexual activity in older adult males also decrease due to a decline in testosterone (Scott et al., 2012). In addition, physical health issues such as erectile dysfunction influence the frequency of sexual activity for older males, which may deteriorate their quality of life (Smith et al., 2007). Similarly, as old women age, their sexual activity decreases due to physiological or physical changes such as menopause which may adversely affect their sexual desire or ability to engage in sexual activity (Thomas et al., 2015). Furthermore, females are more likely to reduce or cease their sexual behaviors due to the loss of a partner due to their partner passing away or a divorce (Huang et al., 2009). In sum, the physical and physiological changes of older adults have wide ranging impacts on their mental health, quality of life, sexual desire, and satisfaction (Smith et al., 2007).

Cultural Differences

Culture is an integrated system of shared values, beliefs, and lifestyles that arise from the human need to adapt to social, physical, and biological environments (Hofstede, 2001). Accordingly, cultural differences have bearing on sexual attitudes and behaviors depending on one’s internalized cultural values and beliefs (Chun, Moos, & Cronkite, 2006; Lazarus & Folkman, 1984). It is frequently assumed that in making their sexual decisions Asian people display more collectivist motives such as wishing to please their partners and maintaining a relationship, while Americans exhibit more individualistic motives, such as seeking sexual pleasure and reducing sexual stress (Tanga et al., 2012). In addition, people in a collectivistic society are more hesitant to express themselves verbally, while people in an individualistic society exhibit more self-expression (Suh, 2000). In the same context, people living in sexually liberal country, such as the United States, tend to more often disclose sexuality than do people living in sexually conservative countries like China (Schmitt, 2005).

Based on the current findings and gaps in the literature, the purpose of this study is to explore age, gender, and ethnic differences in relationship and sexual communication satisfaction among a diverse sample including Caucasian Americans, African Americans, and Korean Americans. The following research questions were explored in this study:

Is there any age differences regarding sexual communication and relationship satisfaction among middle and older couples?

Is there any gender differences regarding sexual communication and relationship satisfaction?

Is there any race/ethnic differences regarding sexual communication and relationship satisfaction?

Are the levels of sexual communication satisfaction associated with those of relational satisfaction among participants?

Methods

Participants

This study was approved from Institutional Review Board (IRB) of a mid-sized public institution in the Midwest. Purposive and convenience sampling methods were used to recruit participants from senior centers and community centers in Northwest Ohio. Potential participants were given a recruit script with the purpose of the study, procedures, and an explanation about ethical considerations. Researchers answered questions from them and provide the consent forms. Participants who agreed to voluntary participation signed the consent form. And then, they filled out the questionnaires. They were given the identical questionnaires in English and Korean, respectively. A total of 352 middle-aged and older adults participated in the study, including 164 (or 46.6%) Caucasian Americans, 76 (or 21.6%) African Americans, and 112 (or 31.8%) Korean Americans residing in Northwest Ohio in the United States. Within the sample, 206 (or 58.5%) of participants were females and 146 (or 41.5%) were males. The study participants were divided into three age groups: the young (aged 40 to 49), the intermediate (aged 50 to 59) and the aged (60 and over) (see Table 1). For the purpose of this study, only participants who self-reported being married, cohabitating, or having a romantic sexual partner were eligible for participating in this study. Korean Americans who have a permanent residency or U.S. citizenship were included for this study.

Table 1

Demographics (N = 352)

		Ethnicity
		Caucasian American	African American	Korean American	Total Number (%)
Gender	Female	95	47	64	206 (58.5%)
	Male	69	29	48	146 (41.5%)
Age	40–49	58	36	20	114 (32.4%)
	50–59	65	30	52	147 (41.8%)
	60+	41	10	40	91 (25.9%)
Total		164 (46.6%)	76 (21.6%)	112 (31.8%)	352 (100%)

