Yes, Old People Have Sex (Sorry)
A strange, recurring and not-totally-untrue story on elder-humping resurfaced this weekend when Dr Ezekiel Emanuel, writing in The New York Times, brought up the issue of sex among the elderly. More specifically, he wrote about an increase in some sexually transmitted diseases (STDs) among the Social Security set: “between 2007 and 2011, chlamydia infections among Americans 65 and over increased by 31 percent, and syphilis by 52 percent.” Pretty scary or creepy or both, huh?
His numbers derive from CDC data so I quickly had a look. When I went to the CDC website, however, I found a slightly different story. Admittedly, I used the available comparison from 2008 to 2012, not 2007 to 2011 (sorry—this is what the CDC has readily posted—gotta complaint? call them). Yes, chlamydia rose by more than 25% in the 65+ crowd, from 887 cases in 2008 to 1134 in 2012, as it rose across all age groups by a similar rate—reflecting broader testing as promulgated by newer public health recommendations and more accurate, easier to perform tests.
But in the data I looked at, rates of gonorrhea stayed the same at about 650 cases a year while syphilis rose only slightly from a numeric perspective—from 105 to 123,—a whopper of an increase if looking at rates but it’s 18 cases over 5 years using a diagnostic test that captures decades-old untreated cases (latent disease) as well as fresh infection.
No matter which data is more reflective of the situation, when small numbers are at play, it’s an old and not entirely trustworthy trick to use rates, not actual numbers. A person earning 10 dollars a week can see a 100% increase by getting a raise to 20 bucks a week—bur remains impoverished. In a similar vein a billionaire whose wealth grows by a million bucks has a tiny increase in proportion but is sitting on another million clams—a small change in percent but a handsome wad for those counting. Taking the tiny numbers in the Social Security set and reflecting the percent increases sure makes a good headline and a fine candidate for most emailed, but surely oversells the problem.
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The elder-humping story though won’t die. The first wave of these reports came out in 2012 from, of course, the Brits. After an article in the Student British Medical Journal by an, um, medical student (ah the irony!) found that STDs in the British elderly (defined as those over 45 years—vigorous, un-dentured Gen-X’ers for Christ’s sake) had doubled over a ten year period. This was followed in 2012 by a spate of media articles in the US trying to grab attention using similar headlines.
The speculative explanation then and now is somewhat irresistible: people living longer healthier and therefore hornier lives; the nursing home as a latter-day dorm complete with winking cads on the prowl; drugs to pump up the excitement, though it’s Viagra this go-around, not pot or alcohol; a demographic advantage to the guys that finally fulfills the age-old promise of the Jan and Dean classic, Surf City: “Two girls for every boy” and plenty of that most-teenage of all elements, crushing boredom.
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Plus there is an element of truth in this—at least by the extremely modest increase in cases and the stories, perhaps true, of nursing home animal house behavior.
But in the telling, this entire construct seems less like a second chance to get laid than a lame Neil Simon play. Which is not awful I suppose. There is however contained in the attitude of those who do not consider themselves randy seniors (most everyone) a destructive force both to the elderly and to STD control nationally. The stories are at their base quite insulting and belittling: old people as a focus of almost anthropologic study, a curious and somewhat delightful if primitive tribe that humps then clips coupons then humps some more. The tone alternates between old-school young-guy prurience and a condescending, “oh look at how well you’re doing!” tone reserved for the very young and the very old (or an adored pet).
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The larger problem though is the deflection of the real story in STDs. Sexually transmitted disease is, was, and always will be almost entirely a young person’s preserve: chlamydia rates for example in the 65+ crowd are one-one-thousandth that of those aged 20 to 24: 2 per 100,000 compared to more than 2000 per 100,000. Sorry, seniors, you just can’t compete.
I think it’s best if we deep-six these stories and focus on the actual problems at hand. It should not be news that people over 60 and 70 are having sex—Masters and Johnson (and biblical Abraham for that matter) told us that ages and Ages ago. And of course old and young alike need to be mindful of infection risk in order to take steps—condoms, restraint, monogamy, etc—to lower the chances of becoming ill. But here is what we need to pay attention to: there are worrisome and potentially dangerous increases in STD’s in people in their twenties, HIV continues to increase in many at-risk populations, and becoming old and sick is anything but cute.
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