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Published in final edited form as: Sex Cult. 2024 Dec 4;29(2):782–797. doi: 10.1007/s12119-024-10297-x

Sexual Consent Cognitions and Consent-Seeking Behaviors Among U.S. Adolescents

Anne J Maheux 1,#, Hannah Javidi 2,3,#, Laura Widman 4, Jordyn McCrimmon 4
PMCID: PMC12337999  NIHMSID: NIHMS2043605  PMID: 40791869

Abstract

Sexual consent is an ongoing agreement to engage in sexual behavior, requiring individuals to provide consent when sexual behavior is desired and seek consent from partners. While many initiate sexual activity during adolescence, adolescents remain mostly absent from the sexual consent literature. No work has explored consent cognitions and behaviors across adolescents of diverse gender and sexual identities. The current study explores differences in consent-seeking behaviors and consent cognitions across diverse youth and investigates links between consent cognitions and behaviors. We recruited U.S. adolescents (n = 833, age 14–16, M age = 15; 43% White, 17% Black, 17% Asian, 13% Latine) using social media. Participants represent diverse gender and sexual identities (52% cisgender girl, 27% cisgender boy, 21% gender minority; 45% heterosexual, 28% bisexual, 11% gay/lesbian, 16% another sexual minority identity). On average, participants reported high consent self-efficacy, positive consent attitudes, and frequent ongoing consent behaviors. Cisgender boys and heterosexual youth were less likely to report consistent consent-seeking behaviors and reported less positive attitudes towards consent compared to their peers. Positive attitudes towards consent and consent-seeking self-efficacy were both associated with a greater likelihood of consistent consent-seeking behavior. Results highlight the importance of promoting healthy consent practices among adolescents.

Keywords: Adolescence, Sexuality, LGBTQ+, Sexual consent

Introduction

Adolescence presents opportunities for positive sexual development but also high risk for negative sexual outcomes. Many individuals initiate sexual activity during adolescence, and although these experiences may promote well-being in certain contexts (Harden, 2014), adolescents report higher rates of sexual violence victimization than other age groups (Banvard-Fox et al., 2020). Sexual consent, a fundamental component of healthy sexual experiences, is nuanced and multidimensional, encompassing a range of factors beyond verbal agreement (Muehlenhard et al., 2016). Consent is a protective factor against sexual violence (Jozkowski & Peterson, 2013), while simultaneously fostering the development of healthy relationships and contributing to overall sexual satisfaction (Javidi et al., 2022; Marcantonio et al., 2020). Some research suggests there may be challenges inherent in adolescents’ consent communication, including limited sexual experience and communication skills (Miller, 2017; Santelli et al., 2018). However, adolescent consent behavior is critically understudied. Additionally, the conventional understanding of sexual consent primarily centers on the acts of giving or interpreting consent. An equally important, yet underdiscussed, process involves seeking ongoing consent from a sexual partner throughout a sexual encounter. Thus, this study specifically aims to understand influences on adolescents’ consent-seeking cognitions and ongoing consent behavior.

Adolescent Development and Sexual Consent

Adolescence is characterized by major changes in almost all systems (Dahl et al., 2018). Brain development is associated with reward-seeking behaviors and challenges applying cognitive control during states of heightened arousal, including sexual activity. Social changes facilitate experimentation with romantic relationships and sexual initiation. Cognitive changes allow adolescents to build skills to establish boundaries and communicate respectfully with a partner (Dahl et al., 2018). Comprehending and communicating sexual consent becomes essential to navigate these situations safely.

