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The main thesis of this article is about how women and men have different views on consent and when they should be given. The article discussed how heterosexual women believed consent should be given regardless of how long the relationship has lasted for but in contrast to men, they believe that the need for consent lessens as the relationship progresses. Two key terms are influence and initiator. Influence means to have an effect on someone and the way they act and initiator means someone who suggests something first and wants you to follow along with them. I think these words will be beneficial to my paper because they both can occur and be used during a sexual encounter.

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The Role of Sexual Consent and Past Non-consensual Sexual Experiences on Rape Supportive Attitudes in a Heterosexual Community Sample

Abstract

The present study aimed to investigate the relationship between (a) sociodemographic variables, past non-consensual experiences and sexual consent and (b) the endorsement of rape supportive attitudes. A sample of 1042 heterosexual adults (42.4% men) was surveyed. A predictive model indicated that the most relevant predictors of rape supportive attitudes were gender (i.e., being male) and most dimensions from sexual consent such as (Lack of) perceived behavioural control, Sexual consent norms, and Awareness and discussion. On the contrary, holding a positive attitude for the establishment of consent in sexual encounters negatively predicted rape supportive attitudes. The positive association between gender (i.e., being male) and (Lack of) perceived behavioural control was stronger among participants who were not victims of past non-consensual sexual experiences than among participants who were victims of past non-consensual sexual experiences, and the same held true when Positive attitude toward establishing sexual consent was involved in the interaction. These findings may help us understand the role of sexual consent on the attitudes that support violence, which can better guide future prevention programs aimed at reducing them.

Introduction

Sexual consent can be defined as the freely given clear communication of a feeling of willingness to engage in sexual activity with a particular person in a particular context (Hickman & Muehlenhard, 1999; Willis & Jozkowski, 2019). In this framework, sexual activity can only continue if both partners express active interest (Javidi et al., 2022). Thus, sexual consent is a form of sexual communication that has recently acquired a tremendous practical importance in everyday sexual interactions, even as a legal indicator to determine the existence of sexual violence (Humphreys & Brousseau, 2010).

Several studies have investigated sexual consent signalling and people's actual behaviour in communicating consent (King et al., 2021; Muehlenhard et al., 2016; Newstrom et al., 2021). Research has shown that both women and men tend to signal consent nonverbally more than verbally and implicitly more than explicitly (Groggel et al., 2021; Humphreys, 2007; Willis et al., 2019, 2021). For example, both men and women tend to signal consent nonverbally by physically approaching, kissing, touching intimately or not resisting their partner's advances (Willis & Jozkowski, 2022). Young adults also tend to communicate consent indirectly and passively (Jozkowski et al., 2014; Orchowski et al., 2022; Shumlich & Fisher, 2020). However, research has shown that explicit verbal cues of consent are most accurately interpreted by a partner compared to other types of consent cues, including implicit and nonverbal (Willis et al., 2021). For this reason, sexual consent is considered an important mechanism for reducing sexual assault and coercion (Shumlich & Fisher, 2020).

The Role of Gender and Past Non-consensual Sexual Experiences

Research from a psychological perspective has focused mainly on the individual and interpersonal correlates of sexual consent. For instance, Humphreys and Herold ( 2007) investigated the impact of gender in a heterosexual population. They found that heterosexual women considered it more important that consent be given regardless of relationship length and that consent be an ongoing process during the sexual encounters rather than a one-time event. In contrast, heterosexual men were more likely to hold the view that consent from a partner can be assumed without direct verbal communication, that consent only needs to be given once at the beginning of sexual activity and that the need for consent decreases as the length of the relationship increases (Humphreys, 2007; Humphreys & Herold, 2007). Other research has shown that, although men and women do not differ in their conceptions of sexual consent, women place more importance on this issue than men (Graf & Johnson, 2021).

Sexual precedents and past non-consensual sexual experiences may also impact one's attitudes, beliefs and behaviours about consent (Willis & Jozkowski, 2019). According to Kilimnik and Humphreys ( 2018), women's previous sexual experiences may influence their understanding of consent and the ways in which they negotiate sexual consent. A history of non-consensual experiences plays a role in consent relevant constructs, such as sexual risk perception and negotiation (Marx & Soler-Baillo, 2005), endorsement of rape myths and risk for re-victimization (Peterson & Muehlenhard, 2011). This is consistent with research on sexual communication strategies, which shows that individuals with non-consensual sexual experiences have less effective strategies for exiting risky dating and social situations compared to individuals without such experiences (Nason & Yeater, 2012).

Sexual Consent and Sexual Violence

Although most research views sexual consent as an individual and interpersonal issue, attitudes and behaviours on sexual consent may be related to cultural and social factors. Indeed, sexual consent is associated with traditional sexual scripts, i.e., men as initiators of sex and women as sexual gatekeepers (Hirsch et al., 2019). Men are typically assigned the role of actively seeking activity and sexual consent, while women are typically assigned the role associated with the responsibility to give or withhold consent, and thus determine whether or not sexual activity occurs (Jozkowski & Peterson, 2013). The belief, among many adults and college students, that men are socially and sexually dominant leads to double standards and men to assume consent in the absence of clear signals otherwise (Jozkowski et al., 2017). Studies have found that many men indeed stop sexual advances only when there is a clear and explicit (usually verbal) signal to stop (Goodcase et al., 2021; Marcantonio et al., 2018), which often leads to unwanted sexual behaviours (Orchowski et al., 2018). Sexual assault, then, is undoubtedly tied to sexual consent, especially as sexual assault is defined as sexual acts without consent (Jozkowski & Peterson, 2013).

This can have an impact not only on an individual level, but also on social perceptions of sexual violence and rape. Some studies have found that college students who had greater knowledge of sexual consent issues reported higher rates for bystander helping intentions and behaviour in cases of sexual violence than those with less understanding (McMahon et al., 2019; Moschella-Smith et al., 2022). Similarly, Orchoswki et al. ( 2022) examined bystander attitudes among young adult male active-duty soldiers and found that those who placed more importance on obtaining verbal sexual consent from a partner showed more favourable intentions to intervene when violence occurred. In addition, the intentions to respect communication of consent appear to be negatively related to rape myths, i.e., beliefs that serve to deny and justify men's sexual aggression against women (McMahon & Farmer, 2011; Shafer et al., 2018).

In this sense, sexual consent may be one of the key factors influencing the perception of violence. According to Willie and Kershaw ( 2019), violence against women is not a merely individual issue, and a social-ecological perspective can provide a comprehensive framework to better understand and address it. If some personal variables may be risk factors at the individual and relational level (e.g., CDC, 2019; Conley et al., 2017; Kelley et al, 2016; Tyler et al., 2017), some social attitudes may be conceived as risk factors at the cultural level. Indeed, a large body of research has used the gender stereotype framework to investigate how cultural values and gender stereotypes may affect the perception of violence against women (e.g., CDC, 2019; Rollero, 2020; Rollero & De Piccoli, 2020; Saucier et al., 2015; Yapp & Quayle, 2018). Gender-role stereotypical attitudes may influence the recognition of some behaviours, such as restriction of freedom and emotional abuse, as actual forms of violence against women (Rollero et al., 2021). Moreover, people who hold sexist attitudes are more likely to blame the victim of a sexual assault than women and men who hold more non-traditional views (e.g., Canto et al., 2014; Chapleau et al., 2007; Moyano et al., 2017; Rollero & Tartaglia, 2019).

Consistent with this framework, we argue that attitudes and behaviours related to sexual consent may be associated with rape supportive attitudes. Indeed, being less concerned with seeking and receiving sexual consent prior to sexual encounters may be associated with more positive attitudes toward rape (Warren et al., 2015), not only at the interpersonal level, but also in relation to the social perception of rape. Based on this reasoning, the purpose of our study was to extend past research on sexual consent by investigating its role on the social perception of rape. To our knowledge, previous literature has considered sexual consent as mainly an individual or interpersonal issue, and its association with attitudes toward violence has not been tested yet.

The Present Study

In this study we analysed the relation among gender, involvement in past non-consensual sexual experiences, beliefs, attitudes and behaviours concerning sexual consent, and justification of violence, as measured by rape-supportive attitudes. Specifically, based on the literature above, we tested a moderated-mediated predictive model aimed at examining the following hypotheses:

H1

Compared to women, men would show stronger rape supportive attitudes.

H2

Involvement in past non-consensual experiences (as victims) would be associated with lower rape supportive attitudes.

H3

Adaptive sexual consent attitudes, beliefs and behaviours related to sexual consent would be negatively related to rape supportive attitudes. Therefore, a low (Lack of) perceived behavioural control, a strong Positive attitude towards establishing consent, a low Indirect behavioural approach, strong Norms of sexual consent and a strong Awareness of consent would be positively associated with lower rape supportive attitudes.

H4

Regarding the likely mediating/moderating role of sexual consent between the sociodemographic variables and rape supportive attitudes, we expected that attitudes, beliefs and behaviours related to sexual consent may be influenced by gender and past non-consensual sexual experiences (Graf & Johnson, 2021; Kilimnik & Humphreys, 2018; Willis & Jozkowski, 2019).

Method

Participants

We surveyed 1226 Italian adults. We excluded 182 who declared a non-exclusive heterosexual sexual orientation, as each group was too small to be included in the analysis, or they did not answer the question. Thus, we performed our analyses on a dataset composed of 1042 participants (men = 42.4%, women = 57.6%, no participants declared themselves as non-binary/trans, M age = 30.54, SD  = 11.60, min = 18, max = 60). Among them, 44% referred to have been victims of non-consensual sexual experiences (e.g., unwanted touching or stroking).

Measures

Past Non-consensual Sexual Experiences

We measured involvement in past non-consensual sexual experiences using a dummy variable (1 = yes, 0 = no). Based on the Sexual Experiences Survey (SES; Koss & Gidycz, 1985), participants were asked if they have ever had unwanted sexual experiences.

Consent Attitudes, Beliefs and Behaviours

We used an Italian adaptation of Humphreys and Brousseau's ( 2010) Sexual Consent Scale-Revised (SCSR) that provides information regarding attitudes, beliefs and behaviours related to sexual consent. In its original version, the scale is composed of 39 7-category Likert items Humphreys and Brousseau's ( 2010) analyses showed that SCSR has a 5-dimension factorial structure: (a) (Lack of) perceived behavioural control (measured by items such as, 'I think that verbally asking for sexual consent is awkward' and 'I am worried that my partner might think I'm weird or strange if I asked for sexual consent before starting any sexual activity'), (b) Positive attitude toward establishing consent (measured by items such as, 'I feel that sexual consent should always be obtained before the start of any sexual activity' and 'I believe that asking for sexual consent is in my best interest because it reduces any misinterpretations that might arise'), (c) Indirect behavioural approach to consent (measured by item such as, 'Typically I communicate sexual consent to my partner using nonverbal signals and body language' and 'It is easy to accurately read my current (or most recent) partner's nonverbal signals as indicating consent or non-consent to sexual activity'), (d) Sexual consent norms (measured by item such as, 'I believe that sexual intercourse is the only sexual activity that requires explicit verbal consent' and 'If consent for sexual intercourse is established, petting and fondling can be assumed'), and (e) Awareness and discussion (measured by item such as, 'I have discussed sexual consent issues with my current (or most recent) partner at times other than during sexual encounters' and 'I have discussed sexual consent issues with a friend').

After a series of Confirmatory Factor Analyses (CFAs) (see Table S1 in the Supplementary material), based on the combination of theoretical reasoning and of the inspection of the modification indices the software provided, we discarded 24 of the scale's items, in that their inclusion would have led to an unsatisfactory fit and/or it would have led to a different number of items measuring the five factors of the scale. The remaining 15 items (reported in Table S2 in the Supplementary material) showed the expected 5-factor structure. The fit of the model was good, CFI = 0.97, RMSEA  = 0.0 (90% CI 0.03-0.05). Using CFA, we computed five SCSR scores as factorial scores of the scale. Cronbach´s alpha values ranged from 0.59 to 0.82.

Rape Supportive Attitudes

We used an Italian adaptation of Lottes' ( 1991) Rape Supportive Attitude Scale (RSAS). In its original version, the scale is composed of 20 5-category Likert items, such as 'Being roughed up is sexually stimulating to some women' and 'If a girl engages in making out or petting and she lets things get out of hand, it is her fault if her partner forces sex on her', and has a unidimensional structure. After a series CFAs (see Table S3 in the Supplementary material), we deleted 5 items to maximize the fit of the factorial solution. The resulting 15-item battery (reported in Table S4 in the Supplementary material) showed a unidimensional structure and a satisfactory fit, CFI = 0.92, RMSEA  = 0.06 (90% CI 0.06-0.07). Using CFA, we computed one RSAS score, as the factorial score of the scale (α = 0.82).

Sociodemographic and Control Variables

We used gender (dummy variable: 1 = men, 0 = women) and past non-consensual sexual experiences (dummy variable: 1 = yes, 0 = no). Moreover, in our analyses we controlled for participants' age and years of education.

Table 1 Descriptive statistics for the study's variables and bivariate correlations between them

Table 1 reports the descriptive statistics for our variables and the bivariate correlations between them.

Procedure

Participants were recruited using a snowball sampling procedure, begun with postings by the researchers and their students in several social networks, email groups and web pages in which information about this research was provided. The link from the posting took participants to a secure, anonymous online questionnaire where they read an informed consent before beginning the study. Participants were also informed that their participation was voluntary and that they could discontinue the study at any time. The questionnaire took approximately 20 min to complete. No compensation was given for their enrolment. The Ethics Committee of the University of Torino approved the study protocol (protocol number: MAR.20/11.PRY).

