Susan Stone is the creator and presenter of It's a Jungle, exploring the people, science, and ideas shaping our health and wellbeing. Here, she talks about the connection between sexuality and longevity.
When Dr Juliana Hauser says, "If you're breathing, you're sexual," it stops people in their tracks. Not because it's shocking, but because it reframes everything we think we know about sexuality and health.
After speaking with the therapist, educator, and author of A New Position on Sex, I'm convinced that by keeping sexuality in the shadows, we've been missing a fundamental piece of the longevity puzzle.
This is the latest in my series exploring women's health and longevity. We've covered building physical resilience with Dr Vonda Wright and understanding our hormones with Dr Jennifer Garrison. Now we're
venturing into territory that Dr Hauser calls "the final frontier of self-development" - one that research shows directly impacts not just quality of life, but longevity itself.
Dr Hauser has been called "your best girlfriend...with a PhD," and within minutes of our conversation - and it's clear why. She has the rare ability to make the most intimate topics feel as comfortable as discussing the weather, while delivering science-backed insights that could transform how we think about ageing, relationships, and resilience.
What makes her expertise particularly valuable is that it's actually quite rare. As both a licensed therapist and what she calls a "sexpert," Dr Hauser bridges a significant gap in healthcare training.
Why Sexuality Belongs in the Longevity Conversation
Research consistently shows that sexual satisfaction and longevity are intimately connected, yet, as Dr Hauser puts it, "Sex has had bad PR and sexuality has had even worse PR."
Recent research from the Longitudinal Ageing Study Amsterdam - a 27-year follow-up of adults aged 55 to 84 -found that greater enjoyment of sexuality is linked to longer life, but only among those who consider sexuality important in their lives.
The study showed that, after accounting for health and psychosocial factors, sexual enjoyment was positively associated with longevity, with the effect most pronounced in individuals for whom sexuality retained personal significance.
In contrast, no such association was found among those who did not value sexuality highly in later life. These findings highlight not just the importance of sexual well-being, but also the role that individual values and perceptions play in healthy ageing.
This isn't about performance or frequency. It's about something Dr Hauser calls "sexual agency" - a concept that extends far beyond the bedroom into every aspect of how we live, choose, and age.
"Sexual agency is learning your terms and then learning how to live your terms," she explains. "It's looking at how well you know yourself, and if you know yourself well, then do you know what your yeses and nos are, what your wants and needs are, and do you know how to express and communicate that?"
This framework - knowing yourself deeply and having the courage to live authentically - turns out to be one of the most powerful tools for navigating life's challenges, including the physical and emotional
changes that come with ageing.
The Agency Evolution: From Empowerment to Agency
Dr Hauser maps out a progression that many women will recognise: "There is a pathway towards agency, and it starts with boundaries that you give to other people. Then it's boundaries that you keep to yourself. Then, usually, when you get to the place of having the experience of standing up for yourself...you stay there enjoying your voice, which then leads you to empowerment."
But empowerment, she argues, isn't the end goal. "Empowered people are amazing...but empowerment ends when there's a conflict of needs and wants, which invariably happens in any kind of relationship that has depth to it."
True agency is relational. "Agency says, here's who I am. I've done the work to know who I am and what I need and what I want. And I've created a space for you to be somebody who knows who they are... And let's talk about the ripple effects together."
This distinction matters enormously for women's health and longevity. Research shows that strong, authentic relationships are among the strongest predictors of healthy ageing.
Dr Hauser's framework provides a roadmap for building those relationships - starting with the relationship you have with yourself.
A Framework for Transformation: The Nine Pillars
Dr Hauser's book outlines nine pillars of holistic sexuality, but this may not be what you expect. The first pillar isn't about sex acts at all - it's about sensuality.
"If you can put aside that being a sexual person means that you're being active with sex acts...then everything else falls into place and everyone is a sexual being if you're breathing," she explains.
The nine pillars are: sensuality, wellness and fertility, pleasure, desire, intersecting identities, power and trauma, sex acts and interest, relationships and connections, all centred in agency - create what Dr Hauser calls "a 360 of who you are as a person."
This comprehensive approach addresses a gap that exists even in healthcare. "In the US, as therapists, we don't have to have one class in sexuality in order to practice," Dr Hauser reveals. "There's only one
state that requires it for licensure and the rest, you're on your own."
The Resilience Connection: An Act of Self-Trust
Perhaps the most compelling aspect of Dr Hauser's work is how sexual agency becomes a source of resilience during life's inevitable challenges. She describes agency as "an act of self-trust" that builds
upon itself.
