“I’ve had plenty of anonymous sex before,” she said, “and I still know how to find it.” Jan intended this as a threat or warning, obviously, but she also knew it stung in its own right. She first learned to weaponise her own sexuality when she saw the crestfallen look on her father’s face when she knew he knew what she’d gotten up to with John one night. Since that day, she had learned a number of ways to use her own numbness to sex to devastate men. Not that it made her feel that much better, but it was something.
Maybe it was revenge. Maybe it was something else, but it gave her a feeling of power, and who doesn’t want to feel that sometimes? Everyone wants to feel a little control over things. The way she told it, she had always controlled her own sexuality. She was 12 the first time, she said, and she knew exactly what she was doing. Her parents were gone for the day and she called her school band director on the phone and asked him over. It was her idea. That’s what she said.
She said it hurt, but he was very nice. He took care of her. When he lost his job at the school, she and some other girls formed a group to get signatures on a petition to get him his job back. They really liked him. When she graduated high school, she wrote to him to let him know she was doing all right, and he wrote back and said he was glad to hear it.
Bobby couldn’t believe what he was hearing. He told her she was only 12, for God’s sake, and definitely no child could be responsible for what she described. She had obviously been groomed and manipulated, and so had all the other girls. She was raped, he said, but she averred. “But I knew what I was doing was wrong,” she said, “That’s why I never told anyone before now.” Bobby told her it wasn’t her fault, but he wasn’t prepared for this conversation.
Somehow, he made her feel more judged than supported, not that he was trying to, but he really wasn’t equipped to respond to this information, and he felt a little sick. But Jan didn’t notice that. She was just trying to make a point about her prissy classmates who acted so shocked to find that a professor was having an affair with a student. She was just wanting to say, “Hello! I was having sex with a teacher when I was 12! Grow up.”
A non-practicing Catholic, I guess, is someone born into the Catholic faith who no longer adheres to any of it’s prescribed behaviours or rituals, and I would suppose some people don’t feel they need to practice it once they know how to do it. Practicing Catholicism must be for newbies.
But Baptists are a different beast all together. Technically, if you follow the letter of Baptist convention, no one is born into the Baptist faith. No one, no matter the circumstances of birth, can become a Baptist without actively choosing to do so, though the age of consent for such a choice is surprisingly low. This is why you see so many Baptist preachers dunking little kids in the water—it shows those children have chosen of their own free will to live their lives for Jesus. And if you check the news of late, you’ll find some preachers seem a little confused about what other things children are or are not able to consent to, under the laws constructed by good old human beings.
Once your accepted in the fold, you are saved, and there’s not much you can do to get kicked out, and you don’t have to practice, either. If you don’t keep up your Godly work by staying clean and pure and avoiding all the temptations the earth has to offer, you’re only human and no one should throw stones at you (according to New Testament law).
If you’ve slipped a little, you’re officially a backslider. Baptists believe that a truly saved person can’t genuinely fall out of favor with God. If you actively reject God and all God’s work, you are not a backslider but a reprobate, and God will surely turn against you, because when you said you wanted to devote your life to Jesus when you were six, you must have been a lying little demon.
Bioethicists and experts on aging spend some time advising people on advance directives aimed at helping us make decisions about our medical care in the event of dementia or unconsciousness near the end of our lives. The idea is that we may give prior consent for decisions to be made when consent is not possible. We generally make decisions about what treatments should be offered or withheld in the event of fading autonomy.
Perhaps we should consider a broader range of choices as well. In some cases, a person with dementia can consent to a variety of activities that might not have seemed appropriate previously. In Holding and Letting Go: The Social Practice of Personal Identities, Hilde Lindemann gives an example of a life-long vegetarian and animal rights activist who ends up in a residential care facility and desperately wants to eat the meat dishes offered his fellow residents. Should his earlier convictions be respected or should his later desires be sated?