Data Analyses

Using MPLUS, we resorted to a structural equation modelling approach, combining CFA (the SCSR and the RSAS were measured as latent variables) and a path analysis aimed to test the hypotheses above (see Fig. 1). As the CFAs described above, this predictive model was estimated using the Maximum Likelihood method. We evaluated the fit of all of our models via the Comparative Fit Index ( CFI) and the Root Mean Square Error of Approximation ( RMSEA). Based on Xia and Yang ( 2019), we considered the models to be satisfactory with a CFI value > 0.90 and an RMSEA value < 0.08.

Results

Table 2 shows the results of the moderated-mediated structural equations model aimed at testing our hypotheses. The first 10 columns report the results for the left portion of the model, aimed at predicting the five SCSR factors, modelled as latent variables. Among the control variables, age showed a positive association with (Lack of) perceived behavioural control and a negative association with Awareness and discussion, while education was positively associated with Positive attitude toward establishing consent and negatively associated with Indirect behavioural approach to consent and Sexual consent norms. More interestingly as concerns our goals, substantially consistent with our hypotheses, being male had a positive association with (Lack of) perceived behavioural control and with Sexual consent norms and a negative association with Positive attitude toward establishing consent. On the other hand, past non-consensual sexual experience had a positive association with Awareness and discussion and a negative association with Indirect behavioural approach to consent.

Table 2 Moderated-mediated model predicting rape supportive attitudes

Having been victim of non-consensual sexual experiences moderated the associations between being male and (Lack of) perceived behavioural control (see Fig. 2). A simple slope analysis showed that the being male-(Lack of) perceived behavioural control positive association was stronger among participants who were not victims of past non-consensual sexual experiences, simple slope = 0.97, SE = 0.15, than among those who experienced unwanted sexual contacts, simple slope = 0.58, SE = 0.12. The difference between the two slopes was statistically significant, t(1006) = 2.03, p  = 0.04.

Having been victim of unwanted sexual experiences moderates the relation between being male and (Lack of) perceived behavioural control

Having been victim of non-consensual sexual experiences moderated also the association being male and a Positive attitude toward establishing sexual consent (see Fig. 3). The negative association between these variables was stronger among those who did not have unwanted sexual contacts, simple slope = − 1.02, SE = 0.12, than among those who had unwanted sexual contacts, simple slope = − 0.67, SE = 0.10. The difference between the two slopes was statistically significant, t(1006) = 2.24, p  = 0.03.

Having been victim of unwanted sexual experiences moderates the relation between being male and Positive attitude toward establishing sexual consent

Table 2's last 2 columns report the parameters for the right portion of the model, aimed at predicting RSAS, modelled as latent variable. Being male showed a positive association with RSAS, while age, years of education and past non-consensual sexual experiences were not associated with it. More interestingly as concerns our goals, consistent with our hypotheses, RSAS showed a positive association with (Lack of) perceived behavioural control, Sexual consent norms, and Awareness and discussion and a negative association with Positive attitude toward establishing consent. Its association with Indirect behavioural approach to consent was not significant. The indirect association between being a man and RSAS was positive and significant, indirect effect = 0.12, SE = 0.02, p  < 0.001.

Discussion

The present study aimed to examine the relationships between sexual consent, conceptualised as a five-multidimensional construct encompassing attitudes, beliefs and behaviours, and rape supportive attitudes in a community sample of heterosexual men and women. The predictive role of gender, past non-consensual sexual experiences and of their interaction was also considered, while age and education were statistically partialled out. Overall, some dimensions of sexual consent showed a positive association with being male, especially among participants who had been victims of non-consensual sexual experiences in the past. In addition, having difficulties to ask for consent, less positive attitudes towards establishing consent, endorsing certain sexual consent norms and greater awareness and discussion about sexual consent were predictors of higher rape supportive attitudes.

The first relevant finding from our study is that gender plays a role on sexual consent. In particular, men, more than women, indicate higher (Lack of) perceived behavioural control and more Sexual consent norms. That is, they have more difficulties for establishing consent prior sex and hold more sexual norms in relation to consent. Our findings are in line with traditional gender roles in which men are those who should initiate sex, while women should reject sexual activity, even if they want it, while men insist or ignore women's refusal (Jozkowski & Peterson, 2014). This is consistent with recent results showing that a sexual double standard still exists and influences whether or not and how we communicate within a sexual context (Gómez Berrocal et al., 2019; Moyano et al., 2022; Sánchez-Fuentes et al., 2020). In addition, an interaction between being male and previous non-consensual experiences was found for both (Lack of) perceived behavioural control and Positive attitude for establishing consent. These results indicate that those men who were victims of violence will be more willing to establish sexual consent, in contrast to those who did not. This greater favourable attitude toward negotiating consent has been recently shown among those who reported to have been sexual victims (Moyano et al., 2022) which emphasizes the connection between sexual violence and sexual consent (Rousseau et al., 2020).

A second relevant finding is that participants who experienced non-consensual sexual experiences also indicate being more aware of this topic. In addition, when they approach consent in their relationships they are less likely to display indirect behavioural signalling, instead they would use more explicit or direct strategies, such as verbal manifestations. This contradicts previous results from Kilimnik and Humphreys ( 2018) in undergraduate women with a history of non-sexual consent, who reported fewer positive attitudes toward obtaining consent and more indirect approaches to express consent, while other studies did not find assault history as significant (McKenna et al., 2021). Instead, our study emphasizes that victims increase their awareness after non-consensual activities, which is consistent with a previous study from Spain in which sexual victims, in comparison to non-sexual victims, consider important the establishment of consent (Moyano et al., 2022). Furthermore, victims would not easily assume consent without direct verbal communication, and it should be obtained explicitly to reduce ambiguity (Humphreys & Brousseau, 2010).

A final relevant finding is that the variables that better predict rape supportive attitudes are the following: being male, lower self-efficacy to ask for consent, negative attitudes toward establishing consent, endorsement of more sexual consent norms and greater awareness about consent. Therefore, most attitudes, beliefs and behaviours related to how sex is negotiated are linked to attitudes about rape. This association is of great relevance, given that, as Moyano et al. ( 2017) have previously shown, supportive attitudes toward rape are related to violent or aggressive behaviours. In their study, Moyano and colleagues showed that male aggressors have more supportive attitudes toward rape than non-aggressors. As hypothesized, in our study, gender differences have also emerged. Similarly, Camp et al. ( 2018) found that women, compared to men, endorse more positive attitudes towards explicit consent. On the contrary, hypermasculine attitudes and acceptance of the rape myth have been related to unfavourable attitudes towards communication about sexual consent (Shafer et al., 2018). Moreover, men who are more exposed to sexualized women also accept more myths about rape and myths of sexual abuse, gender stereotypes and interpersonal violence (Sáez-Díaz, 2016). Furthermore, undesired explicit advances that are supported by sexual scripts would lead to greater invisibility and refusal of consent. Taken together, maintaining a culture that supports certain ideas associated with the perpetuation of sexual violence behaviours reduces the responsibility for seeking sexual consent (Argiero et al., 2010; Kilimnik & Humphreys, 2018).

Our study adds support to the multidimensionality of sexual consent, by distinguishing between beliefs, attitudes and behaviours. Therefore, our findings show that having certain knowledge about sexual consent, discussing about it does not necessarily lead to the endorsement of being more favourable to consent. On the contrary, behavioural control and positive attitudes do mean being favourable to consent, as they are probably core factors of consents, showing a stronger connection with particular sexual behaviours.

Limitations and Future Directions

There are some limitations that should be noted. First, as it often happens in social-psychological research, a convenience method for sampling was used and, therefore, our findings cannot be generalized to the general Italian population. Second, our study is cross-sectional, thus the direction of the relationships among the examined variables cannot be established. Longitudinal studies could help us to better understand this phenomenon and its changes across life span. Third, we used a self-report method. Thus, we have no actual information about participants' past sexual experiences. These limitations are typical of the large majority of the studies performed in this field. Fourth, when fitting the RSAS and, especially, the SCSR we had to discard some items. This was one of the first times these scales have been used in the Italian context. Moreover, our analyses were much more demanding that the original ones. A deep methodological study could be conducted in order to explore whether this was a problem of the Italian adaptation or any other intrinsic problem of the scales. Therefore, it could be interesting to conduct a replication study in order to provide support to the validity of our scales. Finally, due to the skewed distribution of our participants on the sexual orientation items, we have to discard the non- heterosexual participants. A replication of this study performed in more diverse samples and with sexual minorities could be interesting. In addition, future studies could explore how each particular dimension of consent, beliefs, attitudes and behaviours are differently related to particular sexual aspects.

Nonetheless, on the positive side, in contrast to previous research in which college student samples were mostly used, our study provides an analysis of the phenomenon of sexually consent in a heterogeneous sample from different ages and in which men and women were equally distributed.

Conclusion

The present study moves forward to approach the question of how some attitudes, beliefs and behaviours related to sexual consent are a predictor of key attitudes to understand sexual violence, particularly rape supportive attitudes among heterosexual men and women. In this sense, we would like to highlight three main contributions of our present work: First, men have more difficulty than women in asking for and establishing sexual consent, which is a relevant predictor of attitudes toward rape. Prevention programmes should consider this as a key issue and train men and women in their communication strategies and assertiveness when negotiating sex, mitigating some sexual scripts and masculinity standards. Further research could get deep into men´s ideas associated to sexual consent request, as they are likely to feel vulnerable when asking for it. Second, previous non-consensual experiences are a key aspect that makes victims more aware and sensitive to the issue of consent, leading them to show more explicit and direct strategies when it comes to negotiating sex. Third, there is still a culture that emphasises the persistence of a social dominance of men over women. This is noteworthy, given that rape supportive attitudes are crucial to understanding a culture based on violence. Several implications can be drawn for sexual violence prevention education, related to emphasising the need for a culture of consent, even beyond young people and college students. This is necessary not only at the individual level, but also at the social level, as the consent culture can impact on victim blaming and its related cultural processes in case of rape.

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1. University of Torino, Turin, Italy

Chiara Rollero & Michele Roccato

2. University Jaen, Jaén, Spain

Nieves Moyano

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Correspondence to Chiara Rollero.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Moreover, the Ethics Committee of the University of Torino approved the study protocol (Protocol No. MAR.20/11.PRY).

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Rollero, C., Moyano, N. & Roccato, M. The Role of Sexual Consent and Past Non-consensual Sexual Experiences on Rape Supportive Attitudes in a Heterosexual Community Sample. Sexuality & Culture 27, 1352-1368 (2023). https://doi.org/10.1007/s12119-023-10066-2
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Keywords

Sexual consent

Rape supportive attitudes

Past non-consensual sexual experiences

Gender

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The Role of Sexual Consent and Past Non-consensual Sexual Experiences on Rape Supportive Attitudes in a Heterosexual Community Sample - Sexuality & Culture

# data[].attributes.attachment_link.description
The present study aimed to investigate the relationship between (a) sociodemographic variables, past non-consensual experiences and sexual consent and (b) the endorsement of rape supportive attitudes. A sample of 1042 heterosexual adults (42.4% men) was surveyed.

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The main thesis of the article is about how we see sex and how much we give up for the simple act of having sex. This can play into how females have the risk of getting pregnant for having unprotected sex and even if she decided to have unprotected sex as well there is always the risk. It also discusses how sex is not always pleasurable within both parties. Two key terms are emphasize and coerce. These two terms will help me with my research because emphasize can help me give more thought into how consent needs to be very thoughtful and payed attention upon and coerce is in ties with the sexual assault and rape of sexual activity.

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Women are in a bind. In the name of consent and empowerment, they must proclaim their desires clearly and confidently. Yet sex researchers suggest that women's desire is often slow to emerge. And men are keen to insist that they know what women-and their bodies-want. Meanwhile, sexual violence abounds. How can women, in this environment, possibly know what they want? And why do we expect them to?

In this elegant, searching book-spanning science and popular culture; pornography and literature; debates on Me-Too, consent and feminism-Katherine Angel challenges our assumptions about women's desire. Why, she asks, should they be expected to know their desires? And how do we take sexual violence seriously, when not knowing what we want is key to both eroticism and personhood?

In today's crucial moment of renewed attention to violence and power, Angel urges that we remake our thinking about sex, pleasure, and autonomy without any illusions about perfect self-knowledge. Only then will we fulfil Michel Foucault's teasing promise, in 1976, that 'tomorrow sex will be good again'

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In this impressive and intelligent examination of the father figure, Angel expertly intersects the subject with feminism, mythology, Donald Winnicott, Brett Kavanaugh and more. Her unstinting eye and intellectual vigour make Daddy Issues an engaging interrogation. It feels utterly vital in the context of #MeToo and the political flux the world currently finds itself in.

# data[].attributes.attachment_link.description
Women are in a bind. In the name of consent and empowerment, they must proclaim their desires clearly and confidently. Yet sex researchers suggest that women's desire is often slow to emerge. And men are keen to insist that they know what women-and their bodies-want. Meanwhile, sexual violence abounds.

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The main thesis of this article is about asking for consent before proceeding with sexual activities. The article gives many different definitions of consent and reasons for why some individuals may say no to sexual activities. It helps further knowledge on the terms and what they stand for. Two key terms are affirmative and effective. The reason why I wanted to use these terms is because affirmative basically means to clarify and agree with someone or something. It's basically another word for yes. The second term is effective and it means for something to be working constantly and without errors or disruptions.