"When you start living in the truth of who you are, you make decisions that are authentic and powerful...not made in decisions of fear," she explains. "When people make decisions based in fear, you really come
from a place of harm and negativity."
She shares the story of a client, married for 25 years, who felt her life "dulling." Through developing sexual agency - starting with simple questions about her sensory preferences - the woman transformed not just her marriage, but her career and relationship with her adult children.
She used to feel like someone who did this had "audacity" but now sees it as "somebody who has agency," Dr Hauser recounts. "Agency feels so much better."
The Societal Ripple Effects
Dr Hauser makes a bold claim: when societies deny holistic sexual education, we see rises in everything from divorce rates to sexual violence to deaths by suicide. It sounds provocative, but she has the
research to back it up.
"When you don't have a culture that is based in solid sex education that is holistically bound...you see a huge increase in sexual violence," she explains.
Conversely, "when we see that there is more accessibility, there's more education, there's more inclusivity and more diversity...it's always correlated with more positive things."
For women in particular, understanding the relational aspect of agency becomes a superpower. "When women are in agency around other women who are in agency, I have seen mountains move truly," Dr Hauser observes. "Mountains that move in relationships, in communities, in schools, in policy changes."
Starting Your Journey: The Permission to Not Know
For anyone feeling overwhelmed by the idea of exploring sexuality, Dr Hauser offers reassuring guidance. First, remove the assumption that sexuality equals sex acts. Second, "get curious. Learn to get comfortable with 'I don't know.'"
She shares her own transformation story: raised in a conservative family by a radiologist father and ER nurse mother, she went from having a mother who "literally fell down" when she discovered her daughter was sexually active, to that same mother proudly displaying Dr Hauser's book at dinner.
"If my mom can do that, then you can too," she says. "Everyone has a starting point, and there's no destination that's the right destination. All I ask you to do is just to start the journey."
The Mind-Body-Relationship Connection
What makes Dr Hauser's approach particularly relevant to longevity is how it integrates mental health, physical wellness, and relationship quality - all established pillars of healthy ageing.
"When you do the work within who you are as a sexual being...it is unmistakable how it changes your life," she explains. "It is such a difficult place to sit in. It's uncomfortable. It is divisive... And it's so multifaceted that if you choose to ignore it...then you are missing a very big part of the capability of knowing the truth of you."
The loneliness epidemic, she argues, stems partly from this disconnect: "How can you create relationships and how can you actually take in someone's genuine wanting of you if you don't even know who you are?"
Practical Steps: From Luxury to Necessity
Dr Hauser challenges the notion that inner work is a luxury when life gets busy. "We've made things that really aren't necessary to our deeper lives...become the necessity of our life. And thusly, the things that really feed our soul become the luxuries."
She advocates reframing this work as essential maintenance, like "good sleep" but for your emotional and relational wellbeing.
For those ready to begin:
- Start with sensuality: Before thinking about sexuality, explore your relationship with your five senses. What are your yeses and nos for sight, sound, touch, taste, and smell?
- Embrace the unknown: When you encounter uncertainty about your preferences, get curious rather than shutting down.
- Practice the pause: Before any decision, sexual or otherwise, ask, "Do I want to be doing this? Is this what I want?"
- Build your terms: Identify what agency feels like in your body - usually some version of "peace, groundedness, calmness."
- Find community: Dr Hauser's international program, REVEALED, operates in eight countries and five languages, demonstrating the universal need for this work.
Your Sexual Agency Week: Where to Start
Ready to explore this final frontier? Here's your practical starting point:
- Reveal yourself to yourself: Take Dr Hauser's advice and approach one area of uncertainty with curiosity rather than judgment.
- Practice the sensuality pillar: Spend five minutes each day noticing your sensory preferences - the textures you enjoy, the sounds that soothe you, the sights that energise you.
- Check in with your yeses and nos: Before your next significant decision, pause and ask: "Is this truly a yes for me?"
- Find your agency feeling: Notice what peace and groundedness feel like in your body when you make an authentic choice.
Start the conversation: Share one authentic preference or boundary with someone you trust.
Dr Hauser's work reminds us that sexual health isn't separate from overall health - it’s integral to it. By reclaiming this aspect of ourselves, we're not just improving our intimate relationships; we're building the self-knowledge, authentic communication, and resilience that research shows are essential for ageing well.
The final frontier of self-development might just be the first step toward your most vibrant, authentic, and healthy years ahead.
The views and experiences expressed here are those of the author and do not represent or reflect the views of RTÉ.
