Aging, Gender, and the Body
Abstract and Keywords
In this chapter, the author considers some of the theoretical and methodological conundrums that she encountered in her qualitative research that has focused on later life experiences of the aging body as a site of inequality. Western culture is replete with deeply entrenched ageist stereotypes, which position old bodies as inherently asexual, dependent, frail, obsolete, senile, unproductive, and undesirable. Negative cultural constructions of old bodies are further reflected in and buttressed by masculinity and femininity ideals as well as societal assumptions concerning personal responsibility for health. Collectively, these cultural norms shape research in powerful ways as they lead to the avoidance of certain topics, taken-for-granted assumptions that are difficult to elicit or interrogate, and complex power dynamics between researchers and study participants. Reflecting on the intricacies of researching later life body image and embodiment, I offer some suggestions about how the challenges might be reframed as opportunities.
Population aging is dramatically changing the demographic make-up of societies around the world (World Health Organization 2015). As an unprecedented number of individuals are living longer than ever before, ageism has become a ubiquitous social problem that delimits the lives of older adults, particularly in Western countries (Calasanti 2016; Nelson 2002). In this chapter, the author explores how ageism influences the research encounters and examines the methodological complexities of studying older bodies.
Ageism, Gender, and Body Image in Later Life
Defined as “the systematic stereotyping of and discrimination against older adults because they are old” (Butler 1975, 12), ageism arises from and is legitimated by the use of age as an organizing principle of society. The resultant age relations privilege young and middle-aged adults and disadvantage the old, who face increasing social exclusion and cultural invisibility (Calasanti and Slevin 2001). Ageism is manifested in the discrimination that older adults face in the workplace (Harris et al. 2018; Stypinska and Turek 2017), the health care system (Ben-Harush et al. 2017; Chrisler, Barney, and Palatino 2016), and their everyday interactions with others (Hurd Clarke and Korotchenko 2016; Vincent 2015), as well as in the way that are underrepresented and negatively portrayed in the media (Hurd Clarke 2017/2018). The body is central to older adults’ marginalization as cultural narratives of later life decline are expressed in and reinforced by ageist stereotypes that equate old bodies with obsolescence, loss of productivity, poor health, senility, dependence, asexuality, and diminishing romantic appeal (Gullette 1997; Hurd Clarke and Korotchenko 2011; Laws 1995). In contrast, bodies in young adulthood are assumed to be the epitome of physical attractiveness, health, sexual desirability, happiness, innovation, and social engagement (Calasanti and Slevin 2001).
Age-based discrimination is not just a social problem. Rather, ageism infiltrates and often confounds the research encounter. To begin, researchers may shy away from topics they erroneously presume are of no interest or relevance to older adults as a result of their own internalization of ageist stereotypes. Certainly, in my doctoral research concerning older women’s body image, I was initially guilty of this myself, as I failed to ask my participants about their experiences of sexuality until one of the women in my study confronted me about my avoidance of the topic (Hurd Clarke 2003, 2012). Her challenge to me to ask older women about their perceptions and experiences of sex was an important turning point in my research career, leading me to consider not only societal ageism but also my own internalization of age-based discrimination. Other scholars have similarly noted that researchers often inaccurately assume that older adults are not sexually active or that they are uncomfortable and unwilling to discuss their sexual experiences (Gott and Hinchliff 2003; Hurd Clarke 2003, 2012; Thorpe et al. 2017). As well as reinforcing cultural norms that position sexuality as the sole purview of young and middle-aged adults, these assumptions are grounded in heterosexism and the equating of sexuality with partnered, heterosexual intercourse (Fileborn et al. 2015b; Thorpe et al. 2017; Thorpe, Fileborn, and Hurd Clarke 2017). Therefore, the experiences of single or lesbian, gay, bisexual, and transgendered older adults are largely absent from the existing research (Fileborn et al. 2015a; King et al. 2018; Peel and Harding 2016). Narrow definitions of what constitutes sex, combined with researcher discomfort with the topic, lead to a failure to consider how older adults perceive or experience masturbation and oral sex (Hurd Clarke 2006; Thorpe et al. 2017).