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Am J Sex Educ. Author manuscript; available in PMC 2023 May 18.

Published in final edited form as:

Sonya S. Brady, PhD LP, ¹ Ellen Saliares, MPH, ² Amy J. Kodet, MPP, ³ Vienna Rothberg, MPH, MSW, ⁴ Meredith Schonfeld Hicks, MPH, ⁵ Emily Hager-Garman, MPH, ⁶ and Carolyn M. Porta, PhD, MPH, RN SANE-A, FAAN ⁷

Abstract

Sexual communication skills are needed to create healthy romantic relationships. Arguably, these skills also can be used to prevent some instances of unwanted sex. This study presents a qualitative analysis of adolescents' comments after reading a teen-friendly article on sexual consent as part of a web-based sexual health promotion intervention. The sample was comprised predominantly of female adolescents recruited from a Midwest urban region in the United States. Adolescents varied with respect to self-efficacy to request, provide, and deny consent, as well as the perceived need to ask for consent in the context of established relationships. Many adolescents perceived that nonverbal methods of communication were sufficient to request, provide, or deny sexual consent. Factors that make it difficult to discuss sexual boundaries and say "no" to unwanted sex included low self-efficacy and an underlying desire to nurture or preserve a relationship. Cultural norms must be changed to support verbal, affirmative sexual consent. In addition, adolescents must be aided in the development of skills to request sexual consent, say "yes" to specific activities, and say "no" to others. Without supportive norms and skills to enhance self-efficacy, adolescents may be unwilling to engage in verbal communication about sexual consent and boundaries.

Keywords: adolescence, sexual consent, sexual boundaries, qualitative research

Sexual violence is a persistent public health problem ( Dills, Fowler, & Payne, 2016; The White House, 2014; Muehlenhard, Humphreys, Jozkowski, & Peterson, 2016; Chicago Tribune, 2019). The determinants of sexual violence are multifaceted and can be conceptualized at different levels of social ecology ( WHO, 2010). At the interpersonal level, one potential determinant of sexual violence is the quality of communication about sexual consent between partners. The Centers for Disease Control and Prevention (CDC) defines sexual consent as "words or overt actions by a person who is legally or functionally competent to give informed approval, indicating a freely given agreement to have sexual intercourse or sexual contact" ( Basile, Smith, Breiding, Black, & Mahendra, 2014). This definition begs several questions. For example, what is the range of overt actions that constitute consent? What makes a person legally or functionally competent to provide sexual consent? How can one determine whether consent is freely given?

Nuanced prevention strategies, including educational tools, are needed to enhance young people's knowledge about sexual consent and skills to request consent, provide consent, and set sexual boundaries. In addition, young people must be provided with knowledge to correctly interpret the words and actions of others, and skills to request clarification when they are not sure of another person's agreement. Communicating effectively about sexual consent may be a strategy to prevent sexual violence, as well as sexual experiences that are agreed to by one person, but not fully desired. Comfort with sexual consent communication is an integral component of the development of healthy, mutually satisfying sexual relationships between individuals ( Harden, 2014). Comfort with sexual consent communication may contribute to an individual's sense of sexual agency, sexual self-efficacy, and sexual autonomy ( Harden, 2014; Kennett, Humphreys, & Bramley, 2013).

The present study is a secondary analysis of qualitative data obtained during an interactive, web-based intervention to promote condom use and other healthy decision-making in the context of romantic and sexual relationships ( Brady, Sieving, Terveen, Rosser, Kodet, & Rothberg, 2015). We analyzed written comments from adolescents after they read a teen-friendly article created to engage them on the topic of sexual consent. Below, we consider two issues that inform our research topic. First, we consider definitions of sexual consent, sexual violence, and related terms in the literature. These terms are nuanced and typically contain multiple components, illustrating the challenge of educating young people about their meaning. Second, we consider literature examining nonverbal and non-explicit verbal communication about sexual consent and refusal. This literature illustrates the importance of providing young people with knowledge to correctly interpret the words and actions of others, and skills to request clarification when they are not sure of another person's agreement.

Defining sexual consent and related terms.

No widely accepted definition of sexual consent exists in academic, policy, or legal circles in the United States (U.S.; Willis & Jozkowski, 2019; Graham et al., 2017; RAINN, 2019). This may contribute to confusion among young people about the practices and features that constitute sexual consent. Graham and colleagues (2017) conducted a nationally representative policy review of nearly 1,000 U.S. colleges and universities and found that 87% had a publicly accessible online definition of sexual consent. A content analysis of a randomly selected subset of schools showed that consent definitions varied widely, but included one or more key themes: inability to consent (e.g., incapacitation due to mental state, alcohol, or other drugs), active signs of consent (e.g., voluntary, affirmative, mutual), circumvention of non-consent (e.g., force, coercion, intentional intoxication), communication (e.g., verbal, nonverbal, silence), history and nature of the relationship (e.g., a prior or current relationship does not indicate consent, some relationships are prohibited based on power differentials), and the revocable nature of consent ( Graham et al., 2017). Among those schools whose definitions included communication, schools differed with respect to whether nonverbal communication could be interpreted as consent. Schools frequently cautioned that consent could not be inferred from silence or passivity. The CDC definition of sexual consent ( Basile et al., 2014), provided at the outset of this paper, is consistent with Graham and colleagues' (2017) policy review. The CDC definition of sexual consent permits words or overt actions to constitute consent, emphasizes the competence of the person providing consent, and emphasizes freely given agreement.

There are many terms used to describe sexual behaviors that take place without sexual consent. The CDC defines sexual violence as "a sexual act that is committed or attempted by another person without freely given consent of the victim or against someone who is unable to consent or refuse" ( Basile, Smith, Breiding, Black, & Mahendra, 2014). Inability to consent can be due to "the victim's age, illness, mental or physical disability, being asleep or unconscious, or being too intoxicated (e.g., incapacitation, lack of consciousness, or lack of awareness) through their voluntary or involuntary use of alcohol or drugs." Inability to refuse can be due to "the use or possession of guns or other non-bodily weapons, or due to physical violence, threats of physical violence, intimidation or pressure, or misuse of authority." Sexual violence encompasses sexual assault, rape, and sexual coercion. The U.S. Department of Justice (DOJ) defines sexual assault as "any nonconsensual sexual act proscribed by Federal, tribal, or State law, including when the victim lacks capacity to consent" (U.S. DOJ, n.d.). A key feature of this definition is its emphasis on the law. The National Center for Injury Prevention and Control (NCIPC), part of the CDC, defines rape as "any completed or attempted unwanted vaginal (for women), oral, or anal penetration through the use of physical force (such as being pinned or held down, or by the use of violence) or threats to physically harm and includes times when the victim was drunk, high, drugged, or passed out and unable to consent" ( Smith et al., 2017). A key feature of this definition is the use or threat of physical force or harm. In contrast, NCIPC defines sexual coercion as "unwanted sexual penetration that occurs after a person is pressured in a nonphysical way," including "being worn down by someone who repeatedly asked for sex or showed they were unhappy; feeling pressured by being lied to, being told promises that were untrue, having someone threaten to end a relationship or spread rumors; and sexual pressure due to someone using their influence or authority" ( Smith et al., 2017) A key feature of this definition is the presence of non-physical pressure.

The absence of sexual violence does not necessarily indicate that sex is wanted. Kern and Peterson (2020) define unwanted sex as "sex that is not fully desired," regardless of "whether an individual agrees to it or not." They further note that unwanted sex "can be coerced-when one person compels another unwilling person-or not coerced-when a person willingly agrees to participate." Kern and Peterson (2020) collected narratives of unwanted sex from 276 university students and coded narratives into the following categories: actively forced sex (29% of narratives; e.g., participant was physically restrained, participant said "no"); non-resisted physically coerced sex (12%; e.g., participant was "too drunk" to make a decision, participant was asleep); verbally or situationally coerced sex (32%; e.g., other person continued to ask until the participant consented, other person made the participant feel guilty); non-coerced sex with avoidance motives (20%; e.g., participant agreed to have sex due to fear of or worry about a negative outcome, participant felt obligated); and non-coerced sex with approach motives (7%; e.g., participant agreed to have sex because they wanted to please their partner, participant agreed to have sex and did not report coercion or avoidance motives). Thus, unwanted sex encompasses sexual violence, but also includes consensual experiences that were not fully desired.

Nonverbal and non-explicit verbal communication about sexual consent and refusal.

Muehlenhard and colleagues (2016) conducted a review of the literature on sexual assault and sexual consent. They noted that when nonverbal behaviors count as affirmative consent, the affirmative consent standard becomes less distinguishable from traditional sexual scripts. Traditional sexual scripts for heterosexual couples rely primarily on nonverbal communication, place a burden on women to refuse or resist unwanted sex, and portray men as initiating sex and persisting in their attempts despite initial reluctance on the part of women ( Hirsch, Khan, Wamboldt, & Mellins, 2019; Muehlenhard et al., 2016). Such scripts, when enacted, may conceivably increase risk for sexual violence or unwanted sex. At least one study has examined adolescents' understanding of sexual consent ( Righi, Bogen, Kuo, & Orchoswki, 2019). Adolescents defined consent as a verbal provision of affirmative consent. However, both adolescent women and men believed that women typically conveyed consent through nonverbal cues. Adolescent women indicated that they would convey sexual refusal through nonverbal cues, while adolescent men reported that they would proceed with sexual activities until they heard a verbal expression of "no." This pattern of communication suggests that adolescent women's non-verbal refusals may be unnoticed, noticed but incorrectly interpreted, or correctly interpreted and disregarded. Both adolescent women and men believed that adolescents who had previously engaged in sexual activity together could assume consent for subsequent sexual encounters, particularly within the context of an established relationship. This highlights the potential for sexual violence or unwanted sex to occur in the context of relationships.

Research conducted among young adults illustrates the importance of providing young people with an understanding that both partners are responsible for sexual consent negotiations, knowledge to correctly interpret the nonverbal communication of partners, and skills to request clarification when they are not sure of another person's agreement ( Holmström, Plantin, & Elmerstig, 2020). Holmström and colleagues conducted focus groups among Swedish young adults aged 18-21. Participants were presented with a series of vignettes to guide conversation. In one vignette, two acquaintances met at a night out, flirted, consumed alcohol, and ended up in one person's apartment. Participants differed in their opinions about whether going to an acquaintance's apartment constituted willingness and consent to have sex. Participants described the difficulty of communicating unwillingness "too late" (e.g., once one had arrived at the apartment or taken off one's clothing), noting that the other person could feel disappointed, rejected, or angry. Participants emphasized the importance of being clear in one's communication, yet described verbal sexual consent negotiations as awkward and a "turn-off"; instead, negotiations were described as being guided by body language, gestures, movements, and eye contact. Consistent with heterosexual sexual scripts, women were described as "gatekeepers" in sexual consent negotiations and responsible for clearly indicating acceptance or refusal.

Clarity of communication may conceivably be undermined by sexual consent norms that rely upon non-explicit verbal or nonverbal communication. Jozkowski, Manning, and Hunt (2018) interviewed 30 heterosexual university students in the southern U.S., who described talking in "code" to avoid explicit negotiations of sexual consent. For example, one woman described knowing that "Do you want to come over to watch a movie?" was code for "Do you want to come over for sex?" If she did not want to have sex, she might respond by saying she was too tired or had too much coursework. Coded consensual language was described as minimizing the embarrassment of both request and refusal. Jozkowski and colleagues (2018) observed that there appears to be "a substantial gap between how college students currently communicate consent-with subtle, implicit, nonverbal cues-and what is being proposed via affirmative consent policies-explicit, obvious, potentially verbal cues." Willis and colleagues (2019) surveyed over 700 students from three southern and midwestern U.S. universities about the ways in which they communicated sexual consent to partners. Their instrument included five open-ended narrative items to identify how students would communicate consent to engage in different sexual behaviors. Responses were coded into five consent cues: (1) explicit verbal (e.g., stating "I really want to have sex with you," responding "yes" to an explicit request); (2) implicit verbal (e.g., stating "I think we should move this to the bedroom," responding "yes" to an implicit request); (3) explicit nonverbal (e.g., jumping on top of and straddling a partner, nodding one's head to indicate "yes" to a request); (4) implicit nonverbal (e.g., removing clothing without speaking, leaving a public location for somewhere private); and (5) no response (e.g., not resisting, not saying "no"). For the narrative item that asked participants to describe a consensual vaginal-penile sexual encounter, 57% of responses were coded as explicit verbal, and nearly 18% were coded as explicit nonverbal. This data is striking, in that nearly 25% of undergraduates' descriptions of consensual sexual encounters involved consent cues that are arguably ambiguous in terms of what is being requested or consented to (e.g., "I think we should move this to the bedroom," leaving a public location for somewhere private) or not consistent with most definitions of consent (e.g., not resisting, not saying "no").

The reviewed literature highlights a need for didactic and interactive tools to aid conversations with adolescents about sexual consent and sexual boundaries. The purpose of this study is to present an analysis of adolescents' comments after reading a teen-friendly article created to engage adolescents on the topic of sexual consent. The sample was comprised predominantly of female adolescents with recent heterosexual sexual experiences, recruited from a Midwest urban region. Findings from the present study are most applicable to cisgender youth attracted to partners of a different gender. These findings may be integrated with other literature to understand what is similar and dissimilar across the sexual consent experiences and beliefs of young people who vary with respect to gender identity, sexual orientation, geography, and culture.

Materials and Methods

Participants and procedure.

