Search Results (28)

Sexual consent is one of the most important tools used in the prevention of sexual violence, for which adolescents are especially vulnerable. However, it is unclear how sexual consent processes are defined and used by this population. To bridge this gap in knowledge, this scoping review sought to identify and synthesize the existing empirical research findings on sexual consent conceptualizations and processes among adolescents, as well as determine critical gaps in knowledge. Forty-three articles were reviewed following a systematic search of six academic databases. Articles were included if they were original empirical work published in English between January 1990 and March 2020, included adolescents aged 10 to 17 in their sample, and specifically studied sexual consent conceptualization, communication, and/or behavior. Seventeen articles, diverse in study design and geography, met these criteria and were analyzed. The findings suggest a propensity for adolescents to abstractly define sexual consent as verbal and direct in nature while simultaneously espousing indirect and non-verbal behavioral processes when presented with “real life” scenarios (e.g., vignettes, reflections on personal experience). In addition, the results reveal the significance of concepts like gender norms, normative refusals, and silence as key aspects of adolescent sexual consent. This review demonstrates that research on sexual consent among adolescents is highly limited overall, and the findings that are available indicate some concerning perceptions. Full article

This exploratory qualitative study investigates the challenges faced by young adults (aged 18–40) with severe mental illness (SMI), intellectual disabilities (IDs), and autism spectrum disorder (ASD) in navigating body perception, affectivity, intimacy, gender identity, and sexuality. Through semi-structured interviews with 13 participants recruited from a community habilitation center, thematic analysis revealed systemic barriers rooted in societal stigma, familial overprotection, and institutional neglect. Key findings highlight tensions between bodily autonomy and familial control, with prolonged caregiver dependency in intimate hygiene reflecting patterns of infantilization. We found that participants’ self-image was shaped by gendered expectations and familial critiques, reinforcing internalized stigma. Romantic relationships were often idealized through cultural narratives, yet lacked practical guidance on consent or boundaries, exacerbating vulnerabilities. Fragmented sexual education left individuals reliant on pornography or peers, perpetuating misconceptions and anxiety. Despite these barriers, participants demonstrated resilience and agency in advocating for inclusive interventions. This study underscores the urgent need for trauma-informed, rights-based approaches that prioritize autonomy, dignity, and intersectionality. Recommendations include structured skill-building programs for independence, disability-adapted comprehensive sexuality education, and systemic reforms fostering interdisciplinary collaboration. By centering lived experiences, this work challenges structural inequities and advocates for community care models that honor the diverse needs of individuals navigating the intersection of disability, identity, and sexuality. Full article

Adolescents with intellectual disability have a right to sexuality education, including relationships and consent education. This scoping review explored relationships and consent education for adolescents with intellectual disability. We searched across four databases (Scopus, Medline, Web of Science and PubMed) to identify studies focusing on the provision of, experiences with and needs of education on relationships and consent for adolescents aged 12–19 with intellectual disability. Based on the inclusion criteria, 20 studies were eligible to be included in the review. The findings suggest that despite adolescents’ strong desire for comprehensive, evidence-based education on relationships and consent, the depth and content of the education provided varied by the provider type. Many educators and parents felt unprepared to address complex relationship and consent topics, resulting in inconsistent and often risk-focused education. The review indicated the need for more tailored resources, engaged learning methods, increased training and support for providers, and collaborative approaches between different providers. Future consent and relationships education could benefit from moving from a risk-based approach to focus on personal development and the promotion of sexual well-being for adolescents with intellectual disability. Full article

In spring 2023, controversy arose over Spring Fever, an annual campaign to promote sexual and relationship education in primary schools in The Netherlands. This led to parliamentary questions and even death threats against employees of Rutgers, The Netherlands Center on Sexuality, which developed the program. This article examines how child sexuality was framed both in the Spring Fever project and in the resulting controversy. The analysis is based on newspaper articles from March to June 2023. One premise of Spring Fever is that children are seen as sexual agents able to develop their sexuality safely through age-appropriate education, which aims for children’s healthy development, including negotiating consent and experiencing pleasure. During the 2023 controversy, discourses of childhood innocence emerged in response to this, alongside accusations of focusing too much on “woke” themes, such as gender diversity. This paper concludes that, due to global anti-gender movements and local right-wing politics, the Dutch model of sex education—pragmatic, comprehensive, and evidence-based, as seen in Spring Fever—no longer maintains its depoliticizing effect. Additionally, the Spring Fever controversy signals a shift in the politics of sexual nationalism in The Netherlands. Full article

