Abstract
Objective:
External consent communication and internal consent feelings may be influenced by alcohol consumption. However, whether the way someone communicates sexual consent differs when alcohol is or is not involved is not well understood. The goal of this study was to assess the within- and between-person effects of alcohol use, gender, and sexual identity on internal and external consent.
Method:
Young adults (n = 375) completed a 10-minute web-administered survey about their internal and external consent in a recent alcohol- and non–alcohol-involved sexual encounter. External consent included five different behaviors to communicate consent. We conducted a repeated-measures analysis of variance to assess the within- and between-person effects of alcohol use, gender, and sexual identity on internal and external consent.
Results:
Internal consent did not differ across sexual experiences or identities. In alcohol-involved encounters, there was a decreased use of implicit communication. Heterosexual women used more verbal communication during alcohol encounters than during sober encounters. Compared with men, women used more nonverbal and implicit communication across encounters.
Conclusions:
Alcohol use did not influence internal consent and was associated with a reduced use of implicit communication. The disinhibiting effects of alcohol may lead people to feel more confident and open about expressing their sexual desires. Affirmative consent initiatives can use findings to encourage more clear communication and continue to educate on gender differences in sexual consent.
Sexual assault victimization continues to be a pervasive problem for young people (Koss et al., 2022; Muehlenhard et al., 2017). People who identify as a sexual minority face an increased risk of experiencing sexual assault victimization (Coulter & Rankin, 2020; Coulter et al., 2017). Experiencing a sexual assault is associated with myriad consequences, including an increased risk of developing mental health disorders or substance misuse (Dworkin, 2020; Dworkin et al., 2017). Given the pervasiveness and consequences associated with sexual assault victimization, researchers aim to prevent the behavior from happening. To prevent sexual assaults, educators promote active and ongoing consent communication among young people to ensure clarity about each person's boundaries during sexual activity (Willis & Jozkowski, 2018; Willis et al., 2019b). Yet, alcohol use could influence one's ability to communicate sexual consent clearly—which may lead sexual partners to interpret ambiguous cues as signs of consent in the absence of clear communication. To date, however, researchers have primarily focused only on sexual experiences that involve alcohol, which limits our ability to understand if the way someone communicates sexual consent differs when alcohol is involved. This study aims to investigate the within-person effects of alcohol use on external consent communication and internal consent feelings.
Internal consent feelings and external consent communication
Sexual consent is the voluntary, verbal, or nonverbal expression of one's unimpaired and conscious willingness to engage in sexual activity (Hickman & Muehlenhard, 1999; Willis & Jozkowski, 2019). Sexual consent involves internal feelings and external communication of those feelings (Muehlenhard et al., 2016). Internal consent relates to feelings of comfort, safety, willingness, and readiness for sex (Jozkowski et al., 2014; Muehlenhard et al., 2016). The stronger one's internal consent is, the greater their use of external consent communication (Willis et al., 2019a, 2021a). External consent can be conveyed by (a) explicit signals (e.g., saying yes), (b) verbal communication (i.e., asking to move to the bedroom), (c) nonverbal communication (i.e., removing clothing), (d) implicit signals (i.e., inviting facial expressions), and (e) “no-response” signals in which one allows the sexual activity to continue without stopping (Jozkowski et al., 2014; Muehlenhard et al., 2016).
Internal and external consent and alcohol use
Internal and external consent can be influenced by alcohol use (Herbenick et al., 2019; Jensen & Hunt, 2020; Jozkowski & Wiersma, 2015; Willis et al., 2021b). Alcohol use before sexual activity is associated with reduced feelings of internal consent (Jozkowski & Wiersma, 2015; Willis et al., 2021b). The reduction in internal consent when drinking alcohol may be attributed to alcohol's impact on judgment and perception (Sayette, 1999; Steele & Josephs, 1990), leading young people to feel less comfortable, ready, sure, or safe during their sexual encounters.