Data were collected from 70 adolescents who participated in the intervention arm of a pilot randomized controlled trial of TeensTalkHealth, an interactive, web-based intervention to promote condom use and other healthy decision-making in the context of romantic and sexual relationships ( Brady, Sieving, Terveen, Rosser, Kodet, & Rothberg, 2015). Participants were recruited from three community clinics specializing in adolescent sexual health and three schools in Minnesota between January and October, 2011. Adolescents were eligible to participate in the study if they were aged 14-18 years, had engaged in vaginal or anal sex at least once in the past three months, and typically used the Internet at least twice a week for a total of two hours or more. Adolescents aged 18 provided consent; assent was obtained from adolescents aged 14-17 along with parental consent. Participants chose a non-identifying username and password to use on the website. The TeensTalkHealth study was approved by the University of Minnesota Institutional Review Board (IRB) and a federal certificate of confidentiality was obtained.

During the 4-month intervention, participants were instructed to watch video vignettes 3-5 minutes in length, read teen-friendly articles, and participate in discussion topics posted by health educators. These materials served as conversation catalysts on asynchronous message boards visible to all adolescents participating in the intervention. Materials were developed by health educators on the research team. Resources for development included health educators' prior experience; publicly available health-oriented websites for adolescents and young adults; the empirical research literature; and the research team's youth advisory board. The primary purpose of health education materials was to provide information and engage participants in subsequent discussion on asynchronous message boards. Consistent with the Information-Motivation-Behavioral skills (IMB) model of risk reduction ( Fisher, Fisher, Bryan, & Misovich, 2002), health educators moderated discussion by providing health-promoting information, motivation, and behavioral skills in response to adolescents' comments and questions. Key principles of TeensTalkHealth moderation included (1) demonstrating that it is possible to protect health while also establishing, maintaining, and strengthening relationships, and (2) developing a climate in which adolescents could feel comfortable disclosing their own experiences, sharing what they have learned, and providing guidance to others. By adding comments to video, article, and discussion topics, adolescents may have clarified their values and beliefs. Health educators attempted to reinforce health-promoting attitudes and behaviors and respectfully challenge risk-promoting attitudes and behaviors. It was anticipated that health education materials utilized in TeensTalkHealth would be modified over time, based on evolving approaches to sexuality education and feedback provided by intervention participants.

Data analyzed in the present study.

The present study is a secondary data analysis of data from intervention participants who read the teen-friendly article, Sexual Consent; completed a brief, private survey about the article (n=70); and then commented on a corresponding message board (n=66). The Sexual Consent article appeared next to a photograph of a female young person straddling and leaning down over another young person, who was laying on a couch. The person laying on the couch appeared to be a young male person, although this was somewhat ambiguous due to the angle of the camera. The article (see Appendix A) began with a basic definition of sexual consent and concise explanation of how sexual consent may be provided (i.e., The only way you can give consent is to tell your partner "yes"). The article then provided four scenarios to illustrate nuanced verbal and nonverbal modes of communication through which individuals may convey interest or reluctance to engage in sexual behaviors. The article made the point that while "body language is a powerful form of communication and often has more meaning than the words we speak," it is "not enough for consent." Simple, explicit questions were provided for requesting consent from partners, not only for penetrative sexual behaviors, but also for ongoing, potentially progressing sexual behaviors (e.g., Are you happy with this?). Similarly, simple, explicit statements were provided for setting boundaries (e.g., I don't want to go any further than kissing; I want to stop). The article emphasized that intoxicated individuals "cannot legally give consent," "having sex with someone who is drunk or high can be considered sexual assault," and "since it can be hard to tell how impaired someone is, it's best to wait to have sex until both people can give consent." The article also emphasized the importance of requesting sexual consent every time one engages in sexual behaviors with a partner, and attempted to foster the belief that "talking about sex can be sexy."

Immediately following the Sexual Consent article, adolescents were prompted to complete a brief, private survey to assess attention and understanding. Adolescents were first asked, "How much did this article interest you?" Response options were 1-not at all, 2-a little, 3-somewhat, 4-pretty much, and 5-very much; adolescents could also indicate that they chose not to answer. Adolescents were next asked three open-ended questions: (1) In your opinion, what are the most important parts of this article? (2) What things in the article are unclear? (3) What other things do you wish the article covered? After submitting their responses, adolescents were asked to add at least one comment to the corresponding Sexual Consent message board, which was made visible only after the survey was completed and could be viewed by other adolescents on the website. Adolescents were asked to respond to one of the message board discussion questions, reply to another person's comment, or say something else about the article. The discussion questions posed to participants after the Sexual Consent article and survey are shown in Table 1 . Appendix B contains a list of moderation guidelines followed by health educators, and Appendix C contains selected health educator responses to specific issues of concern expressed by adolescents.

Table 1.

Article Synopsis

The simplest definition of consent is 'saying yes' or giving permission. When it comes to sex, consent is a verbal agreement that it is ok to do a specific sexual behavior. Consent is an active process and a responsibility shared by both partners in any situation.

Learning Objectives (not shown to participants)

1. Understand the definition of consent

2. Determine whether article scenarios included consent

3. Learn effective ways to request and provide consent

Discussion Questions

1. Can you see yourself asking consent questions like the ones in this article? Can you see yourself making "slow down" or "stop" statements like the ones in the article? (14 responses)

2. What are some other realistic things you could say if you wanted to get or give consent? (12 responses)

3. What makes it difficult to say "yes" to sexual activities? (16 responses)

4. What makes it difficult to say "no" to sexual activities? (36 responses)

5. Is it more difficult to set clear boundaries with a new person or with someone you've been dating for a while? What things make it easier or harder to do? (25 responses)

Analytic approach.

We examined the distribution of the single survey item designed to assess interest in the Sexual Consent article. We also summarized responses to the three open-ended survey questions using content analysis ( Taylor-Powell & Renner, 2003). We selected quotations from participants' open-ended responses to illustrate content analysis categories. Following this preliminary analysis, we conducted an in-depth qualitative analysis of participants' comments on the Sexual Consent message board. For message board comments, analysis consisted of a series of inductive open coding and thematic analysis processes focused primarily on participants' responses to health educators' discussion questions (articulated data), and secondarily on emergent data generated organically by participants ( Massey, 2011). We categorized comments under major themes using N-Vivo, and selected quotations from participants' comments to illustrate themes. We quoted participants verbatim, without editing of spelling or grammatical mistakes.

The first and second authors addressed the trustworthiness of data through maintaining a methodological archive of files, maintaining faithfulness to participants' words, and discussion throughout the coding process ( Shenton, 2004). Reliability was not calculated due to our analytic approach. One author led the content analysis of open-ended responses to survey questions. Two authors read message board data. One author took the lead in coding and thematic analysis. The second author reviewed the developed hierarchy of themes and subthemes and asked questions that facilitated revisions.

Results

Sample Demographics and Characteristics

Among the full study sample (n=70), the average age of participants at baseline was 17.5 years (SD=1). The age reported at screening ranged from 14 to 18 years; during the baseline survey, however, two participants reported being 19 and 20 years of age, respectively. A majority of study participants indicated that they were female when asked their biological sex (n=61; 87%); 9 participants indicated that they were male (13%). Participants' self-reported race and ethnicity were coded into the following categories: White (59%), Black or African American (10%), Asian (7%), Latinx or Hispanic (3%), and Multi-racial (21%). Participants were asked the question, "When you think of the people you are attracted to in a sexual way, are those people all male, all female, or both male and female?" As with all questions, participants could choose not to answer. Of the 61 female participants, 77% reported being attracted to male partners, 2% reported being attracted to all female partners, and 21% reported being attracted to both male and female partners. Of the 9 male participants, 22% reported being attracted to male partners, 56% reported being attracted to all female partners, and 22% reported being attracted to both male and female partners. Of adolescent women's reported sexual partners in the past month, all but one were male. Of adolescent men's reported sexual partners in the past month, roughly one-third were male and two-thirds were female.

Sexual Consent Brief Check of Attention and Understanding

Interest in article content varied (M=3.46, SD=1.13), with 17% of adolescents indicating they were "very much" interested, 38% indicating they were "pretty much" interested, 23% indicating they were "somewhat" interested, and smaller percentages indicating they were only "a little" interested (16%) or "not at all" interested (6%). Adolescents' responses to open-ended questions are summarized below. Percentages of adolescents whose responses fell under a specific content analysis category are provided; these percentages do not always tally to 100, both because of rounding and because adolescents' open-ended responses could fall under more than one category. Table 2 contains selected responses that fell under identified content analysis categories.

Table 2.

Category

Participant Description

Open-Ended Survey Questions and Illustrative Comments

Definition of sexual consent

Asian female adolescent, 18 years

The important parts in this article was the definition of consent, what doesn't count as consent, and the mentioning of how consent of an intoxicated person is considered not really a consent. (also categorized under "intoxicated persons cannot provide consent")

White female adolescent, 17 years

To always get a yes from your partner rather than to just do what you think is right. With sexual situations you need to make sure both parties understand and want to continue with what is happening. (also categorized under "importance of consent")

In your opinion, what are the most important parts of this article?

Content analysis yielded four categories of response. The percentage of adolescents whose responses fell under each category were as follows: definition of sexual consent (53%); importance of consent (30%); assertion that an intoxicated person cannot provide consent (20%); skills to request consent, deny consent or advocate for one's sexual boundaries, and interpret the verbal and nonverbal communication of a partner (e.g., body language, mixed signals) (26%).

What things in the article are unclear?

Content analysis yielded four categories of response. The percentage of adolescents whose responses fell under each category were as follows: the article was clear (63%); suggestions for improvement (27%); uncertainty about or questioning the assertion that sexual consent should be verbal (6%); questioning the assertion that intoxicated individuals cannot provide consent (4%). A few adolescents suggested that the article should indicate the specific scenarios in which consent was obtained. Relatedly, some adolescents wondered if nonverbal communication (i.e., body language) was sufficient to obtain consent. Several adolescents suggested that the article provide additional examples, better examples, or easier examples to request, provide, or deny consent, as well as to slow things down. One adolescent requested examples of how one could go about obtaining verbal consent from a partner, beyond the partner's solely nonverbal consent, without making things awkward. Some adolescents questioned the assertion that individuals could not provide consent while under the influence of substances, highlighting that substances could enhance confidence, particularly if one was shy. Other adolescents wondered who would be accountable for sex while intoxicated (e.g., who can decide if it's rape).

What other things do you wish the article covered?

Content analysis yielded four categories of response. The percentage of adolescents whose responses fell under each category were as follows: unable to think of additional issues (43%); requests for additional information that could be used to develop sexual consent skills (41%); requests for guidance on what to do if partners do not respect denial of consent (7%); information about sexual assault and other forms of sexual misconduct (7%). Adolescents requested additional information that could be used to develop sexual consent skills, particularly with respect to requesting, providing, and denying consent; determining when to ask for consent for specific activities; distinguishing non-consensual from consensual activities (e.g., when someone has not verbally consented but appears to be enjoying what is happening); interpreting body language; understanding how gender can influence the consent processes; and resolving moral or ethical dilemmas (e.g., what to do if a potential partner would be 'cheating' on someone else). One adolescent asked for tailored information about sexual consent for same-sex couples, highlighting the additional difficulty of saying "no" to sexual overtures when one has limited opportunities to be in a same-sex relationship. Several adolescents asked for guidance on what to do if a partner did not respect their denial of consent (e.g., not listening, continuing to exert pressure, becoming mad or frustrated). One adolescent asked for information about the perspectives of adolescents who feel pressured and "go along" with the wishes of their partner. A few adolescents requested information about the legal consequences of sexual assault, resources for those who have been victimized by sexual assault, and other forms of sexual misconduct (e.g., sexual harassment).

After completing the Sexual Consent survey, respondents could view and contribute to the corresponding message board.

Sexual Consent Message Board Themes

Table 1 contains the number of participants responding to each discussion question; numbers ranged from 12 to 36. Fourteen adolescents (21.2%) responded to a fellow adolescent's comment; these comments usually indicated agreement and elaborated upon the point under discussion. Most adolescents only made one comment on the message board; seven adolescents (10.6%) made two comments. Below, data are organized by Sexual Consent discussion question to show how comments may have been elicited by specific questions posed by TeensTalkHealth health educators. Each discussion question is considered a theme, and different categories of direct responses to each question are considered sub-themes. Emergent themes and sub-themes linked to specific discussion questions are presented after reviewing "direct response" sub-themes for the corresponding discussion question. In total, 8 themes (articulated "discussion question" themes and emergent themes) are presented. Illustrative quotations to represent themes and sub-themes are presented in Table 3 .

Table 3.

Major Theme

Participant Description

Discussion Questions and Illustrative Comments

More difficult with new partners

White female adolescent, 16 years

I think saying no can be difficult with anyone really. If you're with someone new, it could be hard because you don't want to turn them away from you. You want to keep the new person. But it's also hard with someone you've been with for a while, especially if you've already had sex. They may think you're trying to break up with them or they did something wrong. Saying no can be hard, especially if you're worried about hurting them... (also categorized under "more difficult with established partners")

Easier with new partners

Multi-racial female adolescent, 17 years

With a new person, you can stop them from going too far by simply stating that you barely know each other and don't feel like it's right to go too far yet. But with someone you've been dating for a while, certain sexual behaviors are expected and it can be hard to say no when the other person really wants it. (also categorized under "more difficult with established partners")

Perceived benefits of conversations about boundaries

White female adolescent, 18 years

I think it is important to know how to say to someone that this is how far you want to go with them and that you don't want to go farther. It is important to make that clear to the other person so that there is no confusion. (emphasis added)

Can you see yourself asking consent questions like the ones in this article? Can you see yourself making "slow down" or "stop" statements like the ones in the article?