To date, however, our understanding of consent within the context of adolescence (i.e., roughly ages 10–18) remains incomplete. Results from the limited studies indicate that adolescents’ grasp of consent appears to be significantly influenced by external factors, particularly media portrayals (Alexopoulos & Cingel, 2022) and to a lesser extent, parental guidance (Padilla-Walker et al., 2020). Overall, adolescents feel positively about consent, reflecting an awareness of its significance (Righi et al., 2021); however, girls report more positive attitudes than boys (Javidi et al., 2020) and adolescent girls, more than boys, often employ direct verbal cues to both communicate and interpret consent (Richards et al., 2022). Many adolescents have difficulty communicating sexual boundaries due to feelings of pressure, guilt, or an underlying assumption that sexual consent is assumed for all future encounters after saying “yes” to a partner in the past (Brady et al., 2022). These results highlight the complexities of the sexual consent process among adolescents; however, these studies overlook adolescents’ experiences of actively seeking ongoing consent from a partner.

Multiple Dimensions of Sexual Consent

Sexual violence is often defined as sex without consent. Proponents suggest that a standard of active, affirmative, enthusiastic consent may reduce sexual violence by putting the onus for consent on the perpetrators, rather than potential victims (Featherstone et al., 2024; Hilgert, 2016). Part of this conceptualization stresses that consent is an ongoing process, in which all parties may revoke consent and choose to end the encounter at any time (Glace et al., 2021; Muehlenhard et al., 2016). Additionally, consent is distinct from wantedness; individuals may agree to unwanted sexual encounters due to prevailing sociocultural pressures, such as the expectation of heteronormative sexual interactions and peer influence (Bay-Cheng & Bruns, 2016), or desires to satisfy a partner’s needs and avoid relationship conflict (Vannier & O’Sullivan, 2010). Given the prevalence of consensual unwanted sex, perhaps especially among adolescents (Brady et al., 2022), adolescents may benefit from seeking indications of their partners’ wantedness of sexual activities, in addition to their consent (Beres, 2007; Muehlenhard et al., 2016). Thus, a key element in ensuring that sex remains consensual and wanted by all parties is the ongoing process of “checking in” with a partner to ensure their enthusiastic consent.

Sexual consent communication is often governed by sexual scripts and social roles. The traditional sexual script defines consent as a process with an initiator and a gatekeeper, wherein one party initiates sexual behavior and the other provides consent (Simon & Gagnon, 1986). This script is gendered and heteronormative, with men and boys being expected to initiate while women and girls are expected to gatekeep (Simon & Gagnon, 1986). This script may not apply to all people in all sexual situations (e.g., individuals from sexual and gender minority (SGM) communities). Additionally, sexual activity is often a mutually initiated process (Beres, 2007), making the process of seeking and providing consent potentially more complex and requiring all parties in a sexual encounter to simultaneously seek and provide consent.

Given these sociocultural expectations and scripts, demographic differences in ongoing consent-seeking behaviors may arise among adolescents. One study of adults found no notable gender differences in initiation behaviors, but men exhibited a greater tendency than women to engage in borderline-pressuring tactics to encourage sexual activity without directly seeking a partner’s explicit consent (Jozkowski et al., 2014). College women tend to report higher self-efficacy (or, perceived ability) to seek consent compared to college men (Edison et al., 2022). Additionally, SGM adults consistently demonstrate greater support for consent compared to cisgender and heterosexual counterparts (Glace & Kaufman, 2020). For example, nonbinary young adults, in contrast to their cisgender counterparts, exhibit proactive (i.e., thoughtful, intentional, and cautious) consent beliefs, attitudes, and behaviors (McKenna et al., 2021). Another qualitative study revealed that asking for consent may be a form of indicating consent among SGM college students, challenging traditional paradigms of sexual initiation (Griner et al., 2021). The heightened appreciation for consent among SGM populations may stem from their non-adherence to conventional gender norms and sexual scripts in which consent-related messages are rooted, or their need to create new scripts given that the traditional sexual initiation script is highly gendered and heteronormative. However, more work is needed to address consent cognitions and behaviors across adolescents of diverse gender and sexual identities.