Some researchers have found that alcohol use before sexual activity is associated with fewer reports of explicit nonverbal consent signals (Jozkowski & Wiersma, 2015). In addition, higher levels of alcohol consumption before sexual activity were associated with reduced use of explicit consent signals and an increase in implicit signals (Willis et al., 2021b). This finding is reflective of prior research in which some young people reported that a few drinks can be “ideal” for a sexual encounter without hindering consent communication, but heavy intoxication can affect consent communication and interpretation (Hunt et al., 2022; Jensen & Hunt, 2020). Collectively, alcohol use appears to influence internal consent feelings and how one communicates external consent. The influence of alcohol on consent is concerning considering the frequent involvement of alcohol during sexual assault experiences by both the perpetrator and victim (Abbey, 2002, 2017).
Internal and external consent by gender and sexual identity
Individual factors, such as gender or sexual minority identity, may also influence the alcohol and consent relationship. For instance, there are consistent gender differences in consent communication when people are not intoxicated, such that men tend to use verbal and explicit cues and women use implicit and nonverbal cues (Muehlenhard et al., 2016). However, when intoxicated, these gender differences may not be as prominent. Both women and men report that they can consent after drinking alcohol (Drouin et al., 2019; Jozkowski et al., 2023) and both report using active consent communication (e.g., verbal, nonverbal, explicit, and implicit) when under the influence of alcohol (Willis et al., 2021c). Thus, alcohol use could be related to women and men communicating consent similarly after drinking.
Researchers have examined differences in internal or external consent during alcohol-involved sexual encounters between sexual minority or heterosexual people to a lesser extent. In a recent study by Marcantonio & Willis (2022), participants from both groups reported on their internal and external consent after consuming alcohol and no differences were found. This may be because sexual minority and heterosexual people reported that alcohol use can complicate sexual consent and create challenges with refusing a sexual encounter (Gaspar et al., 2021; Hunt et al., 2022; McKie et al., 2020). Furthermore, both groups appear to communicate consent similarly, regardless of sexual identity (Marcantonio et al., 2022; McKie et al., 2020; Sternin et al., 2022). Thus, alcohol use may similarly affect sexual minority and heterosexual people's internal and external consent.
Next steps with consent and alcohol research
Alcohol use, gender, and sexual identity may relate to internal and external consent (Hunt et al., 2022; Marcantonio & Willis, 2022). However, this work fails to consider how one may feel and communicate consent when alcohol is not involved. Specifically, compared with a sober experience, does alcohol reduce internal consent or alter how people communicate consent? Are the effects of alcohol use on consent seen equally across gender and sexual identity? Currently, we are unable to answer these questions, which leaves consent prevention efforts with a lack of clarity on if or how alcohol use may alter consent and may result in ineffective prevention messaging. To address these issues, the goal of this within-person study was to examine if alcohol use influenced how young people internally felt and externally communicated their sexual consent. We also examined the relationship between alcohol use, gender identity (cis women and cis men), and sexual identity (sexual minority and heterosexual). Based on the prior research, we had the following hypotheses:
Hypothesis 1: Compared with non–alcohol-involved, alcohol-involved sexual encounters will be associated with reduced internal consent feelings for both women and men and sexual minority and heterosexual young adults.
Hypothesis 2: Alcohol-involved, compared with non–alcohol-involved, sexual encounters will be associated with (Hypothesis 2A) fewer reports of explicit and verbal external consent signals and (Hypothesis 2B) greater nonverbal, implicit, and no-response (i.e., letting sexual activity happen without stopping) external consent signals.
Few researchers have found gender or sexual identity differences in how consent is communicated after young people have consumed alcohol. However, this work has not compared one's communication in a sober versus intoxicated sexual experience. Thus, we do not advance directional hypotheses and instead examine if consent communication differs across gender and sexual identity in an alcohol- and non–alcohol-involved sexual encounter.
Method
Participants and procedure
All procedures were approved by the university's institutional review board committee. Participants completed an online cross-sectional survey through Prolific Academic. Participants were compensated $4.00 for a 10-minute survey. Participants read a short summary of the study on Prolific's website and if interested, they clicked on the link and were prompted with an informed consent. The survey included quality checks to ensure participants were reading.