While later life sexuality remains a largely unexplored topic of theorizing and research, considerable literature has examined one of the most salient ways that ageism is established and maintained in Western society, namely cultural norms and ideals related to femininity and masculinity. Gendered body ideals emphasize the importance of being youthful, albeit by emphasizing different aspects of physicality in men and women. Men are prized for their physical and social accomplishments in their bodies as idealized masculinity is equated with youthful athleticism, strength, hypersexuality, leadership, political influence, and workplace productivity (Grogan 2017; Thompson and Langendoerfer 2016). In contrast, women’s social value is assumed to primarily derive from their appearance, specifically their approximation to the feminine beauty ideal of a young adult who is healthy, toned, slim, yet voluptuous (Bordo 2003; Grogan 2017). Sontag (1997) has argued that differing body ideals for men and women reflect and reinforce a gendered double standard. Men who look older are often considered to be distinguished rather than unattractive (Sontag 1997), and those who are wealthy and influential may continue to be seen as socially desirable in their later years through their accumulation and retention of economic and political power (McGann et al. 2016; Thompson 2006). Rather than inevitably undermining their cultural currency, aging, so long as it is not accompanied by poor health and disability, may augment a man’s status as an experienced, influential, and socially esteemed leader (Hurd Clarke, Bennett, and Liu 2014). Women, on the other hand, are perceived to become older at a younger age than their male counterparts and aging is especially detrimental to their social status. The onset of physical signs of aging such as age spots, wrinkles, sagging skin, increased weight, and gray hair progressively diminishes women’s erotic capital (Hakim 2011; Hurd Clarke 2011). The perceived loss of feminine beauty that is associated with aging has everyday consequences for older women who are less likely to secure and retain employment or promotions (Bowman et al. 2017; Duncan and Loretto 2004; Jyrkinen and McKie 2012; Walker et al. 2007) or to win and retain the affections of romantic partners (Fales et al. 2016; Hurd Clarke and Griffin 2008) as compared to younger women.
As well as resulting in social inequities in everyday life, gendered interpretations of the signs of aging shape men’s and women’s body image, which is defined as the ways that individuals perceive, feel about, and manage their aging bodies (Cash and Smolak 2011). Although studies that include or focus exclusively on older individuals continue to be relatively sparse, the existing body image literature reveals that many older adults view later life and their changing bodies with dissatisfaction, if not repugnance (Bytheway and Johnson 1990). That said, men’s and women’s body image dissatisfaction reflects cultural gender body ideals and norms. Related to the emphasis masculinity ideals put on the body as a tool for social action, older men identify the reduced muscularity, changes in health status, and declining physical and sexual abilities that often occur in later life as their primary sources of body image dissatisfaction (Kaminski and Hayslip 2006; Liechty et al. 2014; Meadows and Davidson 2006). Older men report that loss of strength, health, and functional abilities undermines their sense of masculine identity and cultural currency (Silver 2003; Spector-Mersel 2006; Thompson and Langendoerfer 2016). In contrast, and like their younger female counterparts, older women tend to express “normative discontent” (Rodin, Silberstein, and Striegel-Moore 1984, 267) with their appearances, specifically their weight (Allaz et al. 1998; Grogan 2017; Hurd Clarke 2002; Stevens and Tiggemann 1998). Studies have also found that older women are discontented with the signs of aging in their appearances, directing their displeasure primarily toward their wrinkles, sagging skin, and gray hair (Baker and Gringart 2009; Hurd Clarke 2011; Tiggemann 2004; Ward and Holland 2011).
