{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:00:08Z","timestamp":1785157208481,"version":"3.55.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NHS England"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sexual health in later life remains an overlooked area in healthcare. Despite being the first point of contact for most patients, primary care healthcare professionals (HCPs) rarely initiate discussions about sexuality with older adults (OAs). This study investigates how these HCPs talk about sexuality in later life and examines the extent to which existing guidelines support inclusive, age-appropriate care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore NHS primary care professionals\u2019 experiences of discussing sexuality with OAs, including the circumstances that prompt these conversations, the factors shaping them and the extent to which professionals use formal guidance in these discussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative design was used. Semi-structured interviews were conducted with 16 HCPs in England. An inductive reflexive thematic analysis approach was used for data analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three key themes were identified. First, unspoken assumptions, clinician discomfort and time pressures often limited discussions, creating uncertainty around how and when to address sexual health. Second, physical symptoms served as \u2018natural openers,\u2019 but such conversations maintained their medical focus, overlooking other aspects contributing to OAs\u2019 quality of life. Third, participants described minimal reliance on guidance, instead drawing on instinct or experience. Overall, discussions were reactive and shaped by competing clinical demands. Clinicians consistently expressed a need for clear, concise and psychologically informed tools and training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the need to normalise later-life sexual health discussions by attending to clinician discomfort and integrating inclusive practices into routine care. Recognising sexuality as important in later life may help challenge age-related assumptions in primary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag219","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:40:14Z","timestamp":1783424414000},"source":"Crossref","is-referenced-by-count":0,"title":["Sexuality behind clinic doors: experiences of healthcare professionals in primary care addressing sexuality with older people"],"prefix":"10.1093","volume":"55","author":[{"given":"Andrea","family":"Kocurkova","sequence":"first","affiliation":[{"name":"School of Psychology, Sport Science & Wellbeing, College of Health and Science, University of Lincoln , Brayford Pool, Lincoln LN6 7TS ,","place":["United Kingdom of Great Britain and Northern Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"De Boos","sequence":"additional","affiliation":[{"name":"University of Nottingham Faculty of Medicine and Health Sciences, Doctorate in Clinical Psychology, School of Medicine, University of Nottingham , B Floor, YANG Fujia Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB ,","place":["United Kingdom of Great Britain and Northern Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Cogger-Ward","sequence":"additional","affiliation":[{"name":"Doctorate in Clinical Psychology, School of Medicine, University of Nottingham , B Floor, YANG Fujia Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB ,","place":["United Kingdom of Great Britain and Northern Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072708080090700_ref1","doi-asserted-by":"publisher","DOI":"10.18356\/13bf5476-en","volume-title":"Statistical Papers - United Nations (Ser. A), Population and Vital Statistics Report","author":"United Nations","year":"2019."},{"key":"2026072708080090700_ref2","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1016\/j.socscimed.2003.08.025","article-title":"General practitioner attitudes to discussing sexual health issues with older people","volume":"58","author":"Gott","year":"2004","journal-title":"Soc Sci Med"},{"key":"2026072708080090700_ref3","volume-title":"Sexual Health, Human Rights and the Law","author":"World Health Organization","year":"2015"},{"key":"2026072708080090700_ref4","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1111\/hex.12418","article-title":"Let\u2019s talk about sex: older people\u2019s views on the recognition of sexuality and sexual health in the health-care setting","volume":"19","author":"Bauer","year":"2016","journal-title":"Health Expect"},{"key":"2026072708080090700_ref5","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1177\/15598276241293100","article-title":"Sexuality in older adults: comprehensive strategies for clinicians and patient-centered care","volume":"19","author":"Penhollow","year":"2025","journal-title":"Am J Lifestyle Med"},{"key":"2026072708080090700_ref6","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1080\/00224499.2010.548610","article-title":"Seeking medical help for sexual concerns in mid- and later life: a review of the literature","volume":"48","author":"Hinchliff","year":"2011","journal-title":"J Sex Res"},{"key":"2026072708080090700_ref7","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1016\/S0140-6736(13)62366-1","article-title":"Sexual function in Britain: findings from the third National Survey of sexual attitudes and lifestyles (Natsal-3)","volume":"382","author":"Mitchell","year":"2013","journal-title":"The Lancet"},{"key":"2026072708080090700_ref8","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1056\/NEJMoa067423","article-title":"A study of sexuality and health among older adults in the United States","volume":"357","author":"Lindau","year":"2007","journal-title":"N Engl J Med"},{"key":"2026072708080090700_ref9","doi-asserted-by":"publisher","first-page":"91","DOI":"10.29173\/cjfy18949","article-title":"A review of the literature on sexual development