This Sex and Intimacy in Later Life book series will explore, interrogate and enlighten upon the sensual, sexual and intimate lives of older people. The motivation for launching this series was a concern with the relative lack of attention in public, professional and academic/ intellectual spheres to sex and intimacy in later life (indicatively, Hafford- Letchfield, 2008; Simpson et al, 2018a, 2018b). The series is intended to contribute to and enrich the development of the field of studies in the intersections of age, sex, sexuality and intimacy as a critical and important area of scholarship. It is only beginning to be recognised as an important social, cultural and political issue within and beyond the ‘Western’ academy, from which it has emerged. Its earliest contributions, of which this volume are a part, are motivated by a desire to recognise and reject the pathologies and prejudices that have infused this intersection – what Simpson has termed ‘ageist erotophobia’ (Simpson et al, 2018b: p 1479) – and fuels the failure to acknowledge older people as sexual agents. This is both an intellectual and a political agenda, to question and evaluate the impact of real rather than assumed losses of cognitive, physical, social and sexual capacity, and to recuperate older people as sexual agents from dismissal, ridicule and trivialisation.

If the latter half of the twentieth century was characterised by challenges to the pathologies of social identities – particularly gender, ethnicity and race, disability, sexuality – and struggles for recognition, rights and liberties, more intersectional struggles and recognitions characterise the twenty- first century (on intersectionality, see indicatively Hancock, 2016; Hill Collins and Bilge, 2016). Significant among these has been the re- evaluation of what it is to age and to be an older agent in contemporary societies. Older people have historically experienced both veneration and respect and neglect and pathology, largely based on differing cultural stereotypes of the value of age (Ylanne, 2012). The most common characterisation is that older people are not sexual, past being sexual or represent a problematic sexuality – or their sexuality is a superficial concern and secondary to concerns of health, care, life course and support by public services and engagement and pensions/ resources. Such concerns are those mainly of ‘Western’ cultures and reflected in the Western influence across the globe in respect of state intervention and provision, but elsewhere they have been subsumed and often rendered invisible into family and kinship structures.

It is now over thirty years since epidemiological studies revealed a relationship between low birth weight and subsequent risk of developing traditionally adult-onset diseases, such as type 2 diabetes, cardiovascular and renal disease. Initial focus was directed towards the importance of fetal undernutrition. However, it is now recognized that a range of other in utero adverse exposures including chronic fetal hypoxia, maternal over-nutrition and maternal stress can also lead to increased risk of cardio-metabolic and renal diseases in later life. Animal models, including those using non-human primates, sheep and rodents have been critical in demonstrating causality of relationships and helped to define underlying mechanisms, such as epigenetic programming of gene expression and oxidative stress. As the field moves forward in the coming years, these mechanistic studies will help to identify rational intervention strategies to reduce the developmental programming of cardiometabolic and renal dysfunction in suboptimal pregnancy.

This Sex and Intimacy in Later Life book series will explore, interrogate and enlighten upon the sensual, sexual and intimate lives of older people. The motivation for launching this series was a concern with the relative lack of attention in public, professional and academic/intellectual spheres to sex and intimacy in later life (indicatively, Hafford-Letchfield, 2008; Simpson et al, 2018a, 2018b). The series is intended to contribute to and enrich the development of the field of studies in the intersections of age, sex, sexuality and intimacy as a critical and important area of scholarship. It is only beginning to be recognised as an important social, cultural and political issue within and beyond the ‘Western’ academy, from which it has emerged. Its earliest contributions, of which this volume are a part, are motivated by a desire to recognise and reject the pathologies and prejudices that have infused this intersection – what Simpson has termed ‘ageist erotophobia’ (Simpson et al, 2018b, p 1479) – and fuels the failure to acknowledge older people as sexual agents. This is both an intellectual and a political agenda, to question and evaluate the impact of real rather than assumed losses of cognitive, physical, social and sexual capacity, and to recuperate older people as sexual agents from dismissal, ridicule and trivialisation.

If the latter half of the twentieth century was characterised by challenges to the pathologies of social identities – particularly gender, ethnicity and race, disability, sexuality – and struggles for recognition, rights and liberties, more intersectional struggles and recognitions characterise the twenty-first century (on intersectionality, see indicatively Hancock, 2016; Hill Collins and Bilge, 2016). Significant among these has been the re-evaluation of what it is to age and to be an older agent in contemporary societies. Older people have historically experienced both veneration and respect and neglect and pathology, largely based on differing cultural stereotypes of the value of age (Ylanne, 2012). The most common characterisation is that older people are not sexual, past being sexual or represent a problematic sexuality – or their sexuality is a superficial concern and secondary to concerns of health, care, life course and support by public services and engagement and pensions/resources.