Many adolescents commented that they could see themselves asking consent questions like the ones in the article, as well as making "slow down" or "stop" statements (see Table 3 , "Adolescent could apply article's examples" sub-theme). Several adolescents noted that they had experience in these domains. Adolescents observed that the simple language used in the article provided helpful examples of how to request consent and say "yes" or "no" in response to a partner. They appreciated that requests for consent could be made in language that was not formal or awkward.

A smaller number of adolescents commented that they could not see themselves asking consent questions or making "slow down" or "stop" statements like the ones in the article (See Table 3 , "Adolescent could not apply the article's examples" sub-theme). These adolescents thought it would feel awkward to use the language in the article, in part because they were uncertain about what would happen next. Some adolescents had difficulty perceiving a need to request sexual consent, particularly because they perceived that their partner was equally desirous of sex.

One emergent theme was adolescents' expressed appreciation for the article (see Table 3 ). Adolescents noted that the article had made them think, become more aware of the potential for sexual assault without clear communication, and become more aware that they should communicate with their partners about sexual consent.

What are some other realistic things you could say if you wanted to get or give consent?

Adolescents did not offer specific language for how they could request consent from a partner or provide consent. For this reason, this anticipated theme is absent from Table 3 . An emergent theme was how to refuse requests for sexual behavior (see Table 3 ). One adolescent offered specific language that could be used to refuse consent from a partner: ...if I'm with someone I'm dating or have been fooling around with for a while then I think it's easy to say things like 'uuum, that doesn't feel right/good, we should stop,' or something like that. Other adolescents did not offer specific language to refuse consent, but did offer rationales for refusal that could be expressed verbally (e.g., talk about maybe having sex after you know each other better and both people are comfortable). Some adolescents suggested combining nonverbal and verbal language.

Two emergent themes involved beliefs about sexual consent (4 sub-themes, see Table 3 ) and the timing and frequency of communication (2 sub-themes, see Table 3 ). Many adolescents endorsed the process of obtaining sexual consent. While one adolescent strongly asserted that consent should be conveyed through verbal communication, several adolescents expressed the belief that consent could be conveyed through nonverbal communication. Other adolescents believed that body language could additionally be used to withhold consent. Several adolescents advocated for communication about sexual consent and sexual boundaries. Adolescents advocated for communication before sexual encounters were likely to occur, as well as in the moment.

What makes it difficult to say "yes" to sexual activities?

Overall, adolescents expressed the opinion that it was much easier to say "yes" in response to a partner's request for sexual activities than to say "no." Adolescents highlighted a few factors that could make it difficult to say "yes" (3 sub-themes, see Table 3 ). One factor was an underlying reluctance or unwillingness to have sex. This was exemplified by having uncertain feelings about sex with a partner, lack of comfort with a partner, a sense of being pressured, or uncertainty about whether one's partner would want a committed relationship after having sex. One adolescent noted that discomfort with one's own body could make a person reluctant to say "yes" to sexual activities. A second factor that could make it difficult to say "yes" was the absence of a request for consent. Some adolescents perceived that it was difficult or awkward to ask for consent in the moment, in part because sexual encounters unfolded in a way that was too spontaneous or fast for conversations about consent to occur. One adolescent expressed regret that her partner did not pause to ask for consent the first time she had sex (see Table 3 ). A third factor highlighted by adolescents was fear of being judged for having sex or one's own belief that having sex would not be right, despite a desire to say "yes."

What makes it difficult to say "no" to sexual activities?

Adolescents highlighted a variety of factors that could make it difficult to say "no" to sexual activities (6 sub-themes, see Table 3 ). Several comments reflected an underlying desire to nurture or preserve a relationship, exemplified by not wanting to turn a new partner away, hurt the feelings of an established partner, offend a partner, or disappoint a partner. One adolescent described the rationalization that can take place when one does not wish to have sex, but nonetheless has sex to demonstrate love (see Table 3 ). Other adolescents described an impulse to take care of their partners' egos, stating that they might not want partners to know if they had no desire to have sex, for fear of communicating that they did not like or love their partners.

Comments of some adolescents highlighted involvement in a potentially unhealthy relationship (e.g., you don't want to have sex but you feel pressured so you have to say yes). Some adolescents found it difficult to say "no" to sexual activities because they might upset or frustrate a partner or make the partner mad. Adolescents commonly described feelings of pressure to have sex. One adolescent described feeling guilty for not wishing to reciprocate. Another adolescent suggested that others might fear a partner would break off a relationship if they did not acquiesce to sexual activities.

Comments of several adolescents appeared to reflect an underlying belief that sexual consent could be assumed after saying "yes" once (e.g., it is difficult to say "no" to sex when it isn't the first time, or you're used to having sex regularly). These adolescents described sex as an expectation and habit in the context of their relationships. One adolescent noted that if both partners were "worked up and into it," it would confuse one partner if the other said no. Another adolescent highlighted that it would be difficult to say no "all of a sudden" with someone they had been dating for a while. Collectively, comments suggested that it would be unfair to one's partner to withhold consent after saying "yes" once, particularly in the context of an established relationship.

A fourth set of comments suggested that adolescents had difficulty saying "no" to sex because of being caught up in the moment. Some adolescents described conflicting feelings or thoughts (e.g., they are doing something good that you don't want to stop, but you know it's wrong; at times your body wants something and your mind agrees with the feeling but not the situation; you want to but maybe you just aren't ready so you say yes). Other adolescents described not thinking, being distracted by feelings, and not caring about anything other than what they were feeling in the moment. These comments did not characterize sex as unwanted, but also did not characterize sex as intentional.

A fifth set of comments suggested that some adolescents have inadequate skills to determine sexual boundaries or deny sexual consent to others. Some adolescents acknowledged that they had engaged in sexual activities without knowing their own boundaries or a partner's boundaries. In these circumstances, adolescents "let it happen" or consciously decided to "give it a shot" and see what happened. Other comments highlighted a lack of skills to deny consent. One adolescent noted that shyness could make it difficult to say "no" to sexual activities. Another adolescent observed that it would be awkward to say "no" to sex in the moment. In response to one adolescent who said she was glad she had the guts to say "no," another adolescent said she wished she could say the same about her own guts. These comments stood in contrast to those of adolescents who did advocate for themselves (e.g., I am not shy or afraid to say something if I don't feel comfortable).

A few adolescents cautioned that intoxication could make it difficult to say "no" to sexual activities. Finally, comments of several adolescents suggested that it would be difficult to say "no" because they were, in fact, willing to consent to sexual activities (e.g., when I am really into my partner and trust my partner; having a really strong attraction to someone). Comments about willingness to have sex were not coded into one of the 6 sub-themes under "What makes it difficult to say 'no' to sexual activities?"

Is it more difficult to set clear boundaries with a new person or with someone you've been dating for a while? What things make it easier or harder to do?

Adolescents differed in their opinions about whether it is easier or more difficult to set boundaries with a new partner or someone they had been dating for a while (4 sub-themes, see Table 3 ). With new partners, adolescents highlighted the difficulty of discussing sexual boundaries when one is just getting to know the partner, feels nervous or uncomfortable, and is unsure of what the partner expects or has in mind. One adolescent expressed doubt that many partners would talk about sexual boundaries when they "barely know" each other. Other adolescents asserted that it was acceptable to ask a new partner questions about sexual boundaries. These adolescents highlighted the advantages of becoming aware of and accustomed to boundaries early in the relationship.

Adolescents also identified barriers to having conversations about sexual boundaries with partners they had been dating for a while. Several adolescents thought conversations about sexual boundaries would be "weird," particularly if partners had become accustomed to specific sexual behaviors. Adolescents believed that it would create confusion to suggest a change to something that had become a habit or expectation. They did not wish to disappoint partners. Adolescents also expressed concern that partners might think they had done something wrong, question whether the adolescent was still comfortable with the relationship, and wonder if discussion about sexual boundaries was a prelude to breaking up. One adolescent asserted that it was possible to set clear boundaries with an established partner, while also noting that it might take time to readjust. Other adolescents suggested that conversations about sexual boundaries could be easier with established partners because there would be more understanding and comfort in the relationship, and partners may have learned things through their experiences together.

An emergent theme was other factors affecting the ease of setting boundaries (4 sub-themes, see Table 3 ). Some adolescents suggested that the relative ease or difficulty of discussing sexual boundaries depended on one's closeness to a partner or overall relationship quality, as opposed to length of relationship (e.g., we talk about everything). Age was mentioned as an additional factor. One adolescent observed that while setting boundaries had once felt awkward and embarrassing, it felt more comfortable now that she was older. The comments of some adolescents modeled self-efficacy for setting boundaries with partners. These adolescents described liking conversations about sexual boundaries and highlighted benefits of having such conversations (e.g., a partner's appreciation for knowing that sexual behaviors are not forced; one's own greater comfort with sexual behaviors). One adolescent framed conversations about sexual boundaries as a "big step" in a relationship.

Discussion

Adolescents varied with respect to their self-efficacy to ask the consent questions provided in the Sexual Consent article, as well as their self-efficacy to deny consent. They also varied with respect to their perceived need to ask for consent in the context of relationships in which sexual behavior had already been initiated, or relationships in which specific sexual behaviors had become expected or habitual. Many adolescents perceived that nonverbal methods of communication were sufficient to request, provide, or deny sexual consent. Adolescents' comments highlighted several modifiable factors that make it difficult to discuss sexual boundaries and say "no" to unwanted sexual activities, including low self-efficacy to identify and communicate sexual boundaries and an underlying desire to nurture or preserve a relationship. Indeed, one of the most striking findings to emerge was the willingness of many adolescents to prioritize a partner's potential feelings of rejection (e.g., am I not liked? am I not loved?) over their own comfort and bodily autonomy during a sexual encounter. Similar findings have been observed in qualitative research of university students ( Jozkowskiet al., 2017). Most of the scenarios that adolescents in the present study described did not sound forced or coercive. Rather, adolescents appeared to assume that discussion of sexual consent and sexual boundaries could challenge the integrity of their relationship, and were unwilling to take the "risk" of explicitly communicating a desire not to have sex. In contrast to comments suggesting low levels of self-efficacy, comments of other adolescents suggested high levels of self-efficacy and a strong endorsement of communication about sexual consent and sexual boundaries.

Nonverbal and non-explicit verbal communication.

The concept of sexual consent may be relatively easy to understand in theory, but is not always easily implemented in practice (i.e., in the "real world"). When surveyed immediately after reading the article, several adolescents wished for additional examples, better examples, or easier examples to request, provide, or deny consent, as well as to slow things down. Throughout the article, we encouraged verbal communication. We offered examples of simple questions to request consent, and brief responses to indicate consent (e.g., "Yes, I love having sex with you") or refusal (e.g., "I don't want to go any further than kissing"). In hindsight, we could have offered more examples, particularly of explicit verbal communication. We also could have offered examples to better illustrate the ongoing nature of consent (e.g., requesting consent for progressing from one activity to another). One of the message board discussion questions posed to adolescents asked for other realistic things they could say if they wanted to request or provide consent. Of note, no adolescent offered specific language for how they could request consent from a partner or provide consent. Thus, verbal sexual communication is likely to be an important domain of skill-building for most adolescents.

Our findings are consistent with other literature suggesting that adolescents are generally more comfortable communicating consent messaging, including "yes" and "no," nonverbally than verbally ( Muehlenhard et al., 2016; Righi et al., 2019). Adolescents may also perceive a conflict between the explicit discussion of sexual consent and engagement in authentic, enjoyable sexual behaviors. This is a concern because nonverbal modes of communication can be, and often are, misinterpreted. Marcantonio and colleagues (2018) developed a quantitative measure to assess three overarching sexual refusal tactics: direct verbal (i.e., verbal expressions of refusal that contain the word "no"), direct nonverbal (e.g., rolling away from one's partner), and indirect nonverbal (e.g., body language). The authors characterized indirect nonverbal refusal tactics as ambiguous. This highlights the importance of interpreting any response other than an enthusiastic expression of willingness to have sex as lack of consent. Marcantonio and Jozkowski (2020) surveyed over 600 students from two universities who had at least one experience where a sexual partner was willing to have sex and they were not; respondents were asked to indicate how they let the partner know that they were not willing and did not consent (or refused). Most responses were coded into one of five categories: saying no (e.g., "I said 'no' until they understood that I was serious"; 53%); implicit internal excuse (e.g., "I told them I was not in the mood"; 12%); implicit external excuse (e.g., "I... told him that... I did not know him that well"; 5%); active behavioral cue (e.g., "I moved their hand away"; 15%); and passive behavioral cue (e.g., "I showed signs of discomfort"; 5%). An additional 10% of responses could not be categorized. These findings highlight the importance of teaching adolescents that many individuals communicate unwillingness to have sex in ways other than saying "no."

Sexual consent in the context of substance use.

One of the four scenarios provided in the Sexual Consent article addressed consent in the context of substance use. A fifth of adolescents identified the assertion that an intoxicated person cannot provide consent as one of the most important parts of the article. However, a few adolescents questioned the assertion that intoxicated individuals could not provide consent. One character in the article's scenario was described as having "a few drinks" and telling the other character, "I want to do it with you." This may have been contributed to some adolescents' questioning, because the character was not obviously incapacitated. The CDC identifies being "too" intoxicated as one condition for being unable to consent ( Basile et al., 2014). This begs the question of what constitutes being "too" intoxicated. Our Sexual Consent article advised, "since it can be hard to tell how impaired someone is, it's best to wait to have sex until both people can give consent."