Given the importance of seeking sexual consent, it is essential to identify cognitive factors that may influence and shape these behaviors, as they could be potential targets for future interventions. Two such factors are positive attitudes (i.e., believing that seeking consent from a partner is important) and self-efficacy (i.e., feeling confident in one’s own ability to seek ongoing consent from a partner). The Theory of Planned Behavior (TPB) offers a theoretical framework for understanding the potential role of these cognitions in predicting sexual consent-seeking behavior. According to the TPB, behavior is influenced by three cognitive components: one’s attitudes, their perceived behavioral control (which aligns with the concept of self-efficacy) and subjective norms (Ajzen, 1991). Despite little research examining these connected cognitive components among adolescents, some previous studies with adult samples suggest that these cognitions could have an influence on ongoing consent-seeking behaviors. For one, positive attitudes toward consent have shown to be correlated with an increased likelihood of asking for consent in practice (Camp et al., 2018). Additionally, men who endorse hostile masculine norms tend to exhibit a diminished sense of control when it comes to asking for consent (Gallagher & Parrott, 2011; Shafer et al., 2018). Further evidence suggests that men in college who developed a more comprehensive understanding of consent during adolescence were less likely to engage in sexual violence during their college years (Santelli et al., 2018), and that men’s self-efficacy to avoid perpetrating nonsexual violence is related to practicing healthy consent negotiation (Hust et al., 2017). Only one study to date has focused specifically on adolescents, examining how portrayals of sexual consent in adolescent-focused media influenced each of the cognitive components of the TPB (Alexopolous and Cingel, 2022). While it is important to be aware of factors that may shape consent attitudes and self-efficacy, a crucial next step is examining how these cognitions can predict actual sexual consent-seeking behaviors.

Current Study

The current study has two goals. First, we will explore demographic differences in consent cognitions (i.e., attitudes and self-efficacy) and consent-seeking behaviors. Based on prior work, primarily with adults, we expect that cisgender girls (H1a) and gender minority adolescents (including transgender, non-binary, and youth questioning their gender identity; H1b) will report more ongoing consent-seeking behaviors, more positive consent-seeking attitudes, and more consent-seeking self-efficacy than cisgender boys. We also expect that sexual minority adolescents will report more consent-seeking behaviors and more positive consent-seeking cognitions than heterosexual adolescents (H2).

Second, we aim to investigate links between consent cognitions and behaviors. Specifically, we expect that positive consent attitudes and consent-seeking self-efficacy will be associated with more consent-seeking behavior (H3).

Method

Participants & Procedure

In Fall 2021, adolescents were recruited via Instagram to participate in a parent study evaluating sexual and mental health interventions (Javidi et al., 2023), which took roughly 45 min to complete. Eligibility included that the participants had to be between 14 and 16 years old, live in the U.S., be able to read and write in English, and be able to complete the electronic survey remotely on their personal digital device. The sample was diverse in terms of gender, race, and sexual orientation (see Table 1).

Table 1.

Sample demographic characteristics (n = 833)

n (%)
Age - M (SD) 15.27 (0.75)
Gender
 Cisgender girls		 433 (52.0)
 Cisgender boys 224 (26.9)
 Transgender girls 10 (1.2)
 Transgender boys 31 (3.7)
 Non-binary AMAB 19 (2.3)
 Non-binary AFAB 82 (9.8)
 Questioning or unsure 34 (4.1)
Race/ethnicity
 White		 359 (43.1)
 Black 144 (17.3)
 Latino/a/e 110 (13.2)
 Asian 144 (17.3)
 Another racial/ethnic identity 76 (9.1)
Sexual orientation
 Heterosexual		 371 (44.5)
 Bisexual/Pansexual 236 (28.3)
 Gay/Lesbian 92 (11.0)
 Unsure/questioning 83 (10.0)
 Another sexual minority identity 51 (6.1)
Sexually active 241 (28.9)
 Experience with sexual touching 233 (28.0)
 Experience with oral sex 177 (21.2)
 Experience with penetrative (vaginal or anal) sex 123 (14.8)
Neighborhood
 Urban		 194 (27.3)
 Suburban 427 (60.1)
 Rural 90 (12.7)
U.S. Region
 Northeast		 165 (22.0)
 Midwest 155 (20.7)
 South 266 (35.5)
 West 164 (21.9)
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Note AMAB = Assigned Male at Birth; AFAB = Assigned Female at Birth. Participants considered sexually active if they reported ever engaging in sexual touching, oral sex, vaginal sex, and/or anal sex