A number of studies have considered how body image is related to sexual orientation in later life. Although some research has found that lesbian women report body image dissatisfaction that is similar to their heterosexual counterparts (Bergeron and Senn 1998; Heffernan 1999; Huxley, Clarke, and Halliwell 2011; Slevin 2006), other studies suggest that appearance norms in lesbian communities may differ from those associated with idealized femininity (Clarke and Turner 2007; Krakauer and Rose 2002). Some lesbian women embrace masculine or butch appearances as a means of making their sexual orientation more visible (Huxley, Clarke, and Halliwell 2014; Lev 2008). Similarly, older lesbian women may adopt short hairstyles to resist gender norms or because they consider gray hair to be a means of disrupting ageist stereotypes (Ward and Holland 2011; Winterich 2007). In contrast, older gay men tend to report greater body dissatisfaction than their heterosexual counterparts (Lodge and Umberson 2013; Slevin and Linneman 2010; Suen 2016). Older gay men’s heightened body image dissatisfaction has been linked to their internalization of subcultural norms in the gay community that emphasize the importance of youthful and muscular appearances (Drummond 2006; Jones and Pugh 2005). Consequently, older gay men are more likely than their heterosexual counterparts to use physical activity, dieting, hair dye, cosmetic surgery, and strategic clothing choices to approximate youthful body ideals and hide their advancing years (Ryan, Morrison, and McDermott 2010; Slevin and Linneman 2010).
Relatively few studies have considered the influence of race and ethnicity on body image in later life. Research with adolescent, young adult, and middle-aged African American women reveals that they collectively tend to have greater body satisfaction and acceptance of heavier body weights as well as a reduced drive for thinness (Franko and Striegel-Moore 2002; Fujioka et al. 2009; Granberg, Simons, and Simons 2009; Molloy and Herzberger 1998) as compared to Caucasian individuals. Dunkel, Davidson, and Qurashi (2010) found that older Muslim women living in the United States reported less concern for achieving the Western thin ideal than did their younger counterparts. Studies with older adults living in non-Western countries reveal similar results. A study exploring body image among Senegalese adults found that while men and women tended to be largely satisfied with their appearances, aging was associated with decreasing body satisfaction for women (Macia et al. 2017). Ando and Osada (2009) found that older women in Japan expressed body image dissatisfaction comparable to Western women, although the importance they gave to appearance declined with age.
Although there has been limited research concerning the influence of culture, ethnicity, and race on later life body image, there has been some consideration of the impact of masculinity and femininity norms and ideals more broadly on the gendered interactions between study participants and interviewers (Arendell 1997; Pini 2005; Sallee and Harris 2011). It has been noted that men are often more comfortable and willing to reveal their vulnerabilities with female interviewers (Williams and Heikes 1993; Yong 2001), perhaps because of women’s traditional nurturing roles or as a result of men’s sense that they do not have to compete for authority as a result of women’s relative disadvantage in the gender hierarchy (Oliffe and Mróz 2005; Sallee and Harris 2011). Certainly, it has not been uncommon for older men to cry during my interviews with them as they have described the loss of loved ones or revealed deeply personal anxieties about their sexual dysfunction or incontinence. In line with the literature (Arendell 1997; Gailey and Prohaska 2011; Pini 2005), I have also encountered situations where older male interviewees have enacted idealized masculinity by being openly flirtatious or overly emphasizing of their sexual prowess in response to interview questions. Finally, I have often found that older men have asserted their authoritative masculinity by offering unsolicited advice, expressing “fatherly interest” (Leontowitsch 2012, 116) in my career and interpersonal relationships, or highlighting their identities as business leaders by carrying briefcases, providing me with evidence that attests to their professional success, or preferring to be interviewed in their places of employment rather than their private homes.
My research interviews with older women have similarly been influenced by femininity norms and ideals both in terms of the ways female participants have interacted with me but also in terms of their responses to my questions. On the one hand, I have found that older women have often engaged with me as a confidant or expert authority, seeking advice or information about everything from personal relationships to vaginal dryness (Hurd Clarke 2003). Some have also positioned me as a granddaughter or daughter, particularly when I was younger, and have offered encouragement to me as a mother or conveyed pride in and esteem for my professional accomplishments. More notably, however, have been the ways that older women have struggled to answer some of my questions about body image. My queries about what they like about the way they look have often been met with astonishment, awkward silence, or suggestions that my questions are either humorous or absurd. While they have sometimes referred to personal qualities that they equated with inner beauty or indicated that they liked aspects of their bodies insofar as they had remained largely unchanged by the passage of time, older women have rarely conveyed pleasure with how their appearances have been altered by age. In other words, the social construction of physical attractiveness as increasingly unattainable with age renders older women unable to consider wrinkles, age spots, sagging skin, or other markers of oldness as acceptable bodily changes, let alone desirable exemplars of beauty.