All participants were from the United States. To be eligible, participants had to report being sexually active in the past year, report consuming at least one alcoholic beverage a week, and be between ages 18 and 30. We had 502 participants begin the survey and 123 were removed for not having experienced both alcohol- and non–alcohol-involved sexual activity or identified as transgender (n = 4). Of the 375 people included in the study, 51.5% identified as a cis woman and 26.9% identified as a sexual minority. Within gender, 35.7% (n = 69) of cis women and 17% (n = 31) of cis men identified as a sexual minority. For racial and ethnic identity, 85.3% identified as White, 15.2% identified as Latina/o, 9.3% identified as Asian American, and 8.0% identified as Black (Table 1).
Table 1.
Demographics
| Variable | % | n |
|---|---|---|
| Age, average | 25.9 | |
| (SD = 3.01) | ||
| Gender | ||
| Woman | 51.5 | 193 |
| Man | 48.5 | 182 |
| Sexual identity | ||
| Bi+ | 18.9 | 71 |
| Lesbian/gay | 6.4 | 24 |
| Queer | 0.8 | 3 |
| Straight | 73.1 | 274 |
| Another sexual identity | 0.5 | 2 |
| Race and ethnicity | ||
| American Indian or Alaska Native | 1.3 | 5 |
| Asian American | 9.3 | 35 |
| Black | 8.0 | 30 |
| Latinx | 15.2 | 57 |
| Native Hawaiian or Pacific Islander | 0.3 | 1 |
| White | 85.3 | 320 |
| Another racial identity | 1.6 | 6 |
| Education level | ||
| GED/high school diploma | 21.1 | 79 |
| Associate's degree or 2 years of college | 14.1 | 53 |
| Bachelor's degree | 53.6 | 201 |
| Graduate degree | 10.9 | 41 |
| Member of a fraternity/sorority in college | ||
| Yes | 14.2 | 53 |
| No | 85.8 | 321 |
| Currently enrolled in college | ||
| Yes | 28.3 | 106 |
| No | 71.1 | 269 |
Note: GED = General Educational Development credential.
Measures
Alcohol- and non–alcohol-involved sexual experiences. Participants were randomly presented with two sets of questions: (a) “Have you engaged in sexual activity after consuming alcohol in the past year?” and (b) “Have you engaged in sexual activity without substance use in the past year?”1 The order of these questions was counterbalanced; sexual experiences were dichotomized as either involving alcohol or no alcohol.
Context of sexual experiences. After a participant answered in the affirmative for alcohol- and non–alcohol-involved sexual experiences, they were redirected to a set of questions about each encounter (see Table 2 for answer options). For relationship status, participants answered, “What was your relationship to the person you engaged in sexual activity with?” For gender identity of the partner, participants were asked, “What was the gender of your sexual partner?” Finally, we asked about the length of time since the sexual experience: “How long ago was this encounter?”
Table 2.
Descriptives of alcohol and non-alcohol sexual encounter
| Variable | Alcohol % (n) | Non-alcohol % (n) |
|---|---|---|
| Relationship status at sexual event | ||
| First time | 4.5 (17) | 4.0 (15) |
| Casual/hookup | 14.9 (56) | 12.3 (46) |
| Romantic | 78.1 (293) | 81.3 (305) |
| Other | 2.4 (9) | 2.4 (9) |
| Gender identity of partner | ||
| Woman | 48.3 (181) | 48.0 (180) |
| Man | 50.4 (189) | 50.7 (190) |
| Gender nonbinary | 1.1 (4) | 4 (1.1) |
| Transwoman | 0.3 (1) | 0.3 (1) |
| Transman | – | – |
| Number of drinks | 3.88 (SD = 1.97) | – |
| Subjective intoxication | 5.85 (SD = 1.66) | – |
| Time since eventa | ||
| Past week | 15.8 (49) | 48.8 (183) |
| Past 2 weeks | 16.4 (51) | 17.6 (66) |
| Past month | 28.6 (89) | 16.8 (63) |
| Past 3 months | 19.6 (61) | 7.2 (27) |
| Past 6 months | 12.2 (38) | 5.1 (19) |
| A year ago | 5.6 (21) | 4.3 (16) |
| More than a year ago | 0.5 (2) | 0.3 (1) |
| Average time since event | 3.20 (SD = 1.46) | 2.16 (SD = 1.46) |
Notes:
64 responses were missing for time since event for alcohol-involved sexual encounters. Dependent sample t test suggested that sexual encounters that did not involve alcohol happened more recently than sexual events with alcohol.
