Sexual identity in men: when it shifts in adult life

There is an increasingly dominant cultural narrative that coming to terms with our sexuality, coming out, and being comfortable with who we are sexually is something we negotiate in the early part of our lives, in late adolescence and early adulthood. For many people, that is genuinely how it happens. In a culture that has become more accepting of sexuality minority identities, more people have been able to access the kind of conversations and possibilities that allow that work to happen earlier.

But that is not how it happens for everyone. Increasingly, I see men in their forties, fifties, sixties and beyond who arrive in clinic to think about questions of sexual identity that have either never been settled, or that have begun to emerge in ways they did not expect. In some sense this should not surprise us. What we are learning about human sexual expression is that it is dynamic. It moves. We accept this when we talk about other parts of sexual life. What men want sexually in their early twenties is rarely what they want in their forties or fifties. Interests change. Preferences change. What turns someone on changes. The partners people choose change.

But the conversation rarely extends to who men are having sex with, or who they are attracted to. There remains a dominant assumption that this part of sexuality is set in early adulthood, or even earlier, and remains fixed for the rest of a man's life. Once a label is attached, the assumption goes, that is who he is. That does not change.

In over ten years working in NHS sexual health services, and across the outcomes we have now published in peer-reviewed work, what I have come to think is that this fixed-identity assumption misses what is actually happening for a significant number of the men I see. This piece is about what that work looks like, and about what most public and clinical conversation about sexual identity in midlife gets wrong.

Why this sits differently for men

There is an interesting asymmetry here. Although these questions can be difficult for everyone, there is far greater social acceptance of the idea that women's sexual attraction can shift, can come and go, can be fluid across a lifetime without that necessarily defining who they are. Many women describe being attracted to other women without that attraction having to become an identity. The cultural narrative allows for it. Female fluidity has language attached to it.

For men, that language barely exists. The idea that a man who has identified as heterosexual all his life could find himself attracted to another man, or could find himself drawn to sexual experiences he had never expected, runs against almost everything in the cultural script for heterosexual masculinity. The labels are tighter. The room for fluidity is narrower. The fear that any movement from the established identity must mean something total, must mean some kind of complete reorganisation of who one is, sits much closer to the surface for men.

That asymmetry alone makes this work harder. The man arriving with these questions often has no internal language for what is happening to him. He has not seen it modelled. He has not heard it talked about openly. He often arrives feeling that whatever is going on for him must be an aberration, or a threat, or evidence of something fundamental about himself that he has not been able to see before.

The historical weight some men are carrying

For the older men I see, particularly those over fifty, there is another layer that is easy to underestimate now. Many of them grew up or came of age in a Britain where homosexuality was criminalised. They lived through the AIDS epidemic. They lived through Section 28 and the silencing of any teaching or open discussion about homosexuality in public life. For many of them, the option to come out, to explore, to even ask the question of themselves, was not just culturally difficult. It was actively dangerous.

For some of these men, the ability to have sex with women and to present to the world as heterosexual provided cover. It felt safer. It was easier to fall into that identity than to challenge what they were thinking or feeling in any other direction. The men I work with from this generation often talk about that period with a complicated mix of feelings. There can be a sense of privilege, of having been able to pass at a time when men who could not were exposed and vilified. But there is also, almost always, the recognition that what they felt did not go away. The thoughts, the attractions, the experiences kept returning. The effort to suppress them shaped their sense of self, their relationships, sometimes even their ability to express themselves sexually with the women they were partnered with.

Many of these men arrive carrying shame. Not necessarily about what they feel, but about the time it has taken to be able to acknowledge it. They have known, on some level, for decades.

Many of these men have known, on some level, for decades.

Two broad presentations

The men who arrive in clinic with these questions are not all in the same position. Broadly, two patterns recur.

The first

The first is the man for whom these questions are not new. There has always been something. There have been attractions across his life that he has minimised, redirected, or suppressed. There may have been experiences in adolescence that he has tried not to think about. There may have been thoughts he has worked hard to keep out of his head. He has, often for decades, organised his life around an identity that has not quite fit. He has been heterosexual on the surface and has lived a life that has looked heterosexual, but there has been something underneath that has not gone away.

For these men, what is emerging in midlife is not a new question. It is a question that has been there all along and has finally become impossible to keep below the surface. The historical conditions that made suppression feel necessary have changed. The men around him are coming out later in life in greater numbers, and the cultural permission to do so exists in a way it did not when he was thirty. Something in him is asking, finally, to be looked at.