Consent education was recently introduced into the Australian curriculum, and has contributed to much of the public discourse for the past few years. However, teens’ accounts of their Relationships and Sexuality Education (RSE) classes indicate that consent is being taught to varying degrees of consistency. Qualitative data collected from 49 semi-structured interviews with 30 Australian teens (aged 11–17), with 19 interviews reprised one year later, involved teens discussing their experiences of RSE, including consent. These data were extended by 4 x teen focus groups with 18 participants. Using thematic analysis, teens’ perspectives and experiences revealed how consent appears to dominate RSE. Teens expressed dissatisfaction with how RSE was delivered and how sex is often framed in a context of safety and risk, where current framings of consent appear to contribute to fear-based messaging. Often, consent was taught as how to seek or give permission for sex or to avoid sexual assault in ways that may not reflect teens’ actual experiences. While the implementation of consent signifies welcome progress in relation to RSE, teens reveal there is still room for improvement. More positive representations of sex and sexuality are needed to balance an emphasis on safety and risk. Support is also required to help educators navigate curriculum changes, while further attention is needed to support teens’ skill development in more holistic and comprehensive aspects of sexuality and relationships. Full article

Over the last three decades, the receipt of formal sexuality education has declined, with half of adolescents nationwide receiving the minimum Healthy People standard of sexuality education from 2015 to 2019. Further, racial and geographic inequities in sexuality education remain, with Black women and girls more likely to receive abstinence-only-until-marriage instruction. We sought to describe Black women’s sexual education in two southern states, North Carolina and Georgia. We conducted a qualitative community-based participatory research study. We held focus-group discussions with forty-nine Black women in Georgia and North Carolina between May 2019 and January 2020. The research team, the reproductive justice organization, and the Research Board reviewed, discussed, and refined themes developed using deductive thematic analysis. Most participants were employed. The median age was twenty-seven. From the participants’ accounts, we observed the inadequacy of sexuality education and the resulting process of unlearning inaccurate, negative information and learning positive and accurate information about sexuality. Participants expressed a desire for accessible, high-quality sexual education for themselves and the next generation that addresses autonomy, pleasure, and consent. Our findings highlight the need for investment in existing community efforts and in creating high-quality, culturally responsive comprehensive sexuality education nationwide to effectively address structural barriers to accessing sexuality and relationship information and skills. Full article

Beliefs are information-processing structures formed along an individual’s developmental pathway. Beliefs can legitimize involvement in inappropriate or violent behaviors, particularly when they crystallize into cognitive schemas. While beliefs aid individuals in interpreting the surrounding world, overly rigid and inflexible beliefs can constrain the individual’s ability to process available information. This Systematic Review, carried out according to the PRISMA norms and guidelines, aims to understand the most prevalent beliefs regarding relationships among young adults and to examine their associations with violent or deviant behaviors. Articles included in this review were retrieved from the EBSCO, PubMed, and Web of Science databases in July 2022, resulting in a total of 594 studies, which were subsequently screened by two independent reviewers. A total of 51 studies were then selected for full reading, but 36 were excluded based on pre-defined eligibility criteria, leaving a final sample of 18 studies published between 2014 and 2022. The main objectives, country of origin, instruments used, sample composition and age, main results and conclusions were extracted from each study. Findings point toward the presence of related and legitimate beliefs about violence in intimate relationships, domestic violence, sexual violence, acceptance of the rape myth, or consent to engage in sexual activities. Full article

Conceptions or ideas that couples hold about sexual consent could be a key factor in their communication, mutual respect, and the prevention of sexual violence. The multifaceted nature of sexual consent makes it a complex concept. The aim of the present study was to explore individuals’ ideas and understanding of sexual intercourse in two distinct contexts: consensual and non-consensual. We used a qualitative approach, adopting the methodology of thematic analysis. In total, 113 surveys obtained from the general population (76.1% women and 23.9% men aged 18 to 59 years) were studied. Two open-ended questions were asked about the general topic of sexual consent, where we distinguished sexual activity in which there is sexual consent vs. no consent. The phases of the thematic analysis approach were applied. For the consensual context, the following themes emerged: mutual reciprocity and respect; open, clear communication and agreements; and awareness and emotional well-being. For the non-consensual context, the following themes emerged: violence and sexual assault, absence and ambiguity of sexual consent, and lack of communication. All of these aspects should be considered in couples’ communication and sexual education to facilitate and improve sexual relationships and, in turn, prevent violence and sexual aggression. Full article