Alcohol use during sexual experiences. For alcohol-involved encounters, participants reported how much alcohol they consumed and how intoxicated they perceived themselves to be during the encounter. Participants were asked: “How many drinks did you consume before sexual activity? (e.g., 1, 3, 6, 10)” and were provided the definition of a standard drink by the National Institute on Alcohol Abuse and Alcoholism (2022). They were also asked, “How intoxicated did you perceive yourself to be during this encounter?” with response options of 0 (not at all intoxicated) to 10 (extremely intoxicated). Number of drinks and subjective intoxication were moderately correlated (r = .60, p < .001).
Internal consent feelings (Willis et al., 2021a). Participants were asked five questions related to their internal consent feelings. Directions read, “Think of your most recent sexual experience that involved alcohol” for the alcohol condition. The non-alcohol condition read, “Think of your most recent sexual experience that did not involve substances.” Participants then reported from 0 (not at all) to 10 (very much) how much: (a) the sexual activity felt consensual, (b) they felt turned on, (c) they felt erected/lubricated, (d) they felt comfortable, and (e) they felt ready. The internal consent items are averaged together to create a mean score at each encounter, with higher scores suggesting stronger internal consent feelings. This measure exhibited strong internal reliability in both alcohol (α = .921) and non-alcohol encounters (α = .890), similar to prior research (Willis et al., 2021a).
External consent communication (Willis et al., 2021a). Participants answered questions on how they communicated sexual consent during an alcohol-involved and non–alcohol-involved sexual encounter. The directions read, “Think of your most recent sexual experience that involved alcohol [or did not involve substances]. How much did you use the following signals to communicate you were willing to engage in sexual activity during this encounter?” There were five items on a 0 (not at all) to 10 (very much) Likert scale. Participants reported how much they used (a) nonverbal, (b) verbal, (c) subtle, (d) straightforward, and (e) no-response signals to communicate consent. Each consent cue is examined individually as a unique behavior; higher scores for each cue suggest that someone used this cue more during a sexual experience.
Analytic plan
To examine the influence of alcohol use before sexual activity on internal and external consent, as well as whether internal consent and external consent differed by gender and sexuality identity when alcohol was and was not involved, we ran six repeated measures mixed analyses of variance (ANOVAs). We used alcohol status as a within-subject factor and gender (cis women or cis men) and sexual identity (sexual minority or heterosexual) as between-subject factors. PROC GML procedure in SAS software, Version 9.4 (SAS Institute Inc., Cary, NC), was used to analyze the repeated measures mixed ANOVA, with an α = .05. We included the Alcohol Involvement × Gender × Sexual Identity interactions in the repeated mixed ANOVA to examine whether the influence of alcohol use on internal consent or external consent differed by gender and sexual identity.
Results
Preliminary analyses
In alcohol-involved encounters, participants reported, on average, four drinks before sexual activity, being moderately intoxicated, and mostly being with a romantic partner or casual partner. For alcohol-involved sexual experiences, 15.8% occurred in the past week, 16.4% in the past 2 weeks, and 28.6% occurred in the month before completing the survey. For non–alcohol-involved sexual experiences, participants' sexual partners were either romantic or casual. For non–alcohol-involved sexual experiences, 48.8% occurred in the past week, 17.6% in the past 2 weeks, and 16.8% occurred in the month before completing the survey. Non–alcohol-involved encounters happened more recently than alcohol-involved ones; t(310) = 10.8, p < .001 (Table 2). Non-alcohol events may have occurred sooner because most participants were in a monogamous relationship in which sexual activity may occur regularly (Willis et al., 2021).
