Describing the "Gray" Area of Consent: A Comparison of Sexual Consent Understanding Across the Adult Lifespan

"What Is Normal?": A Qualitative Exploration of Health Practitioners' Reports of Treating Patients Presenting with Unpleasant Sexual Experiences

Sexual health, including sexual pleasure, is fundamental to holistic health and well-being, and is considered an area of priority health in Australia. Despite the importance of sexual functioning, women experience significant gaps in sexual well-being compared to men and often do not seek medical care or treatment. Health practitioners are central to the identification and treatment of sexual dysfunction, including fostering sexual well-being for patients. Despite this, minimal research has explored health practitioners' experiences in treating reports of unpleasant sex. This study aimed to explore health practitioners' experiences, responses, and confidence in treating patients presenting for unpleasant sexual experiences. An online, mixed-methods survey was completed by 96 participants. Thematic analysis identified 11 core themes. These themes included five patient centred themes (health risks, diverse sex acts, painful vaginal intercourse, relationship breakdown and violence, unwanted sex) and six health practitioner centred themes (communication and counselling, what is normal, ongoing care and follow up, emotional response, limited practical training, and highly prevalent). Participants described a complex sexual health landscape, with social contexts impacting women's sexual experiences and engagement in treatment. Additionally, health practitioners reported the need for a biopsychosocial approach to understanding and responding to unpleasant sexual experiences for patients, while simultaneously reporting limited education in this area. Findings reflect the need for health practitioners to be cognisant of matters related to sexual function, consent, coercion, client engagement, and treatment pathways, identifying a need for greater education and holistic approaches to sexual healthcare across medical settings.

Does "Consent Matter"? An Evaluation of a Sexual Consent Awareness Campaign for College Students

Consent, or lack thereof, is paramount in instances of sexual violence among college students. The current study assessed the impact of the Consent Matters campaign on Canadian undergraduate students' (N = 799) attitudes toward sexual consent, perceived behavioral control in obtaining consent, use of indirect methods of obtaining consent, as well as recall of the campaign materials. Results indicate no significant impact of the campaign on student attitudes and beliefs regarding sexual violence and consent but do indicate students hold strongly positive attitudes toward consent. Recommendations for future campaigns and evaluations are discussed.

"I Don't Care if it Would Kill the Mood. I'm Going to Use My Words": Perceptions and Use of Explicit Verbal Sexual Consent in Neurodiverse Undergraduate Students

Adults entering college, especially autistic individuals, may have a higher likelihood of unwanted or distressing sexual experiences. Additionally, autistic adults appear to endorse dissatisfying sexual education experiences and difficulties with consent cues. The current mixed-methods study examined the types of consent cues college students rely on and potential barriers to seeking sexual consent. We combined data from two studies of undergraduate students: 1) an in-person cross-sectional study exploring conceptualizations and interpretations of consent in autistic and non-autistic young adults (n = 30), and 2) an online, short-term longitudinal study examining predictors of mood concerns in neurodiverse students transitioning into their first semester at 4 northeastern United States university systems in Fall 2022 and 2023 (n = 230). In-person participants completed a semi-structured interview asking about consent expression and interpretation. Participants from both studies completed self-report surveys measuring autistic traits, attitudes and perceptions toward sexual consent, and sexual education history. Qualitative analysis suggested students preferred to rely on explicit verbal consent, but felt they were unusual for doing so. In contrast, quantitatively, students across both studies expressed comfort with explicit verbal consent, to a high and similar degree. Further research may benefit from investigating differences between young adults' perceived and actual sexual consent preferences of peers, with attention to neurodivergent individuals.

[Sexual violence and young people: "it is not something you are born with, but with what you learn"]

OBJECTIVE

To analyse the perceptions and experiences of young people in Spain about sexual violence (SV), its possible causes, victims and perpetrators..

METHOD

Qualitative study based on semi-structured interviews with 22 young people between 18 and 24 years old. A qualitative content analysis was carried out.

RESULTS

In the juvenile narratives, the lack of definition and accuracy about what SV is stands out, except for mentioning rape, lack of consent and use of force in sexual relations. The girls, self-perceived as the main victims, also break with these narratives by providing a broader vision and gender inequalities related. In general, the most prevailed idea is that VS is perpetrated by men against women in heterosexual relationships inside and outside the couple. Regarding explanations, references coexist to both contextual factors (linked to gender inequalities and the social construction of sexual relationships) and behavioural factors (which includes the viewing of pornography). Tentatively proposals for improvement related to sexual and affective education emerge.

CONCLUSIONS

In the perceptions of the young people, ambiguity seems to coexist with explicit references to the different ways in which it manifests itself and the influence of gender inequalities. Sex and life experience appear to influence these narratives. It is necessary to promote a more critical perspective on the social construction of SV and intimate relationships in the young population.