Several qualitative studies have found that adolescents and college students perceive impaired sexual decision-making to be a risk of sex in the context of substance use ( Coleman & Cater, 2005; Cowley, 2014; Lefkowitz, Waterman, Morgan, & Maggs, 2016; Lindgren, Pantalone, Lewis, & George, 2009; Livingston, Bay-Cheng, Hequembourg, Testa, & Downs, 2013; Smith Toadvine, & Kennedy, 2009; Starfelt, Young, Palk, & White, 2015; Ven & Beck, 2009). Research among university students highlights the potential for another person's alcohol consumption to be misinterpreted as a signal for willingness to have sex, particularly by men (Jozkowski et al., 2018). In contrast to men in this study, who thought that alcohol consumption was the initiation of consent, women indicated that alcohol consumption could either be an indicator of consent to engage in sexual activity or an indicator of simply wanting to have an enjoyable time with friends. Further, qualitative research suggests that substance use is a risk factor for both sexual violence victimization and perpetration, including rape and sexual coercion ( Abbey, Wegner, Woerner, Pegram, & Pierce, 2014; Anderson et al., 2019; Gatley, Sanches, Benny, Wells, & Callaghan, 2017; Testa, Brown, & Wang, 2019; Walsh et al., In Press; Wilhite, Mallard, & Fromme, 2018).

Implications for sexuality education and prevention of sexual violence.

Cultural norms must be changed to support verbal, affirmative sexual consent. Sexuality education is an indispensable mechanism of change. To ensure that all adolescents are equipped with sexual consent skills, caregivers, educators, and health professionals can become involved in advocacy efforts to include sexual consent as part of sexuality education. Parents and other caregivers can advocate to school board members that sexuality education extend beyond abstinence and sexual refusal skills. Caregivers, educators, and health professionals can also work with state legislators to develop policies that mandate sexual consent be included as part of comprehensive sexuality education in high schools. Sexuality education can attempt to increase adolescents' self-efficacy to engage in explicit verbal communication about sexual consent. It can also increase adolescents' skills to identify the variety of ways in which unwillingness to have sex or ambivalence might be communicated by others, in contrast to the ways in which an "enthusiastic yes" might be communicated.

State policies that mandate the inclusion of sexual consent as part of health education standards are urgently needed. It is imperative that education about sexual consent occur during adolescence, and not be limited to college and university settings. Hall and colleagues (2019) conducted a recent review of policies on K-12 school-based sexuality education for all 50 U.S. states. Policies included state statutes, state board of education policies, and state department of education or public instruction curriculum standards. Nearly 75% of state policies emphasized abstinence from sexual behavior, and an additional 14% required that abstinence be included in sexuality education. Roughly half of state policies addressed interpersonal issues, such as empowered sexual decision-making (52%), healthy sexual relationships (42%), and sexual violence (54%). A smaller percentage required that sexuality education address communication about sexual consent, such as how to request consent (20%) and how to provide or refuse consent (34%). _, Willis and colleagues (2019) conducted a review of state K-12 health education standards, including sexuality education, for 18 U.S. states selected to be broadly representative of the country. Only two states directly referred to sexual "consent." However, four themes relevant to sexual consent were identified within sexuality education or other health curriculum: communication, decision-making, personal space, and relationships. Willis and colleagues noted that there are thus opportunities within existing curriculum to incorporate the topic of sexual consent. Education about consent, more broadly, can be provided to children and adolescents at every age. As part of a series to prevent sexual harassment, the Harvard Graduate School of Education provides strategies for educators to talk with students about respecting one another's boundaries from preschool through high school ( Tatter, 2018).

Given the small percentage of state policies that mandate education about sexual consent in U.S. K-12 schools, it is not surprising that first sex has been described as "really wanted" by adolescent women only 41% of the time and by adolescent men only 63% of the time ( Martinez, Copen, & Abma, 2011). Some adolescents in our study described reluctance or ambivalence towards having sex as a barrier to saying "yes" or "no" to sexual activities. In our Sexual Consent article, we mentioned "being confused about what [one] want[s] to do" as a potential reason for a partner's mixed signals. Sexuality education for adolescents should attempt to establish a norm in which only an "enthusiastic yes" is interpreted as consent for sexual activities. Such a norm may aid in reducing coercion and other types of unwanted sex. Sexuality education must also enhance adolescents' self-efficacy and skills to communicate their reluctance or ambivalence in a way that also communicates their value for their partner and relationship. Fear of turning a new partner away, hurting the feelings of an established partner, offending a partner, and disappointing a partner were common reasons for having difficulty in saying "no" to sexual activities.

Appendix D contains suggestions for future applications of our Sexual Consent article in the context of sexuality education. Although this article was not written with caregivers in mind, we can imagine it being read and discussed by caregivers and adolescents together. The Sexual Consent article is meant to be processed by adolescents and discussed with the assistance of a health educator or other knowledgeable adult. This can be accomplished in other contexts besides a web-based intervention, including school- and community-based sexuality education and conversations with caregivers. Health professionals can encourage parents and other caregivers to have conversations with adolescents that extend beyond messages of abstinence or delaying sex, contraception, and safer sex. As a prelude to discussing sexual consent, a caregiver could potentially share their hopes for the different ways that caring and respect are shown or will be shown in the context of their adolescent's current or future romantic relationships, respectively (e.g., asking one another to share thoughts and feelings, listening to one another). A caregiver can explain how these practices should be extended to intimate moments, including making sure that each person in a relationship feels comfortable with sexual behavior.

Strengths and limitations.

Strengths of the present study include its innovative approach to collecting qualitative data through a message board, which functioned as an asynchronous online focus group ( Wilkerson, Iantaffi, Grey, Bockting, & Rosser, 2014). By using non-identifying usernames, participants may have perceived fewer barriers to disclosing their thoughts and experiences. The survey, which had to be completed in order for the Sexual Consent message board to become visible, may be considered a check for reading the article. An additional strength of the present study is its collection of data on adolescents' perceptions of how the Sexual Consent article, a learning tool, could be improved.

Limitations of the present study must also be acknowledged. We did not have any checks to ensure that participants had a literacy level that would allow them to comprehend the article. However, we entered the text of our article into an online readability calculator, which classified the Flesch-Kincaid grade level as 5.4. Our approach to collecting data (i.e., in the context of a health promotion intervention) may have prevented some adolescents from expressing a full array of attitudes and beliefs about sexual consent. Asynchronous focus groups can be susceptible to uneven participation ( Wilkerson et al., 2014). Just over 20% of participants in the present study responded to another adolescent's comment on the message board, and most participants made only one comment. Thus, interactions between adolescents were not as extensive as might be expected during a synchronous focus group. Additional limitations are that TeensTalkHealth participants were a convenience sample comprised predominantly of female adolescents in one geographic region.

The Sexual Consent article, in its current form, does not address all of the contexts in which sexual behaviors can occur. Adolescents' discussion of sexual consent and sexual boundaries was predominantly in the context of relationships that were new and developing or established. Adolescents did not explicitly discuss sexual consent in the context of casual sexual encounters (e.g., "hook-ups"). While potential involvement in unhealthy relationships emerged as a barrier to conversations about sexual consent and sexual boundaries, this topic was not discussed in an explicit fashion or at length. Discussion also did not address power imbalances based on status (e.g., freshman/upperclassman). Findings from the present study may be used to address barriers to sexual consent in the context of dating relationships. Different modifiable factors may need to be addressed to prevent sexual violence and unwanted sex in other contexts (e.g., bystander behaviors at parties where substance use may occur; Jouriles et al., 2017; Williams, Rheingold, Shealy, & LaRocque, 2019).

It is important to note that data analyzed in the present study were collected in 2011, before widespread awareness of the #metoo movement ( Chicago Tribune, 2019; Garcia, 2017) and other recent efforts to prevent and address sexual violence (e.g., "It's On Us," The White House, 2014). Culturally prescribed sexual scripts appear to be changing, leading to greater awareness of the concept of sexual consent among young people. Hirsch and colleagues (2019) conducted an in-depth qualitative study of undergraduates at Columbia University and Barnard College between 2015 and 2017. While gendered heterosexual sexual scripts were prevalent (e.g., men initiate sex and always want sex; women regulate men's access to their bodies), so too was an awareness among men that their consent practices might fall short of their school's standard. Men worried that consent, once obtained, might later be revoked and that they might "falsely" be accused of sex that they had judged to be consensual. Such fears not only reflect policies at Columbia and Barnard, but also the larger #metoo movement and its backlash ( Smith, 2018).

Discussion in response to the Sexual Consent article did not explicitly address the concerns of lesbian, gay, and bisexual youth. This was true despite an attempt to feature characters whose names were gender ambiguous, which was intended to facilitate the imagination of either homosexual or heterosexual partnered activity. In addition, transgender, gender nonconforming, and gender non-binary identities were not assessed as part of the TeensTalkHealth study, nor was attraction to partners with these identities. Sexual minority youth are often absent from societal messages about sexual consent, which may serve to heighten their vulnerability to sexual violence and impede healthy sexual development. It is important to identify specific barriers to communicating about sexual consent and sexual boundaries among sexual minority youth (e.g., fear of victimization; McKay, Lindquist, & Misra, 2017) and incorporate these barriers into learning tools.

Conclusion.

Several modifiable factors may make it difficult for many adolescents to request sexual consent, discuss sexual boundaries, and say "no" to unwanted sexual activities. These factors include low self-efficacy, the belief that refusal of consent can hurt one's partner or relationship, the belief that sexual consent or verbal consent is unnecessary in specific contexts, and the belief that consent can be provided while under the influence of substances. Health educators' moderation of adolescents' comments in the context of the TeensTalkHealth intervention provides one model of how learning tools such as the Sexual Consent article can be both didactic and interactive. The TeensTalkHealth modality also demonstrates how peers with health promoting beliefs and high levels of self-efficacy can serve as role models and reinforce the messages of health educators.

Didactic and interactive tools such as the present Sexual Consent article should be updated periodically to address highly visible movements and current events, current legal definitions and cultural norms, and feedback from adolescents. Such an approach would likely enhance adolescents' interest in and engagement with learning tools. Such learning tools are urgently needed. Without opportunities to develop favorable attitudes towards verbal, affirmative consent and skills to enhance self-efficacy, adolescents may be unprepared or unwilling to engage in verbal communication about sexual consent and boundaries. Along with education to enhance sexual communication skills, education is needed to enhance adolescents' ability to correctly interpret the multiple ways in which consent, ambivalence, and refusal can be communicated verbally and nonverbally. Finally, it is imperative to establish sexual norms that dictate respect for sexual refusal by others and engagement in sexual behaviors only when consent is conveyed with enthusiasm.

Acknowledgements

This work was supported by the National Institute of Mental Health, Division of AIDS (R34 MH086320 to S.S.B.) and a University of Minnesota Grant-in-Aid of Research, Artistry, and Scholarship to S.S.B. The authors gratefully acknowledge the support and contributions of our clinic and school partners; The Annex Teen Clinic; our Program Officer Willo Pequegnat, PhD; videographer Paul Bernhardt, BA; Fuzzy Duck Design and Jared Law, Lead Web Designer & Developer; and the following staff and students within the Division of Epidemiology and Community Health at the time of study implementation: Magdalena Osorio, BA; Ramatoulie Jallow, MPH; Cherese Alcorn, BS; Lee McKenna, BS; Jeffrey Johnson, BS; Douglas Lier, BS; and Gudrun Kilian, BA. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, Annex Teen Clinic, HealthPartners Institute, Planned Parenthood North Central States, Massachusetts Institute of Technology, and University of Minnesota.

APPENDIX

Appendix A. Original Sexual Consent article.

Consent

What is consent?

The simplest definition of consent is 'saying yes' or giving permission. When it comes to sex, consent is a verbal agreement that it is ok to do a specific sexual behavior. Consent is an active process and a responsibility shared by both partners in any situation. Consent should never be assumed, even in a relationship or if you've had sex before. If someone doesn't say "no" it doesn't mean 'yes.' Giving in is not the same as giving consent.

How do I give consent?

The only way you can give consent is to tell your partner 'yes.'

How do I get consent from my partner?

Taj and Megan were watching a movie together. Megan was snuggled up to Taj during the movie and they had been holding hands and kissing. After the movie ended they began making out. Taj reached under Megan's shirt and began touching her breasts. They hadn't gone this far before, but Megan seemed to be enjoying it.

Did Taj get consent? Did Megan give consent?

Asking simple questions is one of the best ways to determine if someone is comfortable with a situation and is consenting (saying "yes") to the activity. It's always the responsibility of the person who wants to do something sexual to get consent. It's not the other person's job to say "no."

Sometimes you or your partner might not know what to say or how to share your comfort level with a specific activity. Some simple questions can help you gain consent with your partner:

Do you want to go further?

Are you happy with this?

Does this feel good?

Non-verbal Communication

Julia and Michael are alone together. Julia starts kissing Michael. Michael seems into it, so Julia starts to unbutton Michael's pants. Michael doesn't stop her, so she takes off his pants and starts touching his penis with her hands. He moans a little when she's touching him.

Did Julia get consent? Did Michael give consent?

