Middle-aged and older disabled adults in Britain are less likely to be sexually active yet more likely to experience negative sexual health outcomes, highlighting the necessity for tailored sexual health services extending into middle age and older adulthood.
Key Findings
Results
Disabled middle-aged and older adults were significantly less likely to have engaged in sex in the last 4 weeks compared to nondisabled individuals.
Adjusted odds ratio of 0.60 (CI: 0.51–0.71) for sexual activity in the last 4 weeks among disabled compared to nondisabled adults
Analysis was stratified by sex and adjusted for sociodemographic differences
Study population included adults aged 45–74 drawn from Natsal-3, a British population-representative survey
Of 7082 total participants, 1906 were classified as having limiting disability status
Results
Disabled adults were significantly less likely to be in a steady relationship compared to nondisabled adults.
Adjusted odds ratio of 0.69 (CI: 0.59–0.80) for being in a steady relationship among disabled adults
Analyses used multiple logistic regressions stratified by sex
Disability was defined as a long-standing illness that limits activity, not a specific type of disability
Results
Disabled adults were substantially more likely to report that their health had affected their sex life in the last year.
Adjusted odds ratio of 5.08 (CI: 4.27–6.05) for health affecting sex life in the last year
This was the largest effect size observed among all sexual health outcomes examined
Finding was adjusted for sociodemographic differences between disabled and nondisabled groups
Results
Disabled adults were significantly more likely to have experienced attempted coerced sex and actual coerced sex compared to nondisabled adults.
Adjusted odds ratio of 1.83 (CI: 1.48–2.27) for having experienced coerced sex attempts
Adjusted odds ratio of 1.64 (CI: 1.33–2.01) for having experienced coerced sex
These findings indicate elevated sexual violence vulnerability among disabled middle-aged and older adults
Results
Disabled adults were significantly more likely to have sought help for their sex lives compared to nondisabled adults.
Adjusted odds ratio of 1.73 (CI: 1.38–2.17) for having sought help for their sex life
Elevated health-seeking behavior co-occurred with greater negative sexual health outcomes
Authors interpreted this as highlighting the necessity for tailored sexual health services for this population
Methods
The study used secondary quantitative analysis of Natsal-3 data to examine sexual health among disabled adults aged 45–74 in Britain.
Natsal-3 is described as a British population-representative survey (the third National Survey of Sexual Attitudes and Lifestyles)
Total analytic sample was 7082 participants aged 45–74, of whom 1906 had limiting disability status
Disability was defined broadly as a long-standing illness that limits activity, not restricted to a specific disability type
Bivariate analyses and multiple logistic regressions stratified by sex were used to compare behaviors and outcomes by disability status
What This Means
This research suggests that middle-aged and older adults in Britain who live with a disability that limits their daily activities face a distinctive pattern of sexual health challenges. Using data from a large, nationally representative British survey of over 7,000 adults aged 45 to 74, researchers found that disabled adults were about 40% less likely to have been sexually active in the past month and about 30% less likely to be in a steady relationship compared to their non-disabled peers, even after accounting for differences in age, income, and other social factors.
At the same time, the study found that disabled adults experienced significantly worse sexual health outcomes. They were about five times more likely to say their health had negatively affected their sex life, nearly twice as likely to have experienced attempted or completed sexual coercion, and about 73% more likely to have sought professional help related to their sex life. These findings paint a picture of a group that is both less sexually active and more vulnerable to harm.
This research suggests that sexual health services and public health programs need to pay more attention to disabled people in middle and older age, a group that is often left out of both disability-focused research and sexual health research. The authors argue that the combination of greater vulnerability and higher health-seeking behavior points to an unmet need for tailored support and services for this population.
Sakuma Y, Lin B, Kpokiri E, Khan J, Zou H, Tucker J, et al.. (2025). Sexual Health Behaviors and Outcomes Among Middle-Aged and Older Disabled Adults in Britain.. Perspectives on sexual and reproductive health. https://doi.org/10.1111/psrh.70034