Given that the desexualisation of older people emerged as a dominant theme in the first volume (addressing diversity) in this book series, this volume was created specifically to probe this subject further and, in doing so, provide a coherent and critical overview of it as a possible basis for critique and action.

This volume has showcased a variety of work by emerging and established scholars (based in Argentina, Britain, Sweden and Spain). As such, it has featured a mix of theoretical and theoretically-informed empirical work that reflects theorising from social gerontology, social psychology, structuralism, poststructuralism and feminism and some combinations thereof. In various ways, all contributors have addressed the intersecting influences that help to make up later life sexuality. If the first volume in the book series addressed influences of age combined with gender, sexual identification, race and class, this volume has focused a bit more on age as it enmeshes with gender (see the chapter by Clare Anderson), with sexual identification (see the chapter by Jane Youell) and with disability/ableism (see the chapters by Susan Gillen and Paul Reynolds and by Linn J. Sandberg).

Moreover, the main foci of this volume have concerned the cross-cutting physical/embodied, relational, cultural, structural and policy and practice-related constraints on older people's intimate and sexual self-expression. Although such theorising indicates a fairly wide purview, this volume has presented key examples rather than a comprehensive survey of accounts of desexualisation. Nevertheless, it does provide considerable insight and critical reviews of the state of current scholarship on the subject of desexualisation in later life and prompts ideas for further research.

To avoid a simple recap of key points in individual chapters, this concluding section attempts more of a synthesis of overarching themes

and issues that the chapters point to, though, inevitably, we refer to individual authors. Subsequently, we move to discuss what this volume indicates about the state of scholarship in an emerging field of knowledge and how this suggests an agenda for research and serves as a precursor to a future volume addressing the resexualisation of the older self. Indeed, the agentic capacities of older people as sexual beings are visible in chapters in this volume, and the subject of resexualisation, often in the face of significant obstacles, appears to be much overlooked in analysis (Simpson et al, 2018).

Older people's sexual and intimate lives represent an emerging field of study that fuels demands for change across public, private and voluntary services and holds some promise for representing age as positive change (see the volume edited by Barrett and Hinchliff, 2017). Yet, there remain significant constraints on older individuals’ sexual expression and limitations in knowledge on sexuality in later life (Reynolds et al, 2021). Constraint on sexual and intimate selfexpression and practice, operating in diverse, intersectional modes, was a key motif that emerged in the first volume addressing diversity in this book series on Sex and Intimacy in Later Life. Older people (defined as aged 50 and over in the series introduction in this volume) remain the subject of stereotyping as non-sexual or ‘post-sexual’ (Simpson et al, 2018). Such a concept broadly refers to the process of desexualisation of older people that appears endemic in late modern societies and marks limits to who counts, age-wise, as a legitimate sexual being (Gatling et al, 2017).

Indeed, representations of age stress unsexy, sagging flesh, tarnished bodies, sexual dysfunction and absence of eroticism (Moore and Reynolds, 2016). More specifically, Gilleard and Higgs (2011) talk of how the leaky, less continent bodies of the oldest old are contrasted with the vital performances of younger adults, and Moore and Reynolds (2016) draw attention to a negative aesthetic that equates older people with ugliness and dearth, if not death, of desire. In light of such endemic pathologies and prejudices, it is tempting to believe that older people are generally not only thought of as no longer interested in engaging in sexual activity and pleasure but also are probably not even expected to think of it (Simpson et al, 2018; Bauer et al, 2016). Given the absence of more validating images of ageing sexuality, older people themselves can come to think of themselves in this way (Simpson et al, 2018). It is also quite likely that older people are excluded from the many and varied practices that constitute the ‘sex industry’, though ironically DIY porn sites indicate that older women can be fetishised in a niche way.

Key terms that populate this volume – later life, ageing, ageism, sex, intimacy and ageist erotophobia – were defined in the book series introduction in this volume.

Much of the conceptual architecture of the chapter on physical disability (Chapter 6) is relevant to this chapter on intellectual disabilities: intersectional subjectivities; the impairment/disability dichotomy; the social construction of disability; the heteronormative and genito-centric conception of sexual intimacy; the radicalism of crip/queer theorising; and the necessity of critical deconstructions of normative and normalising discourses that produce desexualising impacts upon disabled people. Similarly, there are important issues to explore at policy and interpersonal levels. The intersection of age and intellectual disability is composed by both the impact of ageing on forms of intellectual capacity – typically conditions such as Alzheimer's and other types of dementia – and people who have intellectual disabilities, for whom ageing might exacerbate or provide added complications – such as people with Trisomy 21 (colloquially Down's syndrome). Or put simply, intellectually disabled people growing old and older people growing into intellectual disability. Yet it would be a mistake to simply extend or map the conceptual framings and analysis of physical disabilities onto intellectual disabilities. There are important differences as well as similarities at the intersections of intellectual disabilities with sex and intimacy in later life.