Instruments

A structured questionnaire was completed through the face–to–face individual interviews. The demographic information included items on age, gender, and race/ethnicity. The sexual communication satisfaction was measured by “The Sexual Communication Satisfaction Scale” (Wheeless, Wheeless, & Baus, 1984) and the relationship satisfaction was measured by “The Relationship Satisfaction Scale” (Hendrick, 1988). Respondents were asked to specify their degree of agreement with statements such as “I tell my partner when I am especially sexually satisfied” using a 7- point response scale ranging from 1 (Disagree) to 7 (Agree) for the sexual communication satisfaction. For the relationship satisfaction, participants responded to survey items such as “How well does your partner meet your needs?” using a 5- point Likert response scale ranging from 1 (Low) to 5 (High). For Korean Americans, the instrument was translated into Korean language. Then, a bilingual research assistant translated Korean into English to ensure the accuracy of the translation and another bilingual research assistant translated them back into Korean.

In the present study, “The Sexual Communication Satisfaction Scale” was a stable tool for all ethnic groups in measuring sexual communication satisfaction, indicating that the Cronbach alphas, a measure of internal consistency, were .91 for the English version for the Caucasian American and African American participants and .97 for the Korean version for the Korean American participants. For “The Relationship Satisfaction Scale,” the Cronbach alphas were .68 for the English version and .71 for the Korean version.

The age, gender and cultural differences in sexual communication satisfaction and relationship satisfaction were analyzed with the analysis of variance (ANOVA) including the interaction effects.

Results

For sexual communication satisfaction and relationship satisfaction, the results showed that there were significant differences based on age, gender, and race/ethnicity. By age, the young (aged 40 to 49) group reported highest sexual communication satisfaction score among three groups, while the intermediate (aged 50 to 59) group reported higher sexual communication satisfaction score than the aged (60 and older) group (see Table 2). However, for relationship satisfaction, the study result showed no significant differences among three age groups.

Table 2

Sexual Communication Satisfaction and Relationship Satisfaction by Age ( N = 352)

Dependent Variable	(I) Age	(J) Age	Mean Difference (I-J)
Sexual Communication Satisfaction	40–49	50–59	7.623**
		60+	12.868***
	50–59	60+	5.245*
Relationship Satisfaction			Not Significant

Note: *p < 0.05, **p < 0.01, ***p < 0.001.

By gender, there were significant differences in the sexual communication satisfaction (p < 0.01) and the relationship satisfaction (p < 0.05). Male participants reported higher scores for both sexual communication satisfaction and relationship satisfaction than female (see Table 3).

Table 3

Sexual Communication Satisfaction and Relationship Satisfaction by Gender (N = 352)

Dependent Variable	(I) Gender	(J) Gender	Mean Difference (I-J)
Sexual Communication Satisfaction	Male	Female	4.118**
Relationship Satisfaction	Male	Female	0.634*

Note: *p < 0.05, **p < 0.01, ***p < 0.001.

By ethnicity, Korean Americans reported the lowest sexual communication satisfaction score than the other groups (p < 0.001), while there were no significant differences between Caucasian Americans and African Americans (see Table 3). There were interaction effects for age and ethnicity on the sexual communication satisfaction. Caucasian Americans and African Americans showed little change in sexual communication satisfaction between the young (aged 40 to 49) and the intermediate groups (aged 50 to 59), while the aged group (60 years and older) of Caucasian Americans showed lower score than that of African Americans. Korean Americans showed rapid drop in sexual communication satisfaction scores between the young and the intermediate groups, while there was little score change between the intermediate and the aged groups (see Fig. 1). For relationship satisfaction, there are also significant differences based on ethnicity. Caucasian Americans reported higher relationship satisfaction score than Korean Americans (p < 0.001), while there were no significant differences between Korean Americans and African Americans (see Table 4).

Figure 1

Interaction effect of ethnicity and age on sexual communication satisfaction.

Table 4

Sexual Communication and Relationship Satisfaction by Ethnicity (N = 352)

Dependent Variable	(I) Ethnicity	(J) Ethnicity	Mean Difference (I-J)
Sexual Communication Satisfaction	Caucasian American	Korean American	12.575***
	African American	Korean American	14.236***
Relationship Satisfaction	Caucasian American	Korean American	2.121***

Note: *p < 0.05, **p < 0.01, ***p < 0.001.