Lindemann breaks down the problem by identifying a capacity for two types of volition: primary and secondary. Primary volition is simply the ability to want something. Secondary volition is the ability to want something but think better of it because of overriding desires, which could be based on moral, social, or health concerns (among others). Our resident is able to want a hamburger but not able to think about the ethics of eating meat and how it affects the animals, the environment, or the economy. People who eat meat tend to say it is harmless to give him a hamburger, so his current desires should be indulged. People who care about animals might take a different view.
But what if we weren’t talking about eating meat? Perhaps our resident never cared about animals, but did care about sexual behavior. He may have been prude or strict moralist. Now, however, he would quite like to masturbate frequently and doesn’t mind who sees or knows. In the past, of course, he would have been more discreet, but he has lost the ability to take such concerns into account. Still, it is his body, and he should be able to do what he wants, even if the comfort of other residents and staff must also be considered. When the occasion arises, Mr. X might gently be guided to a private room.
Or he may meet a fellow resident with similar desires. Surely consensual sexual activity, with allowances for the comfort of other residents and staff, should be respected. When younger people have limited autonomy, we are likely to say they are incapable of consent, making sexual relations with them problematic at the least. Such patients are “protected” from sexual advances of any kind, even if they may appear to be willing “victims.”
Rarely is this debate framed as a “right” to sexual pleasure, but sexual puritanism is the only reasonable explanation for the imbalance in the discussion. Surely sexual pleasure is a human drive and a human need. If it isn’t such a strong drive for older patients, it is certainly still a human good. Currently, even the most progressive attitudes toward sexual pleasure for older patients could only be described as polite tolerance rather than accommodation.
To actually accommodate the sexual needs and desires of older, and sometimes demented, patients would require conversations and actions that are sure to make us uncomfortable. It may be possible to discreetly make condoms available to residents in nursing homes, but asking residents whether they might want a vibrator or other sexual aid available is more of a challenge. Involving children and grandchildren in the discussions is likely to be an insurmountable model, at least without a sea change toward sexual behavior in general and among the elderly in particular.
A further difficulty is posed by the possibility of sexual assault or exploitation. Normal guidelines for consent won’t do. A demented patient might consent to sexual activity that would never have occurred in the absence of dementia. The only way to honor the wishes of a patient’s lifelong values is to have difficult discussions earlier in life. We would need to ask question of this nature: “In the event of dementia, what types of sexual pleasure if any would you like to be available to you? What types of sex if any would you consider appropriate with other people? What types of sexual aids if any would you want provided for your pleasure?”
I would caution any young people thinking of completing an advance directive now to reconsider often. As we age, our estimation of what kind of sex lives we will want in old age changes dramatically. Younger people tend to assume that older people naturally lose interest in sex, and I’m sure some do, but many older people find the opposite.
Sexual pleasure has many advantages for older people. It doesn’t cost a great deal of money or effort. While illness and disability can limit sexual options for people of any age, they do not eliminate it. Sexual pleasure doesn’t require one to leave a residential facility, isn’t inherently risky (especially when partners are not involved), and doesn’t necessarily strain the budget (expensive sex toys and porn addictions notwithstanding). In fact, for many older patients, sexual pleasure may be one of a handful of pleasures still available to them.
Some of the risks of sexual behavior are no longer of concern to older patients. While sexually transmitted diseases are still a distinct possibility, many of the diseases seem much less frightening to someone nearing the end of life. Further, pregnancy is no longer a concern, and people who have already lost their spouses are no longer concerned with issues related to fidelity. In ways the young rarely understand, old age is liberating.
Of course, sexual activity of patents has the possibility of creating discomfort for staff. Taking care of a patient should not mean providing sexual services for patients, unless one is specifically hired as a sexual surrogate. Staff must be protected from sexual assault or exploitation. However, feeling squeamish or embarrassed is not the same thing as enduring sexual harassment or assault, and staff must know the difference.
We can make staff more comfortable by becoming more comfortable ourselves with elder sexuality. Normalizing mature sexuality will go a long way toward opening frank and productive discussions of policy and procedures to protect the sexual rights of patients.