Relationship status can influence consent communication; however, we cannot confirm that the sexual partner was the same partner across each encounter. We conducted one-way ANOVAs to assess if relationship status with a partner at each encounter related to consent communication. There was no difference in how consent was communicated across partners when alcohol was or was not involved.
Finally, before running our ANOVA models, we conducted a series of correlations (Table 3). Of interest, the number of drinks consumed before sexual activity and subjective intoxication level related to consent communication after drinking but not internal consent. As people consumed more alcohol, they reported less use of implicit communication. In addition, the more intoxicated someone perceived themselves to be, the more they reported use of no response as an external consent cue.
Table 3.
Correlations among variables of interest
| Variable | 1. | 2. | 3. | 4. | 5. | 6. | 7. | 8. | 9. | 10. | 11. | 12. | 13. | 14. |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. IC A | – | |||||||||||||
| 2. Explicit A | .39** | – | ||||||||||||
| 3. Implicit A | -.01 | -.14** | – | |||||||||||
| 4. Verbal A | .33** | .62** | -.03 | – | ||||||||||
| 5. Nonverbal A | .15** | .02 | .49** | -.10 | – | |||||||||
| 6. NR A | .14** | .03 | .26** | .05 | .28** | – | ||||||||
| 7. Drinks | -.05 | .00 | -.13** | -.06 | .00 | -.00 | – | |||||||
| 8. SI | -.01 | .01 | .00 | .01 | .09 | .12* | .60** | – | ||||||
| 9. IC S | .61** | .19** | -.04 | .24** | .03 | .02 | -.08 | -.09 | – | |||||
| 10. Explicit S | .20** | .43** | -.05 | .32** | .05 | .01 | -.05 | -.09 | .26** | – | ||||
| 11. Implicit S | -.00 | -.04 | .56** | .03 | .36** | .19** | -.03 | .03 | -.00 | .24** | – | |||
| 12. Verbal S | .20** | .31** | .01 | .49** | -.05 | .01 | -.07 | -.05 | .30** | .66** | .11* | – | ||
| 13. Nonverbal S | .08 | .04 | .35** | -.05 | .61** | .24** | .00 | .04 | .05 | .09 | .58** | -.21** | – | |
| 14. NR S | .09 | .05 | .15** | .05 | .15** | .79** | -.02 | .10* | .02 | -.01 | .23** | .01 | .26** | – |
| M (SD) | 10.3 (1.2) | 9.2 (2.1) | 6.5 (2.9) | 8.4 (2.6) | 7.8 (2.8) | 8.0 (3.1) | 3.8 (1.9) | 5.8 (1.6) | 10.2 (1.1) | 8.9 (2.2) | 7.1 (2.9) | 8.1 (3.0) | 8.0 (2.7) | 8.1 (3.1) |
Notes: IC = internal consent; A = alcohol encounters; NR = no response; drinks = number of drinks consumed before alcohol-involved encounters; SI = subjective intoxication during alcohol-involved encounter; S = sober/non–alcohol-involved encounters.
p < .05;
p < .01.
Test of hypotheses
Internal consent feelings. Internal consent feelings did not differ by whether participants had consumed alcohol before sexual activity (see Table 4 for all F tests); Hypothesis 1 was not supported. Internal consent did not differ by gender or sexual identity.
Table 4.