The second

The second is quite different. This is the man who, on balance, still identifies as a heterosexual man. His relationships have been with women, his attractions are still mostly to women, he still finds women attractive. But something has emerged that he did not expect. Often it begins in fantasy. Pornography that turns him on more than he expected. A scenario he found himself thinking about. Sometimes it begins with a particular person he never imagined being attracted to, with whom feelings have begun to develop. Sometimes it begins with an experience that surprised him, that on the one hand felt good, but on the other seemed to contradict everything he thought he knew about himself.

For these men, the question is not so much who they have always been. It is what to make of something that has appeared, in their forties or fifties or sixties, that the cultural script did not prepare them for. The disorientation is often acute. The fear of what it might mean, what it might require of them, what it might cost them, is often very loud.

What the work looks like for each

The work for these two groups can look quite different, and recognising which territory a man is in is part of the early phase of therapy.

For the first man, the work is often about what has been suppressed and why. What were the conditions that made denial feel necessary. What did he believe would happen if he had named it. What has the cost of suppression been across his life. There can be a particular shame, in our largely well-meaning and sex-positive cultural moment, that if a man has hidden his sexuality for decades, he has somehow colluded with something harmful. He has gone along with a heteronormative narrative that has caused damage to others. That framing is rarely fair to the men I see. They had to make a choice, often in conditions that were genuinely hostile, about what was safest for them at the time. The work is not to judge that choice retrospectively. It is to ask whether the conditions have changed enough now that he could do something different.

If the answer is yes, the work becomes about how. How could he express this part of himself safely now. How could he do so in a way that is kind both to himself and to the people who have known him a particular way for decades. What would it mean to tell others. What would it look like to update his own sense of who he is. That work can be slow, and it can be painful, and it almost always involves rebuilding capacity for self-compassion before anything else.

For the second man, the work is rarely about coming out. It is rarely about a wholesale reinvention of identity. It is more about becoming comfortable with the idea that sexual expression can evolve, that he can have experiences across a broader range than the cultural script suggested, without any of that having to define him in totalising terms. There is a useful concept here, what clinicians sometimes call idiodynamic sexuality, that simply names the fact that sexual response and sexual interest in any individual is fluid and context-specific across a lifetime. Recognising this can be enormously liberating for a man who has assumed that any deviation from his established identity must mean something fundamental. It does not have to.

For some men, this can mean having sexual experiences with other men without ever identifying as gay or bisexual, and without wanting or needing to. This is a real and not uncommon position. It is rarely visible in public conversation about sexuality, because public conversation tends to insist on labels matching behaviour. They do not have to.

The fear of losing something

What is common to both groups is a fear of loss. Many men sitting with these questions arrive worried that to acknowledge what is happening would mean giving up something that has been important to them. The marriage. The family. The visible expression of a traditional masculinity that has felt central to how they have understood themselves and how they have been understood by others. The fear of having to lose any of that often keeps men silent for years.

But that simply is not what acknowledging this part of sexuality necessarily requires. For some men, yes, there will be a process of reorganising their lives that will involve loss and reconfiguration. For many, that is not what the work asks them to do. The work asks them to be honest with themselves about what is happening. What follows from that honesty varies enormously, and is rarely the all-or-nothing reorganisation the fear predicts.

On labels, and on not having one

Modern conversations about sexuality move quickly to labels. Use the word "gay" and a particular set of images comes to mind. Use the word "straight" and a different set comes to mind. The labels are loaded. They carry far more than just information about who someone has sex with. They carry assumptions about politics, about community, about lifestyle, about identity in much broader terms than is reasonable.

For many of the men I see, this is part of what makes the conversation so difficult. They cannot find a label that fits, and the existing labels feel like they would require them to take on a whole set of meanings they do not want. The work, often, is to make space for the idea that one does not have to have a label at all. Sexuality can be a description of what someone does, what they enjoy, who they connect with. It does not have to be a name for who they are in totalising terms.

For some men, naming and claiming a sexuality minority identity is exactly the right thing. It is what they have been waiting to do for decades. For other men, it is not what they need at all. Holding both possibilities open, without prescribing one or the other, is part of what allows this work to actually do something useful.

Two men I have been thinking about

To make this concrete, here are two men, each in one of the two presentations described above.

The cases described in this essay are anonymised. Initials and identifying details have been changed throughout. Some are composites.

E.B.

