Sexuality behind clinic doors: experiences of healthcare professionals in primary care addressing sexuality with older people.

backgroundSexual 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.

objectiveTo explore NHS primary care professionals' 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.

designA 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.

resultsThree 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 'natural openers,' but such conversations maintained their medical focus, overlooking other aspects contributing to OAs' 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.

conclusionThis 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.