Repeated measures mixed analysis of variance findings for alcohol use, gender, sexual identity, and internal and external consent
| Dependent variable | Effect | F | df 1 | df 2 | p | p_η2 |
|---|---|---|---|---|---|---|
| Internal consent feelings | Gender | 2.64 | 1 | 371 | .11 | – |
| Sexuality | 0.03 | 1 | 371 | .86 | – | |
| Gender × Sexuality | 0.01 | 1 | 371 | .91 | – | |
| Alcohol status | 0.19 | 1 | 371 | .66 | – | |
| Alcohol Status × Gender | 1.74 | 1 | 371 | .19 | – | |
| Alcohol Status × Sexuality | 0.42 | 1 | 371 | .51 | – | |
| Alcohol Status × Gender × Sexuality | 0.26 | 1 | 371 | .61 | – | |
| Explicit communication (straightforward) | Gender | 0.40 | 1 | 371 | .53 | – |
| Sexuality | 0.04 | 1 | 371 | .84 | – | |
| Gender × Sexuality | 0.01 | 1 | 371 | .92 | – | |
| Alcohol status | 2.48 | 1 | 371 | .12 | – | |
| Alcohol Status × Gender | 0.06 | 1 | 371 | .81 | – | |
| Alcohol Status × Sexuality | 0.61 | 1 | 371 | .44 | – | |
| Alcohol Status × Gender × Sexuality | 1.53 | 1 | 371 | .22 | – | |
| Implicit communication (subtle) | Gender | 9.21 | 1 | 370 | <.01 | .02 |
| Sexuality | 0.04 | 1 | 370 | .85 | – | |
| Gender × Sexuality | 0.01 | 1 | 370 | .92 | – | |
| Alcohol status | 9.26 | 1 | 370 | <.01 | .02 | |
| Alcohol Status × Gender | 0.03 | 1 | 370 | .87 | – | |
| Alcohol Status × Sexuality | 0.00 | 1 | 370 | .95 | – | |
| Alcohol Status × Gender × Sexuality | 0.26 | .61 | – | |||
| Nonverbal communication | Gender | 10.73 | 1 | 371 | <.01 | .03 |
| Sexuality | 0.10 | 1 | 371 | .75 | – | |
| Gender × Sexuality | 0.35 | 1 | 371 | .56 | – | |
| Alcohol status | 2.88 | 1 | 371 | .09 | – | |
| Alcohol Status × Gender | 0.02 | 1 | 371 | .88 | – | |
| Alcohol Status × Sexuality | 0.03 | 1 | 371 | .87 | – | |
| Alcohol Status × Gender × Sexuality | 0.19 | 1 | 371 | .66 | – | |
| Verbal communication | Gender | 0.28 | 1 | 371 | .60 | – |
| Sexuality | 1.17 | 1 | 371 | .28 | – | |
| Gender × Sexuality | 0.04 | 1 | 371 | .84 | – | |
| Alcohol status | 1.63 | 1 | 371 | .21 | – | |
| Alcohol Status × Gender | 0.41 | 1 | 371 | .52 | – | |
| Alcohol Status × Sexuality | 1.35 | 1 | 371 | .25 | – | |
| Alcohol Status × Gender × Sexuality | 3.96 | 1 | 371 | .047 | .01 | |
| No-response communication | Gender | 3.19 | 1 | 370 | .07 | – |
| Sexuality | 1.82 | 1 | 370 | .18 | – | |
| Gender × Sexuality | 1.65 | 1 | 370 | .20 | – | |
| Alcohol status | 2.63 | 1 | 370 | .11 | – | |
| Alcohol Status × Gender | 0.06 | 1 | 370 | .81 | – | |
| Alcohol Status × Sexuality | 0.52 | 1 | 370 | .47 | – | |
| Alcohol Status × Gender × Sexuality | 0.25 | 1 | 370 | .62 | – |
Notes: No-response communication indicates letting sexual activity happen without stopping. Bold indicates statistical significance.
External consent communication. Explicit communication did not differ by alcohol status (H2A was not supported), gender, or sexual identity.
For verbal communication, there was a significant three-way interaction between alcohol status, gender, and sexuality but not in the hypothesized direction. H2A was not supported. To investigate the three-way interaction, we separated the data by women and men and ran two repeated measure ANOVAs with the covariate of sexual identity. For men, the interaction between alcohol status and sexuality was not significant, F(1, 180) = 0.29, p = .59; for women, the interaction between alcohol status and sexuality was significant, F(1, 191) = 6.44, p = .01. When alcohol was involved, heterosexual women reported using more verbal consent (M = 8.41, SD = 2.70) than when they did not consume alcohol (M = 7.74, SD = 3.25). Across encounters, sexual minority women reported using verbal consent nearly equally (alcohol M = 8.24, SD = 2.94; non-alcohol M = 8.69, SD = 2.75).