of older adults in relation to the asexual stereotype of older adults","volume":"5","author":"Kenny","year":"2013","journal-title":"CJFY"},{"key":"2026072708080090700_ref10","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1080\/13691058.2018.1465203","article-title":"How do older people discuss their own sexuality? A systematic review of qualitative research studies","volume":"21","author":"Gewirtz-Meydan","year":"2019","journal-title":"Cult Health Sex"},{"key":"2026072708080090700_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103566","article-title":"Barriers to older adults seeking sexual health advice and treatment: a scoping review","volume":"107","author":"Ezhova","year":"2020","journal-title":"Int J Nurs Stud"},{"key":"2026072708080090700_ref12","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1093\/fampra\/cmh509","article-title":"\u201cOpening a can of worms\u201d: GP and practice nurse barriers to talking about sexual health in primary care","volume":"21","author":"Gott","year":"2004","journal-title":"Fam Pract"},{"key":"2026072708080090700_ref13","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1093\/fampra\/cmg612","article-title":"Barriers to seeking treatment for sexual problems in primary care: a qualitative study with older people","volume":"20","author":"Gott","year":"2003","journal-title":"Fam Pract"},{"key":"2026072708080090700_ref14","doi-asserted-by":"publisher","first-page":"2658","DOI":"10.1111\/j.1743-6109.2012.02856.x","article-title":"Why don\u2019t healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United Kingdom","volume":"10","author":"Dyer","year":"2013","journal-title":"J Sex Med"},{"key":"2026072708080090700_ref15","doi-asserted-by":"publisher","first-page":"807","DOI":"10.31128\/AJGP-04-18-4556","article-title":"Do you talk to your older patients about sexual health? Health practitioners\u2019 knowledge of, and attitudes towards, management of sexual health among older Australians","volume":"47","author":"Malta","year":"2018","journal-title":"Aust J Gen Pract"},{"key":"2026072708080090700_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2023.107795","article-title":"Promoting sexual health in older adults: findings from two rapid reviews","volume":"177","author":"Stowell","year":"2023","journal-title":"Maturitas"},{"key":"2026072708080090700_ref17","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1016\/S0277-9536(02)00180-6","article-title":"How important is sex in later life? The views of older people","volume":"56","author":"Gott","year":"2003","journal-title":"Soc Sci Med"},{"key":"2026072708080090700_ref18","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1080\/14681994.2014.936722","article-title":"Sex, desire and pleasure: considering the experiences of older Australian women","volume":"30","author":"Fileborn","year":"2015","journal-title":"Sex Relatsh Ther"},{"key":"2026072708080090700_ref19","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1111\/j.1365-2524.2005.00566.x","article-title":"\u2018I daresay I might find it embarrassing\u2019: general practitioners\u2019 perspectives on discussing sexual health issues with lesbian and gay patients","volume":"13","author":"Hinchliff","year":"2005","journal-title":"Health Soc Care Community"},{"key":"2026072708080090700_ref20","volume-title":"Self-Efficacy: The Exercise of Control","author":"Bandura","year":"1997"},{"key":"2026072708080090700_ref21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l2389","article-title":"The 10 minute appointment","author":"Salisbury","year":"2019","journal-title":"BMJ"},{"key":"2026072708080090700_ref22","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1186\/s12909-023-04901-1","article-title":"Gaps in sexual health content of healthcare professional curriculum: a systematic review of educational interventions","volume":"23","author":"Prize","year":"2023","journal-title":"BMC Med Educ"},{"key":"2026072708080090700_ref23","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1126\/science.185.4157.1124","article-title":"Judgment under uncertainty: heuristics and biases: biases in judgments reveal some heuristics of thinking under uncertainty","volume":"185","author":"Tversky","year":"1974","journal-title":"Science"},{"key":"2026072708080090700_ref24","volume-title":"Women\u2019s Reproductive Health Conditions: First Report of Session 2024\u201325 (HC 337)","author":"Women and Equalities Committee","year":"2024"},{"key":"2026072708080090700_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12450","article-title":"Talking to healthcare providers about sex in later life: findings from a qualitative study with older Australian men and women","volume":"36","author":"Fileborn","year":"2017","journal-title":"Australas J Ageing"},{"key":"2026072708080090700_ref26","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1080\/14681811.2021.2002138","article-title":"Educational training for healthcare professionals about sexual health and behaviour in later life: a scoping review","volume":"22","author":"Davis","year":"2021","journal-title":"Sex Education"},{"key":"2026072708080090700_ref27","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1111\/hsc.13172","article-title":"Communicating with older adults about sexual issues: how are these issues handled by physicians with and without training in human sexuality?","volume":"29","author":"Levkovich","year":"2021","journal-title":"Health Soc Care Community"},{"key":"2026072708080090700_ref28","doi-asserted-by":"publisher","DOI":"10.4324\/9780203328422","volume-title":"Managing the Monstrous Feminine: Regulating the Reproductive Body","author":"Ussher","year":"2006","edition":"1"},{"key":"2026072708080090700_ref29","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m693","article-title":"Health equity in England: the Marmot review 10 years on","volume":"368","author":"Marmot","year":"2020","journal-title":"BMJ"},{"key":"2026072708080090700_ref30","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s13178-013-0109-6","article-title":"Evidence of absence: midlife and older adult sexual health policy in Australia","volume":"10","author":"Kirkman","year":"2013","journal-title":"Sex Res Soc Policy"},{"key":"2026072708080090700_ref31","volume-title":"Sexual Health, no. QS178","author":"National Institute for Health and Care Excellence","year":":       . 