Sexual Consent Norms in a Sexually Diverse Sample

Sexual consent has received increased attention in mainstream media, educational, and political settings since the rise of the #MeToo movement in 2017. However, long before #MeToo, sexual consent has been a core practice among people who engage in Bondage and Discipline, Dominance and Submission, Sadism, and Masochism (BDSM). This study examined sexual consent norms among a sexually diverse sample, including people who practice BDSM (n = 116), people who identify with another sexual minority group, such as swingers and sex workers (n = 114), and people who did not identify with a sexual minority group, termed sexual majority group members (n = 158). Explicit consent for both BDSM- and non-BDSM-related activities was rated as more common (descriptively normative) among people who were a member of the BDSM community compared to majority participants. Further, BDSM participants rated consent discussions as less sexually disruptive compared to majority participants. We found no significant group differences in the extent to which people thought sexual consent should be discussed. We also discuss findings from an open-ended question asking participants to recall a recent sexual experience with a new partner. This study demonstrates variability in consent norms between groups and points to the potential to shift sexual consent behaviors among majority participants.

"I Reject it, But That's What Normally Happens": Grey Zones of Gender-Based Violence and Gender Roles in Young People

There has been growing concern about the increase in gender-based violence (GBV) among young people. The aim of this study was to explore the grey zones in GBV alongside gender (masculinities and femininities) discourses in young adults. We used the concept of a "grey zone" as an analytical tool to identify possible contradictory discursive positions where the notions of victims and perpetrators of GBV converge and become ambiguous. We performed a qualitative study based on 20 semi-structured interviews and 4 focus groups (October 2019 to February 2020) in Spain with a sample of 49 cisgender women and men, aged between 18 and 24, some involved in feminist activism and some not. We conducted a sociological analysis of the discourse system. Study findings show how culturally constructed gender norms intervene in the ways in which young people understand and deal with GBV. When asked general questions about GBV, this concept was problematized along with gender assumptions and two discursive positions were identified: the discourse of "men as authors of GBV" and the discourse of "GBV as an individual genderless issue." When vignettes of everyday GBV situations were shown, grey zones became visible when discussing subtle forms of GBV influenced by the myths of romantic love, victim-blaming around sexual violence, digital GBV and bystander men intervention on GBV. In those grey zones, discourses on GBV were articulated around unequal notions of gender that, in turn, served as its justification, reproduction, and normalization. The grey zones identified represent contexts of oppression that illustrate how GBV is systematically reproduced, as well as the ways in which young people can be involved in it, perpetuating power and health inequalities. Our findings provide information as a guide to design GBV interventions and prevention actions that incorporate a focus on gender configurations.

'Breaking the silence': Sexual victimisation in an old age psychiatry patient population in Flanders

BACKGROUND

Sexual violence (SV) is linked to mental health problems in adulthood and old age. However, the extent of sexual victimisation in old age psychiatry patients is unknown. Due to insufficient communication skills in both patients and healthcare workers, assessing SV in old age psychiatry patients is challenging.

AIMS

To assess lifetime and sexual victimisation in the past 12-months, correlates and SV disclosure in an old age psychiatry population.

METHODS

Between July 2019 and March 2020, 100 patients at three old age psychiatry wards across Flanders participated in a face-to-face structured interview receiving inpatient treatment. The participation rate was 58%. We applied the WHO definition of SV, encompassing sexual harassment, sexual abuse with physical contact without penetration, and (attempted) rape.

RESULTS

In 57% of patients (65% F, 42% M) SV occurred during their lifetime and 7% (6% F, 9% M) experienced SV in the past 12-months. Half of the victims disclosed their SV experience for the first time during the interview. Only two victims had disclosed SV to a mental health care professional before.

CONCLUSIONS

Sexual victimisation appears to be common in old age psychiatry patients, yet it remains largely undetected. Although victims did reveal SV during a face-to-face interview to a trained interviewer, they do not seem to spontaneously disclose their experiences to mental health care professionals. In order to provide tailored care for older SV victims, professionals urgently need capacity building through training, screening tools and care procedures.

Prevalence and Associated Factors of Sexual Victimization: Findings from a National Representative Sample of Belgian Adults Aged 16-69

Sexual victimization is a major public health, judicial, and societal concern worldwide. Nationally representative and comparable studies are still lacking. We applied a broad definition of sexual violence, including hands-off and hands-on victimization, and behaviorally specific questions to assess sexual victimization. Lifetime and 12-month prevalence estimates were obtained that are representative of the Belgian general population aged 16 to 69 with regard to sex and age. These estimates indicate that 64% experienced some form of sexual victimization in their lives, and 44% experienced some form of sexual victimization in the past 12 months. Logistic regression analysis revealed significant associations for sex, age, sexual orientation, the number of sexual partners, and the financial situation with sexual victimization. Furthermore, our data show that mental health is significantly worse in persons with a history of prior sexual victimization. Prevalence estimates for all forms of sexual victimization are presented and compared to other national and international studies on sexual victimization. This comparison suggests that prevalence rates may have been underestimated in extant research. The prevalence estimates obtained in this study demonstrate that all sexes and ages are affected by sexual victimization.