Embodiment, Ageism, and Healthism in Later Life
Another way that researchers have considered how older adults make sense of their aging bodies is through the exploration of embodiment, which is defined as our experiences in our bodies as we move through the social and physical world (Hurd Clarke and Korotchenko 2011). The bulk of the later life embodiment research has focused on how bodily changes resulting from illness and disability impact older adults’ everyday lives and sense of self. This literature has highlighted how the onset of health issues in later life often brings the previously taken-for-granted body into a person’s awareness in unexpected and unpleasant ways (Williams 1996). In particular, the pain, functional losses, appearance changes, and/or alterations in life expectancy associated with various chronic illnesses such as arthritis (Gibbs 2008; Sanders, Donovan, and Dieppe 2002), cancer (Aoun, Deas, and Skett 2016; Hannum and Rubinstein 2016), osteoporosis (Barker, Toye, and Lowe 2016), Parkinson’s disease (Gibson and Kierans 2017; Stanley-Hermanns and Engebretson 2010), and stroke (Becker 1993; Kitson et al. 2013) may culminate in a “biographical disruption” (Bury 1982, 167). Bury (1982, 169) contends that “chronic illness involves a recognition of the worlds of pain and suffering, possibly even of death, which are normally only seen as distant possibilities or the plight of others.” In other words, the physical realities and social consequences of being ill threaten, if not displace, previously held assumptions about one’s body, self-concept, future plans and possibilities, and relationships with others (Bury 1982).
However, the concept of biographical disruption is not without controversy and has been the source of ongoing debate. Some scholars have challenged the assumption that illness is universally and inevitably disruptive in later life as they have emphasized older adults’ resilience and accumulated coping resources and strategies. For example, Faircloth et al. (2004, 242) have argued that while chronic illness may initially be physically disruptive, many older adults find ways to incorporate the physical and social impacts of their health losses into their personal narratives, thereby maintaining “biographical flow.” Many studies have found that although they may experience the physical symptoms and social consequences of illness to be challenging if not dismaying, older adults often perceive later life health losses to be natural and inevitable aspects of their personal biographies and of growing older more generally (Gignac et al. 2006; Hubbard, Kidd, and Kearney 2010; Hurd Clarke, Griffin, and the PACC Research Team 2008; Husser and Roberto 2009; Llewellyn et al. 2014; Sanders, Donovan, and Dieppe 2002). In this way, older adults and scholars alike reject the tragedy narratives often associated with aging and having an older body.
Whether or not aging and illness lead to biographical disruption or they are experienced in terms of biographical flow, there is much evidence to suggest that growing older challenges the relationship between the body and the self. Given the devaluation of oldness and the linking of health and gender ideals to youthfulness, it is perhaps unsurprising that older adults often distance themselves from aging and oldness as they suggest that their bodies’ appearances and physical abilities are increasingly unreflective of their identities (Hurd 1999; Minichiello, Browne, and Kendig 2000; Slevin 2006). Older women and men often point to their activities, vitality, and/or sense of purpose as evidence that they are different from those considered old by virtue of their poor health, social disengagement, or physical and social dependence on others (Hurd 1999; Minichiello, Browne, and Kendig 2000). Older individuals may also differentiate between their chronological and felt ages as they contend that they embody a youthful spirit and feel “young-at-heart” despite the passage of time (Choi, DiNitto, and Kim 2014; Furstenberg 1989; Weiss and Lang 2012). The increasing bifurcation of identity from the body over time is reinforced by cultural assumptions that being old is bad while remaining young, at least in attitude if not in appearance, health, and physical ability, is the ultimate goal. In Western culture, this sentiment is expressed in a myriad of taken-for-granted ways such as the ageist depictions of older people in the media and birthday cards or the assumption that it is a compliment to tell someone of advanced age that they look and act younger than their chronological years (Gendron, Inker, and Welleford 2018; Hurd Clarke 2017/2018).
