The investigators sought evidence-based criteria for identifying late-onset hypogonadism in men between the ages of 40 and 79 years on the basis of the association between symptoms and a low testosterone level. The data suggest that late-onset hypogonadism can be defined by the presence of at least three sexual symptoms with a total testosterone level of less than 11 nmol per liter and a free testosterone level of less than 220 pmol per liter.

This survey of a large population of adults 57 to 85 years of age showed that rates of sexual activity decline with age but that many older adults are sexually active. Women were less likely than men to report having a partner and being sexually active. Many older adults reported sexual problems; few had discussed sexuality with a physician. These cross-sectional data inform our understanding of sexual activity and problems in older adults.

Sparse outcome data exist for genetic males who are assigned female sex at birth to overcome severe phallic inadequacy occurring in cloacal exstrophy, a rare, complex pelvic defect. This article reports the subsequent sexual identity of 16 genetic males, 14 of whom were assigned to female sex soon after birth. Eight of 14 subjects assigned to female sex declared themselves male over time; the 2 raised as males remained so.