Talking about sex isn't always easy, but you can have better relationships and better sex when you can communicate clearly with your partner. Hearing your partner say that they want to be with you at that moment can be a big turn-on. In addition to words, being aware of body language can help you to figure out if the person you're with is feeling comfortable. Here are some ways body language can let you know if the person you're with is not comfortable with what is happening:

holding their arms tightly around their body

turning away from you or hiding their face

Here are examples of how body language can let you know the person you're with is comfortable with what is happening:

embracing you or allowing you to touch them

facing you and making eye contact

Body language is a powerful form of communication and often has more meaning than the words we speak. However, it's not enough for consent. Be sure to ask your partner for consent, too.

Mixed Signals

What do you do if the person you are with says "yes" but is hiding their face or is not responding to your touch? This is a good time to stop and talk with them about how they are feeling. Just because they said "yes" verbally, does not mean they really want to do something. A person may feel pressured to say yes or may be confused about what they want to do. It's always better to take time to talk things through.

What if a person says "no" but is giving you body language that seems to say "yes"? Saying "no" always means no. You might want to talk with them if you feel confused, but it's important not to pressure them to change their mind. It's important you are sure that the person you're with wants what is happening. Sexual activity without consent (anything from touching and kissing to penetration) is sexual assault or rape, which is against the law.

Slowing things down and stopping

Sometimes things can move quickly. You may consent to an activity such as kissing or touching but be uncomfortable going further. You always have the right to say "no" and you always have the right to change your mind at any time. It helps if you can be specific when communicating with your partner. Here are some things you can say to slow things down or stop.

I don't want to go any further than kissing.

No.

I want to stop.

Let's stay like this for a while.

Consent cannot be given when an individual is intoxicated

Jose and Alex have been dating a few weeks and are hanging out at a friend's party. Alex has had a few drinks. Soon after, Jose and Alex start making out. Alex says, 'I want to do it with you.' Alex grabs Jose's hand and smiling, leads him to an upstairs bedroom. Jose has brought a condom and they have sex.

Did Jose get consent? Did Alex give consent?

Drugs and alcohol affect people's abilities to make decisions, including whether or not they want to be sexual with someone else. This means that if someone is out of it, they cannot legally give consent. Having sex with someone who is drunk or high can be considered sexual assault for that reason. On the other hand, an individual who performs sex acts without the permission of the other person most often cannot claim to be too drunk to know what he or she was doing. Since it can be hard to tell how impaired someone is, it's best to wait to have sex until both people can give consent.

Get consent every time

Tiffany and Sam are making out. Tiffany reaches for Sam's belt and asks, 'Do you want to go further?' Sam pulls Tiffany closer and says, 'Yes, I love having sex with you.'

Did Tiffany get consent from Sam? In what ways did Sam communicate to Tiffany that he was ok with what was happening? How did Sam give consent?

Every time you want to be sexual with a partner, you must get consent. It might feel awkward at first, but talking about sex can be sexy.

APPENDIX

Appendix B.

(1) Offer thought-provoking, yet specific prompts to continue discussion.

(2) Highlight adolescents' personal strengths.

(3) Praise self-awareness and when applicable, ask for additional information about thoughts and feelings that drive decision-making and behavior.

(4) Provide motivation (explicit rationales for engagement in health protective behavior) and cognitive-behavioral skills (explicit strategies to engage in health protective behavior) whenever possible.

(5) Reframe and challenge risk-promoting statements - try to acknowledge or validate the essence of what has been said so that adolescents will be open to 'hearing' a caution against risk.

(6) Empathize with stressors (acknowledge difficulty) and when applicable, provide cognitive-behavioral skills for coping.

(7) Emphasize adolescents' autonomy and choice with respect to behavior - foster a sense of agency.

(8) Challenge the idea that it is possible to completely avoid negative experiences when choosing to engage in risk.

(9) Encourage adolescents to think about how past negative experiences can inform healthy decision-making in the future.

(10) Encourage adolescents to plan ahead - foster a sense of intentionality.

APPENDIX

Appendix C.

Issue of Concern

Participant Description

Adolescent and Health Educator Comments

Low self- efficacy to set sexual boundaries

Multi-racial female, 16 years

Adolescent: I can't ever imagine saying something like 'I don't want to go any further than kissing' ... I would feel like that would be so awkward... It seems I would just try to not put myself in a position where I would need to say no, but thats just me.
Health Educator: Hey (username), avoiding situations where you have to say no is a good option. But what about when you do need to slow something down or ask for something different? Language is so personal and how a person says something can change the story completely. 'I don't want to go any further than kissing' can sound like 'No' or 'Let's go make popcorn' or (jokingly) 'Hey, what's the rush here?' or 'Let's slow this down a little' or 'I don't want to rush, let's just enjoy kissing tonight.' The words you say have to feel real to you. Finding your own words is a process and having language that feels right to say is only the first step. Talking about sex and what you want is a skill that a person can only develop with practice. And like practicing any skill, it will get easier each time you try it. The first time might flop or might feel ok. But the goal is that both partners get to make choices, have ideas and desires, and enjoy intimacy in a relationship. Try it out and let us know! What does happen for you? Has anyone else done something like this? What happened after you said you had a limit?

Barriers to conversations about sexual boundaries in established relationships

Multi-racial female, 17 years

Adolescent: In my opinion, it's harder to set boundaries with someone you've been dating a while. With a new person, you can stop them from going too far by simply stating that you barely know each other and don't feel like it's right to go too far yet. But with someone you've been dating for a while, certain sexual behaviors are expected and it can be hard to say no when the other person really wants it. My boyfriend used to not understand at all why I wasn't comfortable giving him oral sex yet when he was so willing to do so for me. That was a guilt trip that was hard for me to answer.
Health Educator: Different sexual behaviors can mean different things to different people. For some people, oral sex is something that happens early in a relationship. For other people, it happens later when they feel more comfortable and connected. Some people aren't really into oral sex at all, and that's okay too.
Sometimes people hesitate to say they don't want to do something sexual because they worry that the other person might think they have doubts or don't care. It can help to first say something positive like 'It makes me happy that you want me to feel good,' and then explain 'but I don't want to do that right now.' Or you could say 'I'm not really into that, but I like it when we...' [fill in the blank].
Do other people have suggestions for what to say to someone you've been in a relationship with for a while?

Acquiescing to sex in order to preserve a relationship

Multi-racial female, 17 years

Adolescent: It's difficult to say 'no' when you feel like the other person expects something out of you and will be disappointed if you don't give them what they want. I don't want to leave the other person frustrated or dissatisfied. I have done things I was uncomfortable about for the other person's satisfaction and out of fear they would be disappointed/frustrated if I didn't.
Health Educator: I think this is something that happens more than anyone would like to admit. Sometimes compromise or giving in can help relationships; and sometimes it can hurt them. When it comes to sexual situations, no one should have to do things they are uncomfortable with. Our fears of disappointing someone can get built up to the point where it feels like we don't have a choice. But being sexual should always be a choice.
Does saying 'no' or 'not now' always have to be a frustrating situation? What are some suggestions for handling this kind of situation that have worked for other people?

Assuming sexual consent

White female, 18 years

Adolescent: I couldn't see myself asking for consent from my boyfriend. I don't think it'd be awkward, we just both seem to want to have sex at the same time.
Health Educator: I wonder - how do you know that you're both interested in sex at the same time? Are there things you say to each other? Are there nonverbal signs you give? It seems like you might be getting or giving consent in some way without it being so obvious as the process described in our article.

APPENDIX

Appendix D. Suggestions for future applications of the Sexual Consent article.

A definition of sexual consent provided to adolescents as part of sexuality education should be accompanied with several examples of sexual communication in scenarios that adolescents are likely to experience. Ideally, education should be offered in a modality that allows for interaction between adolescents and health educators. Adolescents should be encouraged to "critique" examples given. Do they seem true to their own experiences or those they have heard about? Adolescents can be asked to provide examples of different ways in which consent, ambivalence, and refusal can be communicated verbally and nonverbally. At this point, a health educator can observe the myriad of ways in which consent, ambivalence, and refusal can be communicated. The health educator can highlight the importance of identifying and respecting what is being communicated, as well as asking clarifying questions if one is unsure of what is being communicated. Health educators can note particular phrases or actions that adolescents have interpreted in different ways. They can ask how the intent can be communicated more clearly, while also emphasizing the importance of asking clarifying questions to one's partner if one is unsure of whether the partner is consenting to a sexual activity. In this way, health educators can enhance adolescents' self-efficacy and skills to communicate. They can simultaneously reinforce the message that it is the responsibility of a partner who wishes to initiate or progress sexual activity to obtain clear consent before proceeding.

Some participants in our study described consensual sexual experiences involving purely nonverbal communication or sex in the context of substance use. When providing sexuality education, health educators can acknowledge that such experiences are possible if members of their audience make similar statements. However, health educators must also help adolescents to understand the concept of risk, which is not an "all or none" phenomenon. Certain types of sexual communication (i.e., nonverbal communication, non-explicit verbal communication) may be more likely to be misinterpreted by a partner than other types of sexual communication (i.e., explicit verbal communication). Sex in the context of substance use may make sexual decision-making and sexual communication more difficult than sex while sober. TeensTalkHealth moderation guidelines emphasized adolescents' autonomy and choice with respect to behavior; health educators attempted to foster a sense of agency. Others who wish to follow these guidelines should not quash the opinions of adolescents who express a preference for nonverbal sexual communication or a liking for sex while intoxicated. Rather, a health educator can explore whether there are situations where the adolescent thinks explicit verbal communication or sober sex would be a better choice. The health educator can also ask the adolescent what they would do if it seemed like their sexual communication was not being understood.

Our Sexual Consent article contains four scenarios to catalyze conversation. Additional scenarios could be developed to further explore the nuances of sexual consent discussed by adolescents in the present study. We view such conversations as skill-building. We wish to be clear that by conceptualizing quality of sexual communication as a risk factor for or protective factor against sexual violence, we are not blaming adolescents who have been victimized by sexual violence. Rather, we are identifying a factor that can be one focus of prevention efforts. It is not the fault of a victim of sexual violence if a perpetrator does not understand their communication or blatantly disregards a refusal that is well understood. In addition to building adolescents' sexual communication skills, it is important to build interpretation skills, as well as norms that dictate respect for the refusal of others and engagement in sexual behaviors only in the context of an "enthusiastic yes."

Footnotes

Declaration of Interest Statement

The authors have no potential conflicts of interest to report.

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# data[].attributes.attachment_link.title
Communication about Sexual Consent and Refusal: A Learning Tool and Qualitative Study of Adolescents' Comments on a Sexual Health Website

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Sexual communication skills are needed to create healthy romantic relationships. Arguably, these skills also can be used to prevent some instances of unwanted sex. This study presents a qualitative analysis of adolescents' comments after reading ...

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The main thesis of the article is that it was conversations between women and they discuss the reasons for why they decided to have sex with a guy as well as their mental state and emotions when the sex is over. One topic discussed was how a girl had sex with a man just due to the simple fact that he bought her a full course expensive meal. Two key terms are abundant and consideration. The reason I chose these words is because abundant means to have plenty of and within the text it supports how men use porn as a guidance and sort of mentor on how sex should be viewed when in reality it isn’t but yet they spend so much time on the website. Consideration is another term because it is still a concept of not being completely sure about something.

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Opinion | When We Consent, We Shouldn’t Feel Terrible After, Right? (Published 2022)

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We deserve more than sex that is merely legal.

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The main thesis of the show is about sexual assault occuring with even the people you held closest to you. It also demonstrates the mental state after being sexually assaulted. I think this will help me with my research because consent when broken can lead to sexual assault and rape. The two key terms I would like to use are sexual assault and bondaries. I wanted to share these words because they are super important to understand the meaning behind them and to also really use those words carefully and not just because you think they are funny or trending because they really create a gap in your mental state.

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Watch 13 Reasons Why | Netflix Official Site

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High school student Clay Jensen lands in the center of a series of heartbreaking mysteries set in motion by a friend's tragic suicide. Watch trailers & learn more.

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The main thesis of the article is that the newer generation, “Gen Z '' is not having as much sex as other previous generations. The article begins to further discuss the reasonings and factors about teens today and their input on sex. Two key terms are prudish and celibacy. I liked the term prudish because it means when someone takes something a little too far when it isn’t needed. I wanted to use this term in scenarios where comments about sex are made within two individuals when they are speaking on a serious matter. The word celibacy is also another key term used throughout the article and it basically just means for someone to not be having sex or doing sexual intercourse.

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Gen Z is not having sex-it's filled with "puriteens." Or maybe the rising generation is just thinking about sex the wrong way, or having the wrong kind of sex. The breathless headlines and speculation brought on by research that shows some people born after 1996 may be having less sex than their elder counterparts are reminiscent of previous panics about teen sexuality. But as always, the real story is more complicated. On a recent episode of ICYMI, Rachelle Hampton was joined by You're Wrong About's Sarah Marshall to talk through the hand-wringing reasons people think the youth aren't having sex, what the data does (and doesn't) show, and how Gen Z might just have the healthiest relationship with sex yet, even if they aren't having any.
This conversation has been condensed and edited.
Sarah: Today, we're going to talk about the sex lives of teenagers. It seems like the culture at large right now is convinced that Gen Z is the most prudish generation. They are allegedly turning their backs on the progressive ideals of sex positivity. We're seeing headlines about Gen Z not having sex. They're all around us-the headlines, not the Gen Zers.

We've been hearing about this since at least 2019. But are the youths actually sex-averse, or is there possibly something more going on there? Why are we so obsessed with the kids' sex lives all the time and now and forever?