For the purpose of making comparisons for relationship satisfaction between participants with the more sexual communication satisfaction and those with the less sexual communication satisfaction, respondents who scored higher than the combined mean for the two groups were coded as “more sexual communication” group and those whose scores fell below the combined mean were coded as “less sexual communication” group. As a result, about 53.4% of participants were categorized as “more sexual communication,” while 46.6% appeared “less sexual communication.” Among “more sexual communication” and “less sexual communication” groups, there were significant differences in the mean for relationship satisfaction, regardless of their ethnicity. That is, “more sexual communication” group reported higher relationship satisfaction scores than “less sexual communication” group (p < 0.001) (see Table 5).

Table 5

Sexual Communication Satisfaction and Relationship Satisfaction

Sexual Communication Satisfaction by Level of Relationship Satisfaction
Sexual Communication Satisfaction	M/SD
Low Relationship Satisfaction	48.463/17.813
High Relationship Satisfaction	63.509/17.640
Between Group		F: 56.041***
Relationship Satisfaction by Level of Sexual Communication Satisfaction
Relationship Satisfaction	M/SD
Low Sexual Communication Satisfaction	23.895/4.774
High Sexual Communication Satisfaction	28.423/3.057
Between Group		F: 34.347***

Note: **p < 0.01, ***p < 0.001.

Similarly, to make comparisons for sexual communication satisfaction between participants with the more relationship satisfaction and those with the less relationship satisfaction, participants who scored higher than the combined mean for the two groups were coded as “more relationship” group and those whose scores fell below the combined mean were coded as “less relationship” group. As a result, about 52.9% were categorized as “more relationship,” while 47.1% appeared “less relationship.” Between the “more relationship” group and the “less relationship” group, there were significant mean differences in sexual communication satisfaction, regardless of their ethnicity. That is, the “more relationship” group reported higher sexual communication satisfaction scores than the “less relationship” group (p < 0.001) (see Table 5).

Discussion

Unlike stereotypes regarding sexuality among older adults, many older adults experience sexual desire and keep their sexual activities with age even in their 70 s and 80 s (DeLamater & Moorman, 2007). However, despite the growing older population, little research has been done focusing on a sexuality issue among older adults who have diverse ethnic backgrounds. The present study aimed to explore the differences of relationship and sexual communication satisfaction among middle-aged and older couples in three different ethnic groups.

The study results showed that there were significant differences in sexual communication satisfaction based on age, gender, and ethnicity. As previous findings, age was negatively related to sexual communication; for example, those in the young group (40–49 years) were more likely to satisfy with sexual communication satisfaction than those in their 50 s and 60 s. Similarly, those in their 50 s were more likely to be satisfied than those in their 60 years and older. It is quite natural that the younger adults are more likely to engage in sexual activity than the older adults (Huang et al., 2009). The findings are reinforced by the physiological and health changes which come to both women and men as they age, affecting their sexual desire and satisfaction (Smith et al., 2007). The findings support that of previous study that the important indicators of sexual communication satisfaction include age of the individuals and sexual needs (Chao et al., 2011). Meanwhile, there were no significant differences in relationship satisfaction depending on age. There are few studies examining age effects on relationship satisfaction: therefore, it is not possible to compare with each other. However, this finding doesn’t support one general assumption that relationship satisfaction follows a curvilinear pattern over the course of marriage, rising in the early years of marriage, declining in the middle years, and recovering through the later years (Charles & Carstensen, 2002).

For gender, male participants showed higher satisfaction scores than female counterparts in both sexual communication satisfaction and relationship satisfaction items. There is little research for gender differences in sexual communication satisfaction. However, this finding supports partly those of previous studies that males than females would report higher levels of sexual satisfaction or relationship satisfaction (Heiman et al., 2011; Laumann et al., 2006; Yoo et al., 2013). A study indicated that higher sexual satisfaction of males may come from overestimating that of their partners (Fallis, Rehman, & Purdon, 2014). In addition, there are many findings regarding gender differences in ways of communication; females tend to engage in conversation to form and keep relationships, while males talk to create and maintain status and dominance in relationships (Tannen, 1990). Even in sexual communication, females are more likely to self-disclose than do males (Byers & Demmons, 2010), while for males sexual communication was more critical for relationship satisfaction at the beginning of a relationship, and less significant as the relationship progresses (Montesi et al., 2011). As a result, these differences in communication may leave females less satisfied with sexual communication and relationship satisfaction.