For implicit communication, we found a difference by alcohol use and gender; however, no interaction effects were significant, and implicit communication did not differ by sexual identity. Sexual encounters that did not involve alcohol had more implicit communication (M = 7.12, SD = 2.98) than sexual encounters that did involve alcohol (M = 6.59, SD = 2.98); H2B was not supported. When alcohol was and was not involved, women reported using more implicit communication (alcohol M = 7.08, SD = 2.89; non-alcohol M = 7.56, SD = 2.79) than men (alcohol M = 6.06, SD = 2.99; non-alcohol M = 6.68, SD = 3.11).
For nonverbal communication, there was no difference by alcohol status; H2B was not supported. There was no difference by sexual identity, but nonverbal communication did differ by gender. When alcohol was and was not involved, women reported using more nonverbal communication (alcohol M = 8.26, SD = 2.59; non-alcohol M = 8.52, SD = 2.38) than men (alcohol M = 7.33, SD = 2.97; non-alcohol M = 7.58, SD = 3.03).
For no-response communication (i.e., letting sexual activity happen without stopping), there were no significant within- or between-person effects for alcohol use (Hypothesis 2B not supported), gender, or sexual identity.
Discussion
We examined how alcohol use before sexual activity influenced young people's internal and external consent. We found no difference in internal consent between sexual encounters with and without alcohol, contrary to Hypothesis 1. In contrast to Hypothesis 2, we found that the use of explicit, nonverbal, and no-response consent cues did not differ across sexual encounters. Alcohol use was related to implicit communication; however, not in the hypothesized direction. Sexual experiences involving alcohol had less use of implicit communication compared with encounters without alcohol. Complementing these findings, we found that verbal communication did interact with alcohol, gender, and sexual identity, such that heterosexual women were reporting more use of verbal communication during alcohol-involved encounters compared with non–alcohol-involved ones; this was our only significant finding with sexual identity. Finally, women used more implicit and nonverbal consent compared with men in both types of encounters; there were no other gender differences.
Alcohol and internal and external consent
We observed no difference in internal consent between sexual experiences that involved alcohol and those that did not. This finding contrasted with prior research (Jozkowski & Wiersma, 2015; Willis et al., 2021b). We may not have found that alcohol use reduced internal consent because of the amount of alcohol consumed during sexual activity. Specifically, participants reported consuming approximately four drinks before sexual activity, resulting in a moderate level of intoxication. Young people have discussed that feeling some effects of alcohol does not necessarily hinder their ability to consent and have considered a few drinks before sexual activity as an acceptable amount of alcohol to consume (Hunt et al., 2022; Marcantonio & Jozkowski, 2023). Thus, young people's consumption may not have been enough to significantly impact internal consent.
Sexual encounters that involved alcohol were associated with less implicit communication. In addition, for heterosexual women, verbal consent was used more in alcohol encounters than in non-alcohol encounters. There could be several reasons for these findings. First, this shift in communication may occur because of cultural and educational changes emphasizing active consent during alcohol-involved sexual experiences. Second, the increased use of verbal communication during alcohol-involved sexual experiences for heterosexual women could be attributed to the disinhibiting effects of alcohol. Specifically, alcohol use can create feelings of liquid courage (Stoner et al., 2007) and encourage heterosexual women, who are often shamed for being sexually forward, to be more open and direct about their sexual desires. However, these effects were at moderate levels of intoxication (four drinks on average) and may not extend to higher levels of intoxication. Indeed, although correlational, we did find that the more intoxicated one perceived themselves to be, the more use of no-response (i.e., not responding when sexual activity begins) they reported. Thus, there appears to be a point at which intoxication is associated with less active consent communication.
Gender, sexual identity, and sexual consent
The gendered patterns we found in consent communication are consistent with prior research in which women tended to use more implicit and nonverbal signals than men (Muehlenhard et al., 2016). According to gender and consent theory, these differences may be attributed to a common scenario where men often initiate sexual activity using explicit and verbal signals, whereas women respond with implicit and nonverbal signals (Muehlenhard et al., 2016). However, in our study, we did not find gender differences in explicit consent communication and found that women were using more verbal consent in alcohol encounters. These findings could be applied to affirmative sexual health initiatives that aim to increase verbal or explicit communication during sexual activity by providing support that women (and others) are using verbal or explicit cues during sex. In addition, researchers may want to focus on encouraging women to generalize their verbal alcohol-involved communication to non–alcohol-involved encounters as well.