One of the men I see often in this position. Someone in his late fifties or early sixties. He grew up at a time when homosexuality was criminalised in Britain, came of age through the AIDS years, and lived his thirties under Section 28. He had attractions in adolescence that he learned not to look at, and moments across his life that he packed away. He married, had children, and lived a life that looked entirely heterosexual from the outside, and that he had largely come to believe in himself. He arrived in clinic, by his sixties, not because his attractions had changed, but because his ability to keep ignoring them had begun to give way. He carried less shame about what he felt than about how long it had taken him to be able to acknowledge it. The work for him was less about discovering something new than about being allowed, finally, to look at something that had been there throughout. He often felt overwhelmed or disoriented. He talked about feeling he was entering a second adolescence; feeling simultaneously filled up with optimism whilst feeling deskilled and uncertain. His journey was beginning again, exploring what care, support and compassion might look like as he opened up to new experiences and connected to himself in new ways.

H.M.

A man I worked with in his fifties, who came to me after he had had a sexual experience with another man. He had been married, had since separated, and was beginning what looked like a serious long-term relationship with a new female partner whom he loved very much. He arrived confused and overwhelmed, with a deep sense of shame, asking what this meant about him.

Over the work, we explored exactly the ground I have been describing. We looked at the concept of fluidity. We worked at decoupling the act from the identity. We held open the possibility that he was not required to come to any particular conclusion. Towards the end of therapy, in something close to an aside, he said this:

> "I don't know if the word straight, or gay, or bi will ever describe me. I'm just a sexual person. I think I like having sex with people I feel connected to. Most of them are women, but maybe, sometimes, it'll be a man."

He said it almost as a throwaway. But it summarised, in a way I have not been able to better, where this work very often wants to land. There is no required label. There is no right way to be sexual. As long as a man is engaging in his sexual life in ways that align with his values and that feel safe for him, the expression of his sexuality can take many forms without that having to take anything away from who he is overall.

There is no required label. There is no right way to be sexual.

What this means in practice

For men sitting in this territory, or for partners and friends and family of men sitting in this territory, a few things follow.

The first is that whatever is happening, it is not unusual. Far more men than the cultural script suggests reach midlife with questions about sexual identity that have either never been settled or have begun to emerge unexpectedly. The silence around it has not made it rare. It has made it lonely.

The second is that the work does not require any single outcome. Some men arrive at a sexuality minority identity. Some men do not. Some men reorganise their lives. Some men do not. The work allows whichever of those is true for the specific man to become possible. It does not prescribe a destination.

The third is that doing this work alone is harder than doing it with someone who can hold the whole spectrum of possible answers open. A therapist whose default frame is that any same-sex attraction must mean a closeted gay man, or whose default frame is that any movement in identity must be a phase, will probably do harm in this work. The right kind of therapist holds the space open and lets the man find his own shape inside it.

The fourth, for the men in established relationships, is that some of this work cannot be done purely alone. Talking honestly to a long-term partner about how interest or fantasy or feeling is shifting can be one of the harder parts of this. It is also, often, what allows a relationship to survive and even deepen across it. Women historically have had slightly more language for talking about how their own attraction and fantasy can shift. Men have not. Building that vocabulary, alongside a partner where possible, is often part of how the work holds together.

Where the work has to start

The starting point in all of this, regardless of which presentation a man arrives with, is to take seriously the idea that human sexuality does not finish forming in early adulthood. It keeps moving. It keeps responding to context, to relationships, to time. That movement is not pathology. It is not a problem to be fixed. It is part of what being a sexual person across a lifetime actually involves.

Human sexuality does not finish forming in early adulthood. It keeps moving.

For the men who arrive in clinic asking what is happening to them, the most useful first thing I can do is name that what they are experiencing is part of human sexuality, not a deviation from it. The shame, the fear of losing something, the dread of having to reorganise everything, are responses to a cultural story that is simply not accurate. When the story is replaced with something closer to the truth of how sexuality actually works, almost everything that follows becomes more bearable.

When the story is replaced with something closer to the truth of how sexuality actually works, almost everything that follows becomes more bearable.

Some men, after that, will reorganise their lives. Some will not. Some will claim a new identity. Some will not. Some will find a quiet, private accommodation with parts of themselves they had not let in before. All of those outcomes are valid. All of them are real shapes that this work takes.

All of those outcomes are valid. All of them are real shapes that this work takes.

What does not work, and what has been the default for too long, is silence. Pretending that a man who arrives at fifty with questions about his sexuality has somehow failed at the task he should have completed at twenty is neither accurate nor helpful. The real task is the one in front of him. It is not too late to do it.

The real task is the one in front of him. It is not too late to do it.

Dr Michael Yates is a Clinical Psychologist, EFS-ESSM Certified Psychosexologist and COSRT-registered Sex and Relationship Therapist. He is Lead Clinician and Psychology Service Lead at 56 Dean Street, part of Chelsea and Westminster Hospital NHS Foundation Trust.