Communication and Interpretation of Sexual Consent and Refusal in Adolescents and Young Adults

The purpose of this study is to evaluate where adolescents and young adults (AYAs) learn about sexual consent and how they communicate and interpret sexual consent and refusal in sexual encounters.

A convenience sample of patients attending either an adolescent medicine primary care or a title X-supported adolescent family planning clinic completed an anonymous survey about their communication and interpretation of sexual consent and refusal.

One hundred fifty participants, aged 14-24 years, completed the survey; 43% were male, and 78% were sexually active. Most (87.6% females vs. 71.9% males) reported having discussed sexual consent with someone, 34.8% (46.1% females vs. 19.7% males) said they had done so with a health care provider. Males and females indicated and interpreted consent and refusal differently. Of sexually active participants, females were significantly more likely to use verbal cues to communicate (94.7% vs. 77.3%) and interpret (96% vs. 54.4%) consent. Females were also significantly more likely to use verbal cues to communicate (98.7% vs. 56.8%) and interpret (90.7% vs. 59.1%) refusal. Approximately half of males and females indicated consent by "no response". Significant gender discordance was found in both the communication and interpretation of sexual consent and refusal.

AYA use verbal and nonverbal cues to communicate and interpret sexual consent and refusal. Males and females may communicate and interpret consent and refusal differently. Education about sexual consent should incorporate real-life AYA communication practices to reduce sexual assault and promote healthy and sexually fulfilling relationships.