The existing literature on sexual consent is extensive, but a new social approach to this topic is emerging, necessitating further research. This article addresses a gap in understanding how men’s interactions with other men, who are not their sexual partners, both before and during sexual encounters, influence their approach to consent beyond sexual cues. The study involved sixteen interviews and two focus groups with men aged 18–25. Conducted within the framework of the Consent project (PID2019-110466RB-100), this research aims to analyze how communicative acts, beyond verbal exchanges, shape relationships where either consent or coercion prevails. The findings reveal that when men engage in coercive interactions with non-sexual male peers, these interactions can encourage the violation of consent in their sexual relationships. Conversely, some men reject this coercive behavior, take a stand, and support others in avoiding situations that compromise consent. These results underscore the importance of addressing norms of masculinity and male interactions to ensure that all individuals can autonomously make decisions about their sexual lives. Full article

Background/Objectives: In recent years, changing paradigms, both culturally and scientifically, have fundamentally altered the approach to the treatment of children with Disorders of Sexual Development (DSD) prior to reaching the age of legal consent. In Germany, the situation changed with the introduction of legislation that includes a partial ban on DSD surgery in children in 2021. This study aims to analyze the impact of this legislation on clinical practice. Methods: From 2014 to 2024, all patients with DSD in our institution were included. The study group comprised all patients operated on after the legislation. All patients operated on before the legislation served as the control group. Karyotype, phenotype, resulting type of DSD, age at presentation and age at operation were recorded. Results: A total of 35 patients were included in this study, with 15 in the study group and 20 in the control group. The operation was authorized by the family court for all patients in the study group. A total of 46,XY patients with severe hypospadias and clinical aspect of intersexual outer genitalia were the largest proportion (25 patients, 71.4%). Nine patients (25.7%) were 46,XX girls with classical congenital adrenal hyperplasia (CAH) type. One patient (2.9%) showed a mixed gonadal dysgenesis. The mean age of the patients at first presentation in our institution was 10.7 months in the control group and 11.0 months in the study group. The mean age at operation was significantly higher in the study group (20.1 months) compared to the control group (15.1 months; p = 0.032, unpaired t-test). Conclusions: The introduction of the legislation with a partial ban of genital surgery in DSD children in Germany has led to a significant delay in surgery. Since the majority of the patients comprise severe hypospadias and 46,XX CAH patients, further amendments of the law are proposed to minimize potential harm. Full article

Sexual and reproductive health (SRH) research is essential for the development of population-tailored evidence-based policies and programs that support sexual health among adolescent girls. However, ethical challenges create barriers to girls’ participation in low- and middle-income countries (LMICs). From February to September 2019, girls aged 16–20 (n = 30) who participated in the Jovenes Sanos study in Tijuana, Baja California (ClinicalTrials: NCT03660514) responded to in-depth interviews (IDs) on the perceived risks and benefits of participating in studies which address gender-based violence, unintended pregnancy, and STIs. Emergent themes indicated the need to ensure that consent and incentive procedures are tailored to the developmental level of participants, while highlighting the importance of researcher–participant relationships, and demonstrating how research can serve as an opportunity to empower girls to express their sexual health medical needs. Understanding adolescent girls’ voices is a critical step in ensuring that consent to participate SRH research is tailored to the developmental needs of participants, is culturally competent, and has a participant-centered approach. Full article

(1) Background: Sexually Transmitted Infections (STIs) in men are a significant public health problem due to the consequences they can have, such as chronic diseases, infertility, cancer, and even death. This study aimed to determine the frequency of microorganisms associated with STIs in men with urethritis attending urology consultations, and to explore their clinical correlations. (2) Methods: A population that attended the urology consultation of the University Hospital “Dr. José E. González” was studied. Written consent was obtained, and interviews and clinical history were conducted about specific risk factors identifying signs and symptoms associated with any genitourinary condition; after that, urine samples were collected. Identification of C. trachomatis, N. gonorrhoeae, U. urealyticum, and M. genitalium was based on amplifying species-specific DNA fragments. (3) Results: A total of 200 patients were included. The mean age was 55 years (20–95). According to the interviews, only 32.5% (n = 65) had received prior sex education. Additionally, 75% (n = 150) do not usually use any protection during sexual intercourse. Regarding clinical factors, 69.4% (n = 138) presented burning or pain when urinating. Molecular analysis revealed the presence of C. trachomatis to be 9.5% (n = 19), with U. urealyticum at 13% (n = 26), and M. genitalium at 2% (n = 4). (4) Conclusions: This is the most extensive molecular epidemiological study of the frequency of STIs in men in Mexico in third-level care and its association with different risk factors. As reported globally, a similar frequency of C. trachomatis, U. urealyticum, and M. genitalium was detected. Full article