Intellectual (as physical) disability and ageing both bring into question how human difference is categorised and understood according to conceptions of what is bodily or customarily normal. The notion of ‘normal’ dominates conventional understandings of ageing, disability and sex and intimacy, and is the discursive basis for the desexualisation of those people bearing these features. It is precisely the development of crip/queer critiques (and in this chapter, a neurodiverse equivalent), that has problematised and deconstructed these qualities and characteristics: dissembling reproduction; genito-centric and penetrative heteronormativities from sex and intimacy; dissembling ableism and the constitution of hierarchies of ability from disability; and dissembling life course developmental staging from age. This involves recognising that categories of distinctions are degrees of difference and not deficit, and the norm should not be morally and culturally privileged but recognised as a statistical measurement of population or an ideological construct that reflects power-knowledge relations and their deployment as orthodoxies to maintain a status quo (indicatively, Foucault, 1980, 2002).

Consent is generally regarded as a problem for the young and the inexperienced. The focus of academic literature, sexuality education and legal and cultural debate is upon those who are entering the sexual world, rather than those who are mature within it (selectively, Archard, 1998; Cowling and Reynolds, 2004; Moore and Reynolds, 2016; Popova, 2019; Stryker, 2017). In part, this is a product of the naturalised and normalised developmental model of sex that identifies sexual risk and danger primarily around the young (Moore and Reynolds, 2018, pp 24– 26). It reflects a minimalist notion of sexual learning, regarded as a part of child social development that is adequately completed with maturity. For older people, consent is principally seen as an issue accompanying concerns about diminished capacity. This reflects the desexualisation of older people, where mainstream cultural representations and articulations of sex and sexuality involve stereotypes of youthful, ‘beautiful’, vigorous bodies and acute and rational minds. Older people do not conform to those dominant representations and its stereotypes (Moore and Reynolds, 2016; Hafford-Letchfield et al, 2020, passim; and this volume). Underlying this is a hetero-(and more recently homo-) normative sexuality that is focused on genitocentric, penetrative sexual functionality and in phallocentric vigour and fecundity (in respect of men) (selectively, Beasley, 2005; Jackson and Scott, 2011; Weeks, 2016). This normativity frames older sexual desires as risk and problem oriented, whether the focus is on desexualised older bodies or dysfunctionality, and discourages approaches to older sexual agency that emphasise sexual experimentation and creativity, which might provide different pleasures and alternative and new forms of sexual learning and knowledge. Consent is not an issue because, surely, older people's sexual desires are diminished or absent?

The implications of this are that consent is not seen as a problem because it is displaced by desexualisation and the ‘normal’ conception of the sexual ‘life course’. Older adults are assumed to understand consent (unless they transgress and commit an offence like rape or sexual assault, or they have problems of competence and are deemed as unable to consent).

This chapter will explore some of the relevant issues for older people's consent to sexual activity, both those factors that are shared with younger people and those factors that are more specific to older people.

Older people experience their sexual and intimate relations as intersectional agents. Their relationships are influenced not simply by age itself, but by gender, ethnicity, sexuality, class and other identarian differences. It is not necessary to subscribe fully to the benefits of intersectionality as a theoretical paradigm to recognise the impact of difference on how older people enjoy or endure the process of ageing (for relevant summaries of intersectionality, see Hancock, 2016; Hill Collins, 2019; May, 2015; Taylor, Hines and Casey, 2011). These differences extend to the sexual and intimate constraints and limitations that constitute desexualisation. This is particularly the case with the intersection of age and physical disability, which becomes more significant as the body ages and its functionality tends to decline. While the rate and form of that decline is differentiated dependent on variables such as robust physical health, income and resources and access to healthcare, the general proposition holds. Bérubé (cited in Gallop, 2019, p 7), commenting on this convergence, sagely observes: ‘[that] many of us will become disabled if we live long enough is perhaps the fundamental aspect of human embodiment’. These changes are exacerbated by the shared cultural prejudices and pathologies that dominate common perceptions of older people and disability. These perceptions produce material physical and regulatory constraints alongside ideological orthodoxies and internalised discursive framings by which older people's sexual agency is diminished and subsumed beneath notions of ‘healthy’ and ‘normal’ sex and intimacy.

Both age and physical disability share common desexualising factors and impacts. Both are steeped in conventionally negative, normative characterisations of physical change across the life course, with changes measured by scientific-medical criteria with a culturally determined functional index. Bodily change or difference impacts on the capabilities and everyday experience of individuals but is considerably

more pronounced and compounded by social and cultural discursive representations. They both carry equivalent prejudices, pathologies and assumptions about sex and intimacy, and communicate subordinated positions within late capitalist modern societies, where the capacity to labour and physically participate in economic activity is privileged (indicatively, Campbell and Oliver, 1996; Phillipson, 1982).