Rachelle: We have decided apparently that Gen Z just is not fucking nearly enough. That is what everyone is talking about. There are so many headlines across the internet about this supposed phenomena. Have you seen any of these? Just in 2021, we got pieces that included GQ's Gen Z Are "Puriteens," But Not For The Reasons You Think, Newsweek's What's Driving Teens' Aversion of Sex?, BuzzFeed's These Gen Z Women Think Sex Positivity Is Overrated, Rolling Stone's Are Sex-Negative 'Puriteens' Actually Taking Over the Internet?, and Vice's Why Gen Zers Are Choosing Celibacy. If you read all those headlines and not the pieces, as most of us tend to do, you might have the thought that perhaps Gen Z is not as horny for each other as previous generations.

Sarah: First, we have to establish that most of these pieces are based on very thin evidence. It's going to be a while before we have actual longitudinal data about the sexual attitudes of Gen Z, not least because the youngest member of Gen Z is 10 years old right now. "Generations" are fake and made up for marketing purposes as well. But what data is actually out there to support the puriteen narrative?

Rachelle: There are a few studies that most of these articles seem be pulling from. The primary ones are from January 2021, where researchers determined adults 18 to 23 weren't having as much casual sex as that same age group 10 years before. And then one from 2020 that found that between 2000 and 2018, there was a significant decrease in men ages 18 to 24 having sex, but no meaningful change in that same time period for women, which is a fascinating little dissonance.

Sarah: And in yet another study, this one for March 2021, researchers found that the biggest factor for the reduction in casual sex among 18-to-23-year-olds is reduced alcohol consumption. But with men, there are also other factors, such as hours spent online or living with a parent. One of the funny things about the study is that it also says they found women would likely be having even less sex than they are if they were online less.

The researchers are also clear in their conclusion that they just don't have the data about why this is happening. They just know it's a thing that is happening.

Rachelle: That is kind of the crux of this entire Gen Z puriteen myth: people just have an idea that something is happening, but have no idea why. There are so many just conjectures flying around. Some "sex neuroscientists," which is a field I did not know you could be in, like Debra Soh in a Newsweek op-ed from last October, suggested that young people aren't engaging in sex as frequently because of the increase in "helicopter parenting" and a decrease in adolescence getting jobs in their free time.

Sarah: Some are also arguing, and you might have seen this coming, that the availability of online sex content means people are satisfying their sexual needs on their own, thanks to pornography, and are engaging in online sex acts, including sexting or webcamming, which are not traditionally classified as sex.

Rachelle: But others have also suggested that the reason for the sex decline of teenagers is because boys have fallen behind girls in education and are therefore disillusioned with sex because they aren't the ones on top anymore, which is my least favorite theory, which probably means that it's maybe right.

Sarah: Blaming things on women in the workplace or in higher ed is often a distraction. Because look, one of the things I do in my work is find the shortest distance between any topic and the satanic panic. And maybe weirdly, I'm going to identify here a connection to the fact that the satanic panic was used partly to scare women for going to work and putting their kids in daycare. The implication is like, you'd better be careful about going back to work you dumb bitch because your child's going to be taken by a coven.

Rachelle: Wow! The real reason is satanic panic. I love that. We've solved it.

Sarah: It's always it.

Rachelle: We spent a lot of time thinking about why other people think teens are prudes, but let's actually look at what Gen Z is saying itself. Also, importantly, the oldest person in Gen Z right now is 26, I believe. Like 1996 is the last year, is the last cutoff. They are teens, but they're not only teens. That's an important consideration. Some of them qualify to pay for their own healthcare.

From the articles that talked directly to Gen Z, like the BuzzFeed piece, we mentioned sex positivity-that is what seems to be the phrase on everybody's lips. They think is that sex positivity is kind of an outdated way to look at sexual interactions. That it's overrated. And that the previous iterations of sex positivity were very focused on the pro-sex aspect, but not necessarily the power dynamics that are inherent in pretty much any sexual interaction.

Sarah: Right. Is it bad for them to point that out? Let's explore that. The concept of sex positivity, we first begin to see this in the 1960s, and it's long also been considered to mean that non-traditional sex acts aren't bad. We have to take ourselves out of a good-bad binary, which has essentially dictated at least American discourse about sex to that point in time. And then we see this transformation of the idea over the years the same way. Sex positivity eventually comes to mean something like women should be free to do whatever they want and what they want should be embracing casual sex as a form of liberation, but this leads to a lot of younger women through the years thinking sex is something that they're required to do in order to be liberated. It becomes an expectation. It is, and this is not my wonderful phrase but I think it's great, the girl-bossification of casual sex.

Rachelle: It's my favorite phrase that I've ever come up with. And that's really what it feels like, where it's this expectation that something that men traditionally have only had access to, whether it's the corner suite or it's casual sex, is inherently liberatory if women also participate in it.

Sarah: And then that comes directly from the idea that like anything men like, it must be good and it must be this exciting achievement.

Rachelle: It makes sense that a new generation is trying to basically push back against the way that sex positivity was portrayed to them in media. But they're also importantly very young and that's not always the best at coming up with the solutions at what is in essence a very complicated ideological and theoretical issue.

Before we attempt to write a dissertation, we'd be remiss not to bring up the fact that Gen Z is probably the most sexually progressive generation that has existed thus far. In the past 20 years, the wider acceptance of queer people has just led to more people embracing non-heteronormative identities. Gen Z has broadened the queer umbrella. They've kind of blown up or are attempting to blow up traditional male-female binary roles. It just tracks that as you think more about sex and gender as it pertains to your sense of self, that it gives you a little bit of distance from societal pressure of what a normal "teen sex life" should look like.

Sarah: For a while, it felt like there was this question of just how can Gen Z be so sexually progressive and also be having less sex. But talking about getting outside of binaries, right? These two things aren't as mutually exclusive as they seem. It's much easier to not feel like you have to do something when you're presented with so many possibilities of what gender and sexuality looks like or can look like.

Rachelle: While you have to know how to navigate online spaces pretty secretively, the internet still offered and continues to offer a freedom that was unthinkable in the past. For the first generation of children on the internet, they knew more about how to navigate those spaces than their parents could ever hope to and could ever hope to.

This freedom is easily a double-edged sword, because there's the Wild Wild West of the internet, and then the popularity of sex positivity kind of all conglomerating and mixing together in the '90s, early aughts. It was a sort of sexual free-for-all that, for me at least, kind of perpetuated this pressure of casual sex as the norm. I-sorry mom-encountered a lot of things on the internet as a child that I definitely should not have. I mean, 2 Girls 1 Cup was just passed around in my middle school band room.

Having access to things like that at the age of 11 or 12 probably wasn't the best for a developing brain. But like thinking about 2 Girls 1 Cup in the band room, I'm just like, "Wow! That's cute." I'm sure there's something far worse out there right now. It's just all normal and it washes over you. It's funny, because I don't even think we have the data on what that means for people of my generation, like what that did to our brain.

It's really funny that we think that we can understand what's happening with the generation that's like 10 years old right now that is, for all intents and purposes, the first one to come up post-internet, amid all these panics about the internet.

Sarah: It's really a variation of the same fear that we saw off playing out after teen dramas became ubiquitous, right? We have the premier of Beverly Hills 90210 in the early '90s, essentially building that genre. And then after that, the hits keep coming and they don't stop coming. We have Dawson's Creek. We have Degrassi. We have The Secret Life of the American Teenager. We have Gossip Girl, and now we're on to Euphoria.

These shows all helped build a cultural understanding of what teenagers are doing, and that has always included sex. The moral panic's priority list is interesting, because I remember the teen sex and teen pregnancy panic, and then we got to should we protect the teens from getting murdered at school? Now we've graduated to protect the teens from discovering their own gender panic.

Rachelle: Before there was too much sex, now there is not enough sex. It kind of just goes to show that as long as teens, as long as children exist, there's going to be panics about sex lives of teens or lack thereof. It's one of the first parts of a child's life that parents genuinely have zero control over no matter how much they try to insert control, which honestly probably a good thing, because it's not like historically adults have been great at teaching kids sex education.

Sarah: Most sex education in the U.S. is still extremely abstinence-focused. It highlights the dangers of sex rather than focusing on offering any meaningful, practical explanations about sex itself and the issues connected to it like consent and power dynamics. If nobody's going to teach them, the kids are going to figure it out for themselves, and that is what they have been doing.

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Rachelle: I think there's this general thought with the kind of sexual positivity movement of the '90s and the early aughts that as sex has become more available and casually accepted, as online dating has made finding someone outside of your immediate circle of friends more readily available, that just meant that more people would be having more sex always, and that that would always be a good thing. I don't know why it took this long, but we're learning now that that isn't the case.

At this point, I feel like we've really spent the entire episode saying it's really too early to tell how exactly Gen Z's going to navigate this moment we're in, which is a very complicated moment, because we're in between the failure of sex positivity to contend with things like #MeToo. But we're also navigating what is essentially an all-out assault on sexual freedom, on abortion, on contraception, on gay rights. I don't envy being a teenager right now having to deal with figuring out what sexual freedom looks like at this moment.

Sarah: At the end of the day, I think adults like to fixate on what teenagers are doing for a lot of reasons. One is that we are afraid that they're going to figure out more than we did and be happier than we were able to be. I say, go do it.

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What Everyone Gets Wrong About Gen Z and the Sex It's (Not) Having

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Before there was too much sex. Now there is not enough sex.

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The main thesis of the article is that it discusses how online apps have influenced hook up culture. Online dating apps are being made to connect people. However, These online dating apps have created more hook ups and sneaky links. The app has made more careless sex rather than meaningful sex and meaningful relationships. The percentage rates have risen throughout the years and discussions about booking up are spoken upon in school. Two key terms I found interesting are glorified and casual. The word glorified means to have praise and hold someone very close to them. The term casual also is important because it means it isn’t special.

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Hook-ups have become normalized, greatly affecting children all around.
With the rise of dating apps like Tinder, one-time hook-ups have become more common among the younger generation of app users. These apps have essentially glorified "one-night stands" and "booty calls," normalizing one-time physical interactions with strangers only to never speak to them again. "Friends with benefits" are also a common occurrence in our society, where two friendly people cross over into intimate territory.

There is certainly a lot of controversy around what this entails for future generations and the precedent Millennials and Gen Z are setting. Social media apps tend to promote hook-up culture in ways that can potentially be unsafe and inadvertently harmful for those who don't properly understand the lasting effects it can have.

In public schools and universities around the U.S., hook-up culture has been wildly normalized as students are surrounded by rumors and speculations of their classmates engaging in casual hook-ups, which sparks influence amongst younger generations to do the same. Around of college students have had some sort of hook-up experience as they gain more freedom and access to contraceptives at a younger age, according to the American Psychological Association. As this influence spreads to the vast majority of teens, hook-up culture only becomes increasingly prevalent.

According to the CDC, the increase in casual hookups directly correlates to the rapidly increasing numbers in STI infections over the past 10 years. The CDC estimates age groups from 15-24 account for at least half of the STI infections reported, though this age group only makes up a quarter of the United States sexually active population.

According to , some studies claim that "mobile dating apps like Tinder and Grindr are in part responsible for encouraging promiscuous sexual activity and encouraging "hook-up" culture." This indicates how younger age groups who participate in casual sexual relations are the leading cause of this increase in STI's.

Commitment is prioritized differently by many people. In recent years, younger audiences have had a skewed perception of the amount of work that goes into having a committed relationship with a significant other. Many teenagers, with their busy schedules, cannot offer the mental capacity, emotional support or dedicated time for a relationship, therefore resorting to short-lived hook-ups with people they're not obligated to care about. Although choosing to remain casual does not define a person as "heartless," hook-up culture diminishes the significance of real relationships.

Hook-ups notoriously do not work out well. One partner may develop feelings and become emotionally attached while the other doesn't. This often results in bad blood between partners and exacerbates mental struggles such as low self-esteem, anxiety and depression. Mental health is already a growing issue among teens and young adults , and hook-up culture only raises the statistics further.

The appeal of instant, physical gratification draws in teenagers at an alarming rate. In the face of society, this prevalence of hook-up culture causes youth to lack the capacity for love in long-term relationships. While some "friends with benefits" situations may lead to mutual attachments, it is not a reliable way to develop honest feelings for another person.

Ultimately, every person can choose how they engage in intimate activities, but the negative influence of hook-up culture damages teenage morals for relationships. These "situationships," as some call them, lead young people into disappointment and confusion. The rise of hook-up culture among teenagers alters the way people value real relationships and should be controlled through smart decisions and commitment.

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Hook-up culture promotes unhealthy morals for younger generations

# data[].attributes.attachment_link.description
Hook-ups have become normalized, greatly affecting children all around. With the rise of dating apps like Tinder, one-time hook-ups have become more common among the younger generation of app users. These apps have essentially glorified "one-night stands" and "booty calls," normalizing one-time physical interactions with strangers only to never speak to them again.

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The main thesis of the article is that it discusses the factors and risks of having hook up sex and casual sex. It brings up how women may be exposed more to sexually transmitted diseases, sexual assault and abuse, human trafficking, and unintended pregnancy. I think this article will help me with my research because it helps me give reasons for why hooking up is bad. Two key terms throughout the article are gratification and manipulation. The first word means to satisfy a craving you wanted or something that you have been wanting so you are gaining pleasure out of it. The second word means to control and influence someone into doing things and acting a certain way.

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Are Hook-ups Pro-Woman? - Choices Pregnancy Services

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Casual sex and hook-up culture often claim to be pro-woman and a form of female empowerment, but is this true? As we dig deeper into the effects of casual sex, we become more aware of the specific ways hook-ups can make women emotionally and physically vulnerable. Let's unpack this below.