Study findings also showed ethnic differences in sexual communication satisfaction as well as relationship satisfaction; Caucasian Americans and African Americans had higher scores than Korean Americans in sexual communication satisfaction and/or relationship satisfaction. The comfort level talking about sexuality within a couple may vary depending on their social and cultural norms which influence a wide variety of human behaviors including sexual one (Haning et al., 2007). Asian older immigrants (e.g., Korean Americans) tend to show more conservative to the sexuality topic than do their non-Asian counterparts due to their cultural teaching of Confucius or an effect of a collectivistic culture: sexual abstinence is considered as a virtue (Gao et al., 2012; Mehrotra & Wagner, 2009; Tanga et al., 2012). However, in spite of ethnic differences in sexual communication satisfaction, there are little difference in relationship satisfaction between Korean Americans and African Americans. That is, for Korean Americans, the levels of sexual communication satisfaction do not seem to affect their relationship satisfaction greatly.

There are interaction effects for age and ethnicity on sexual communication satisfaction: the aged group (60 years and older) of Caucasian Americans had a lower score than that of African Americans while Korean Americans showed rapid drop in sexual communication satisfaction scores between the young (aged 40 to 49) and the intermediate (aged 50 to 59) groups. However, there is little research on sexual communication and relationship satisfaction of older adults based on race and ethnicity to compare with (Huang et al., 2009).

The study also found that between participants with the more sexual communication satisfaction and those with the less sexual communication satisfaction, the sexual communication satisfaction was found to contribute significantly to their relationship satisfaction. Inversely, among participants with the more relationship satisfaction and those with the less relationship satisfaction, the more relationship satisfaction group reported significantly higher sexual communication satisfaction scores than the less relationship satisfaction group. These findings support those of previous studies: that is, levels of sexual communication among couples influenced their relationship satisfaction and reversely couples who were relationally satisfied were positively satisfied with their level of sexual communication (Montesi et al., 2011; Scott et al., 2012).

Implications

Sexual relationship occurs across the lifespan and continues to provide positive effects on the mental health, physical health and quality of life of older adults. More importantly, the effective sexual communication enhances sexual and relationship satisfaction of individuals in long term relationships (Byers, 2005). In this sense, exploring sexual communication and relationship satisfaction in older adults may also provide insight into the development of tailored education programs for middle-aged adults because intimacy and relationship factors of older adults may have precursors in their middle age (Kalra et al., 2011). In addition, in order to effectively deliver health care services for older adults, it is important for health care providers to be educated on sexual health of older adults. Specifically, service providers need to know how to address older people’s sexuality issues based on their social and cultural backgrounds. For instance, some older adults may hesitate to share their concerns or questions about their sexual issues due to age gap between service providers and themselves or cultural differences in terms of sexuality. To address this kind of situation, service providers need to establish safe environment for older adults to share their sexual communication and satisfaction issues. Additionally, there are gender differences in expressing their sexual desires or self-disclosure of sexuality. Considering all these circumstances, age, gender, and culture-specific programs may work better for each older adult who is facing any sexual communication and relationship issues.

Limitations

Despite significant findings from this study, there are several important limitations in the present study. First, this study did not consider the specific situations of participants (e.g., health status and disability status), which may impact their sexual communication satisfaction and relational satisfaction. Second, participants of this study were drawn from a non-probability sampling method residing in Northwest Ohio; therefore, the results cannot be generalized to older adults living in different states in the United States.

Conclusions

Although there are some limitations, this study extends previous research in understanding sexuality issues in later life, especially sexual communication and relationship satisfaction of old adults who have different ethnic backgrounds. Many older Americans are sexually active in their 70 s and 80 s although the frequency of sexual behavior typically declined (DeLamater & Moorman, 2007). In this sense, we may conclude that sexual satisfaction still has positive effects on their quality of life, and an accurate understanding of sexual communication in older adults is critical to improving relationship satisfaction.

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