Another social norm that increasingly challenges the relationship between the body and the self in later life is healthism, or the cultural assumption that health is both a personal responsibility and the product of individual effort (Crawford 1980, 2006). Healthism leads to the social construction of poor health as the result of moral laxity on the part of individuals who are assumed to have inadequately disciplined their bodies through proper diet, exercise, and the use of other health-promoting practices and products. Healthism positions health as an active status that individuals achieve rather than a passive status that results from a combination of genetics, luck, and/or one’s social position and access to resources. The social construction of health as a personal duty and accomplishment is amplified and entrenched by theorizing, research, and health practices grounded in the concept of successful aging (Rowe and Kahn 1997), a paradigm that dominates social gerontology and has led to the medicalization of aging (Katz and Calasanti 2015). Defined as low probability of disease and disability, high functioning, and active social engagement, successful aging is believed to be attainable “through individual choice and effort” (Rowe and Kahn 1998, 37) primarily related to lifestyle. Diverting attention away from the impact of health and social inequities accrued over the life course (Crawford 1980, 2006; Dworkin and Wachs 2009), ageism, healthism, and successful aging narratives collectively situate youthfulness and health as normal, while oldness and illness are constructed as forms of social deviance to be avoided at all costs.
In the context of research about later life embodiment, internalized ageism and healthism may augment the actual and perceived distance between study participants and researchers. Briggs (2003, 914) notes that the research encounter may “create and sustain power relations of modern society” and thereby mirror, if not heighten, the cultural vulnerability of study participants. For example, researchers may ask questions or behave in ways that reflect and reinforce the deeply engrained cultural assumptions that younger, healthy individuals are more socially valued than older, frail individuals (Calasanti and Slevin 2001). As a result, the rapport between interviewers and study participants may be undermined as the latter may feel compelled to respond to questions in ways that position themselves in the best possible light, thus managing potential stigma (Cook and Nunkoosing 2008). Thus, research participants may be reluctant to reveal that they dislike or avoid physical activity and other forms of health promotion for fear of being seen as morally suspect relative to their presumed social responsibility to individually manage and discipline their aging bodies. This issue is something I continually struggle against as a result of my academic location in a School of Kinesiology, an interdisciplinary department concerned with researching and promoting exercise and sport. Study participants invariably assume that I hold strong opinions about the importance of physical activity for health and thus often convey hesitance, at least initially, in disclosing negative or ambivalent attitudes about exercise and other forms of health promotion.
In addition to physical activity, social norms dictate that older adults should engage in a variety of gendered body management practices. Accordingly, older men may endeavor to shore up their masculine identities and respond to or prevent the health and sexual changes that come with age by turning to exercise or the use of pharmaceuticals such as Viagra and Cialis (Calasanti et al. 2013; Marshall 2010). Older women may turn to dieting, exercise, make-up, fashion, hair dye, and/or nonsurgical and surgical cosmetic procedures to mask their chronological ages and more closely approximate the youthful, feminine, beauty ideal (Brooks 2010; Hurd Clarke and Griffin 2008; Hurd Clarke, Griffin, and Maliha 2009; Muise and Desmarais 2010; Slevin 2010; Smirnova 2012; Ward and Holland 2011). In this way, older adults not only seek to sculpt and maintain idealized bodies but also to demonstrate the “will to health” (Higgs et al. 2009, 687). Higgs et al. (2009) argue that the pursuit of health through consumption has become as important as having good health itself in today’s youth- and health-focused society. In later life, body management practices both reflect and enable the expression of one’s membership in the third age, a stage of life equated with “an ageing youth culture” (Higgs and McGowan 2013, 22) characterized by health, choice, autonomy, leisure, self-expression, pleasure, and social engagement (Gilleard and Higgs 2013). The third age is juxtaposed against the social imaginary of the dreaded fourth age, which is associated with capitulation to ageist stereotypes of decline and decay (Higgs and Gilleard 2015, 116). In this context, body management practices not only enable older adults to retain their femininity and masculinity, they also are central to the demonstration of their agency, morality, and social citizenship. That said, the ability to use consumption to signify and maintain optimal health and aging is clearly delimited by social class and individuals’ access to financial and social resources (Calasanti et al. 2013; Calasanti and Slevin 2001). In other words, successful aging through body management practices is a privilege more readily available to the middle and upper classes.