Background and objectives: Cervical cancer is the fourth leading cause of cancer-related deaths in women. Human papilloma virus (HPV) is known to cause cervical cancer. The incidence and mortality of cervical cancer has drastically reduced due to effective vaccination against HPV in developed countries. The projected rise in cervical cancer cases in Latin American and Caribbean countries necessitates a study to evaluate awareness about HPV, cervical cancer, the HPV vaccine, and prevention among women in Antigua and Barbuda. Materials and methods: This was an observational, cross-sectional study. The participants were women aged between 18 and 65 years, residing in Antigua and Barbuda. The study was conducted over the period of February to April 2023. After taking informed consent electronically, sociodemographic and behavioral data was collected through questionnaires sent out as links and QR-codes and were analyzed by Qualtrics^XM. The association between the demographic groups and awareness about HPV, cervical cancer, the HPV vaccine, and prevention was analyzed by a Chi-square test. Results: In total, 467 women were included in the study. The percentage of participants aware of HPV was 91.6% (n = 412). A total of 70.7% (n = 318) and 56.7% (n = 255) women were aware that cervical cancer is caused by HPV and is sexually transmitted, respectively. Although 70.6% (n = 315) of participants were aware that the vaccine protects against HPV, only 12.8% (n = 57) were vaccinated. Of the participants, 49.7% (n = 192) were willing to get vaccinated. The percentage of participants aware of the Papanicolaou (Pap) smear procedure was 98.9% (n = 435) and 87.8% (n = 382) had a Pap smear within the last 10 years while 12.2% (n = 53) never had a Pap smear screening. The willingness to know more information about HPV and the HPV vaccine among the participants was 77% (n = 335). Conclusions: The overall awareness among women in Antigua and Barbuda about HPV, cervical cancer, the HPV vaccine, and prevention was high. We recommend a national health education program and vaccine drive to complement our findings. Full article

With the increased ubiquity of digital technology, sexting behaviours, defined as the online sending, receiving, or disseminating of sexually explicit messages, images, or videos, have become increasingly frequent, particularly among young adults. While prior research found sexting behaviours to be associated with cyberbullying behaviours, the role of consent as part of this association has been largely unexplored. The current study investigates whether the relationship between sexting behaviours and cyberbullying perpetration might be explained by a subset of nonconsensual sexting behaviours, such as engagement in nonconsensual sext dissemination and sext-hassling. A large convenience sample of young Western cisgendered adults (n = 1688, M age = 23.15, SD = 3.23, 52.7% women) completed an anonymous online survey exploring harmful online behaviours (nonconsensual sext dissemination, sext-hassling, cyberbullying victimisation/perpetration). A hierarchical logistic regression was used to analyse predictive relationships between variables. The results showed no significant association between consensual sext-sending and cyberbullying perpetration in young adults. However, nonconsensual sexting behaviours, particularly sext-hassling and nonconsensual sext dissemination, were predictive of cyberbullying perpetration. Finally, cyberbullying victimization appeared to be the most strongly associated factor with cyberbullying perpetration. These findings suggest that future research and prevention efforts surrounding sexting and cyberbullying perpetration would benefit from a focus on consent and the bidirectional nature of cyberbullying behaviours. Full article

The aim of this study was to determine the incidence of infections and cytological abnormalities and to investigate possible predisposing factors such as sociodemographic characteristics, sexual behavioral habits, and gynecological and obstetric backgrounds. Between 2013 and December 2016, a cross-sectional study was conducted among 429 consenting women, from whom cervical samples were tested for the presence of Human papillomavirus (HPV) by polymerase chain reaction (PCR). Susceptibility to HPV infection was assessed by binary logistic regression in light of possible predisposing factors, which were collected using a questionnaire. In our sample population, the prevalence of HPV infection was 49%; high-risk types had a higher prevalence of 89.1%. A larger proportion of HPV-infected women were under 25 years of age, were single, and had monthly incomes up to minimum wage. Multivariate binary logistic regression analysis showed that age younger than 25 years increased the odds of infection fivefold, while a monthly income of one to three minimum wages provided protection against HPV infection, even if the women were married or had a cohabiting partner. In the HPV-positive group, squamous intraepithelial lesions (SIL) occurred more frequently in women who earned up to one minimum wage monthly, but a monthly income of one to three minimum wages protected against the development of SIL. The results suggest that age, marital status, and monthly income are important cofactors for HPV infection and the development of SIL. Full article