Finally, we found no differences in internal and rarely found a difference in external consent by sexual identity and alcohol use, consistent with prior work (Marcantonio & Willis, 2022). The similarity in consent experiences could be attributed to both groups being exposed to similar narratives related to sexual consent through media, education, and childhood experiences. This may lead to minimal differences in how sexual consent is communicated among people, regardless of sexual identity. An additional explanation is that our sexual minority group's largest identity is bisexual and only 8.7% of alcohol encounters and 7.6% of sober encounters occurred with a partner of the same gender identity as the participant. Thus, we may not find differences between our groups because most of the sample is reporting on encounters with someone of a different gender identity than themselves. Unfortunately, our smaller sexual minority sample prevented us from exploring variations in internal and external consent among subgroups such as bi+, lesbian, and gay people. To advance our understanding of alcohol and consent, including more sexual minority participants is needed. Moreover, investigating between-group differences within various sexual minority identities could provide valuable insights into the nuances of consent experiences within these communities.
Limitations and future directions
Several limitations warrant discussion. First, the data rely on self-reports, potentially subjected to recall biases. We attempted to mitigate this by focusing on more recent experiences. However, participants may still experience challenges with recalling how they communicated across these two encounters. Because non-alcohol events occurred more recently than alcohol ones, participants may also more accurately recall their non–alcohol-involved consent communication. This could potentially bias how they recall their alcohol-involved consent communication and may explain our lack of differences across experiences. Second, our study only captured two moments in people's sexual experiences, limiting our assessment of all influencing factors and ability to understand long-term patterns of sexual communication in alcohol- and non-alcohol encounters. Using longitudinal studies or experience sampling methodology could overcome this limitation and assess consent over extended periods. Third, although our sample is slightly more diverse in gender and sexual identity, it predominantly comprised White and educated people. The small number of transgender participants (four) led to their exclusion from analyses because of sample size restraints. Future researchers should continue to prioritize recruiting diverse samples. Fourth, we do not know if the sexual partner is the same across each encounter. Future researchers should ask participants to recall an experience with the same partner to account for the influence of the relationship. Finally, for a deeper understanding of the alcohol-consent relationship, researchers should include additional contextual factors such as alcohol expectancies, prior drinking experiences with the partner, or the timing of consent communication after drinking. By including these factors, we can gain a comprehensive understanding of the complexities of consent dynamics.
Conclusions and implications
Overall, we found minimal differences in consent communication across alcohol- and non–alcohol-involved sexual experiences. The differences we did find—a decrease in implicit communication and an increase in verbal communication for heterosexual women during alcohol-involved encounters—are promising. Educators can incorporate these findings into interventions to provide empirical support that some young people are moving toward more open communication during alcohol-involved sexual experiences. These findings can be used to counter narratives that verbal communication is awkward or that young people do not use it (Jozkowski & Wiersma, 2015; Muehlenhard et al., 2016), as our findings suggest they do. Yet, gender-based differences in consent communication persist, with more women using nonverbal and implicit cues than men. These findings do not imply that women should change their communication patterns. Instead, educators should focus on helping men understand and respect the ways women communicate their boundaries. Our findings also highlight the need for prevention efforts to include sexual minorities when discussing consent, given the lack of group differences. Inclusive examples and conversations reflecting people from all sexual identities communicating consent can enhance the reach and influence of these programs.
Footnotes
Research reported in this article was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH) under Award Numbers L30AA031129 (to Tiffany L. Marcantonio), K01AA028844 (to Ruschelle M. Leone), and L30AA028649 (to Ruschelle M. Leone). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
We asked about substance use for the no-alcohol question because we did not want participants to report on an encounter that did not involve alcohol but involved other substances (e.g., cannabis, methylenedioxymethamphetamine [MDMA]).
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