Internalized assumptions about appropriate, if not requisite, gendered body management practices frequently influence interview dynamics. On the one hand, I have often found it difficult for participants to illuminate their reasons for engaging in their chosen body management practices. While they may easily identify that they shave, dress in particular ways, or use make-up and hair dye, study participants regularly struggle to articulate why they do those things beyond saying that the process as well as the product makes them feel presentable and more masculine or feminine. Twigg (2000) explains this research conundrum by noting that our perceptions of and motives for the things that we do to and with our bodies “exist at a level that is rarely brought into conscious articulation or review” (4). The challenge of researchers is to find ways to open up conversation about and reflections on the mundane aspects of corporeality in productive and nonleading ways. Similarly, the appearances and body practices of researchers may inadvertently enhance or threaten rapport. For example, it has not been uncommon for female participants to remark on my body weight and clothing choices, make comparisons of what they perceive to be my body management choices with their own, or question me as to my views on everything from cosmetic surgery to the use of hair dye. I have also had a cosmetic surgeon slip into conversation his assessment of my apparently numerous bodily imperfections that would benefit from his skillful attention. Finding a balance between being authentic and presenting as a safe, perhaps even neutral, person with whom participants may freely confide can be a tricky endeavor at times, especially in those moments when participants are openly critical of one’s appearance and body management choices. At the same time, those interactions are perhaps among the most illuminating of participants’ as well as our own perceptions, values, and taken-for-granted assumptions about bodies, gender, and age.
Moving Forward: Strategies and Avenues for Future Research
The literature points to a number of fruitful avenues by which researchers may turn the challenges of internalized biases and social distance into opportunities to enhance the exchanges between interviewers and participants. Much attention has been given to the importance and role of reflexivity or “critical self-reflection of the ways in which researchers’ social background, assumptions, positioning and behavior impact on the research process” (Finlay and Gough 2003, ix). Indeed, there is a wealth of literature that explores the topic of reflexivity (see, for example, Berger 2015; Kelly et al. 2017; Underwood, Satterthwait, and Bartlett 2010) and suggests that critical self-reflection may not only minimize the impact of internalized biases on the research encounter but is also “a crucial strategy in the process of generating knowledge” (Berger 2015, 219). Similarly, social distance between the interviewer and study participants may serve to enhance rapport as researchers are positioned and experienced as acceptable outsiders (Hurd Clarke 2003; Thorpe et al. 2017). For example, younger women interviewing older adults may be perceived as individuals lacking expertise on aging who have the potential to be taught by their more knowledgeable elders (Hurd Clarke 2003; Thorpe et al. 2017). In this way, age and gender differences may facilitate sharing and participant comfort during their interactions with researchers.
In the future, the research on later life body image and embodiment would benefit from greater attention to the diversity of older adults’ experiences. In particular, research is needed that more fully considers the perspectives of older lesbian, gay, bisexual, transgender, and queer adults, the experiences of members of racial and ethnic minorities, and the voices and perceptions of individuals from non-Western countries. Such research would enhance our understanding of the ways that culture, ethnicity, and race combine to influence older adults’ internalization and resistance of age and gender norms and how those norms simultaneously vary and remain the same over time and location in a globalized world. Finally, rethinking the way we report on our methods in academic journals would be helpful. Beyond writing about study design, recruitment, and analytic processes, greater attention to researcher reflexivity as well as the often messy backstage (Goffman 1959) interactions that occur and choices that are made would foster greater awareness of the social construction of knowledge as well as the role of bodies and embodiment in the research encounter.
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