2019"},{"key":"2026072708080090700_ref32","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s11195-007-9044-x","article-title":"The extended PLISSIT model for addressing the sexual wellbeing of individuals with an acquired disability or chronic illness","volume":"25","author":"Taylor","year":"2007","journal-title":"Sex Disabil"},{"key":"2026072708080090700_ref33","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1177\/17579139221106348","article-title":"Trends and projections in sexually transmitted infections in people aged 45 years and older in England: analysis of national surveillance data","volume":"143","author":"Camacho","year":"2023","journal-title":"Perspect Public Health"},{"key":"2026072708080090700_ref34","volume-title":"GP Patient Survey 2025: National Results and Trends","author":"Ipsos & NHS England","year":"2025"},{"key":"2026072708080090700_ref35","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l84","article-title":"The NHS long term plan","author":"Alderwick","year":"2019","journal-title":"BMJ"},{"key":"2026072708080090700_ref36","volume-title":"A Realist Approach for Qualitative Research","author":"Maxwell","year":"2012"},{"key":"2026072708080090700_ref37","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1080\/13645570701401305","article-title":"Sampling knowledge: the hermeneutics of snowball sampling in qualitative research","volume":"11","author":"Noy","year":"2008","journal-title":"International Journal of Social Research Methodology"},{"key":"2026072708080090700_ref38","doi-asserted-by":"publisher","first-page":"63","DOI":"10.3316\/QRJ1102063","article-title":"Purposeful sampling in qualitative research synthesis","volume":"11","author":"Suri","year":"2011","journal-title":"Qual Res J"},{"key":"2026072708080090700_ref39","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1136\/archdischild-2022-325049","article-title":"Fraudulent participants in qualitative child health research: identifying and reducing bot activity","volume":"108","author":"O\u2019Donnell","year":"2023","journal-title":"Arch Dis Child"},{"key":"2026072708080090700_ref40","doi-asserted-by":"publisher","first-page":"2954","DOI":"10.1111\/jan.13031","article-title":"Systematic methodological review: developing a framework for a qualitative semi-structured interview guide","volume":"72","author":"Kallio","year":"2016","journal-title":"J Adv Nurs"},{"key":"2026072708080090700_ref41","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","year":"2019","journal-title":"Qualitative Research in Sport, Exercise and Health"},{"key":"2026072708080090700_ref42","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1080\/2159676X.2019.1704846","article-title":"To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales","volume":"13","author":"Braun","year":"2021","journal-title":"Qualitative Research in Sport, Exercise and Health"},{"key":"2026072708080090700_ref43","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1177\/1468794112446106","article-title":"\u2018Unsatisfactory saturation\u2019: a critical exploration of the notion of saturated sample sizes in qualitative research","volume":"13","author":"O\u2019Reilly","year":"2013","journal-title":"Qualitative Research"},{"key":"2026072708080090700_ref44","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-69909-7_3470-2","volume-title":"Thematic Analysis: A Practical Guide","author":"Braun","year":"2022"},{"key":"2026072708080090700_ref45","volume-title":"Supporting Research in Counselling and Psychotherapy Qualitative, Quantitative, and Mixed Methods Research","author":"Braun","year":"2023"},{"key":"2026072708080090700_ref46","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s13584-020-00366-5","article-title":"Sex for seniors: how physicians discuss older adult\u2019s sexuality","volume":"9","author":"Gewirtz-Meydan","year":"2020","journal-title":"Isr J Health Policy Res"},{"key":"2026072708080090700_ref47","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1108\/02683940810850790","article-title":"Leading with emotional labor","volume":"23","author":"Humphrey","year":"2008","journal-title":"Journal of Managerial Psychology"},{"key":"2026072708080090700_ref48","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1007\/978-3-319-73820-8","volume-title":"Contemporary Perspectives on Ageism, International Perspectives on Aging","author":"Gewirtz-Meydan","year":"2018"},{"key":"2026072708080090700_ref49","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.1111\/j.1365-2648.2010.05260.x","article-title":"Discussing sexuality with patients: nurses\u2019 attitudes and beliefs","volume":"66","author":"Saunam\u00e4ki","year":"2010","journal-title":"J Adv Nurs"},{"key":"2026072708080090700_ref50","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1177\/1049732319889354","article-title":"\u201cEverything is perfect, and we have no problems\u201d: detecting and limiting social desirability bias in qualitative research","volume":"30","author":"Bergen","year":"2020","journal-title":"Qual Health Res"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/55\/7\/afag219\/70161173\/afag219.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/55\/7\/afag219\/70161173\/afag219.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T12:08:13Z","timestamp":1785154093000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afag219\/8742280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":50,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afag219","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]},"article-number":"afag219"}}