The study was approved by the [North Carolina State University] IRB (#24277), which evaluated the potential risks and benefits of the study. Because this research posed minimal risk, we requested a waiver of parental consent from the IRB. In accordance with ethical standards, the IRB determined that the confidentiality of the adolescent participants should be prioritized to ensure honest and meaningful data collection while protecting participants from potential harm or discomfort associated with seeking parental permission. This practice has become common in adolescent sexuality studies and is found favorable among adolescents (Macapagal et al., 2017; Mustanski et al., 2017). Participants were recruited through advertisements containing details about study eligibility (i.e., “ages 14–16”) and potential compensation (i.e., “3-part study, earn $10 each time”). The flyer stated, “We are interested in testing two online programs: one focused on mental health and one focused on sexual health.” When adolescents clicked the link in the flyer indicating their interest in participating, they were redirected to an information sheet that clearly explained the nature of the study, including that it focused on understanding adolescents’ experiences with consent and sexuality. The consent form highlighted that participation was completely voluntary, and adolescents had the right to withdraw their participation at any time or skip any question they did not feel comfortable answering. We also emphasized the importance of confidentiality and aimed to ensure participants understood the purpose of the research. Accordingly, after adolescents reviewed the consent form, they had to correctly answer three questions assessing their comprehension of the consent form in order to participate (one of these questions confirmed their understanding that they had the right to withdraw from the study at any time).

The full study procedure included a baseline survey, random assignment to one of two health interventions, and follow-up surveys at 3- and 6-months. Data for the current study are from the baseline assessment, before the interventions were administered. Multiple methods were used to assess for bots and careless responding. Participants were removed if they failed to pass two CAPTCHA items, their free responses to open-ended questions indicated bot or careless responses (as determined by two trained research assistants), their responses were identified as duplicates or blank across all survey items, or they provided an invalid email address. Of the participants who clicked on the ad and accessed the survey (n = 2,528), participants who did not meet eligibility criteria, did not consent to participate, dropped out of the survey, or showed signs of bot or careless responding (n = 1,695) were removed (for complete details see Javidi et al., 2023 and see Supplemental Fig. 1 for study consort diagram), leaving a final sample of 833 participants. Participants were compensated in accordance with standard ethical research practice, as recognition of their time and efforts dedicated to the study (not as an incentive to disclose personal information). Participants who completed the survey and provided their email address received a $10 gift card at each survey timepoint (a minimal amount, to avoid undue influence and ensure fair compensation for their contribution to research on adolescent health).

Measures

Demographics

Participants reported age, sex assigned at birth, gender, race/ethnicity, prior sexual experience (ever engaging in sexual touching, oral sex, vaginal sex, and/or anal sex), and sexual orientation. Participants who were assigned female at birth and identified as girls were categorized as cisgender girls; those who were assigned as male at birth and identified as boys were categorized as cisgender boys. Participants who indicated a different sex assigned at birth than their current gender, or who indicated identifying as non-binary or unsure of their gender identity, were categorized as gender minority (including transgender, non-binary or gender fluid, and unsure or questioning). Participants who indicated heterosexual sexual identity were categorized as such; those who indicated any sexual minority identity label (gay/lesbian, bisexual, pansexual, unsure/questioning, or another written-in sexual identity) were categorized as sexual minority.

Sexual Consent Cognitions and Behaviors

Sexual Consent Attitudes

Attitudes about the importance of sexual consent were captured with 4 items from the Positive Attitude toward Establishing Consent subscale of the Sexual Consent Scale-Revised (Humphreys & Brousseau, 2010). Participants indicated how much they agree, on a 7-point scale, to statements including “I feel that getting sexual consent should always happen before the start of any sexual activity.” Higher scores indicate more positive attitudes towards sexual consent (α = 0.88).

Sexual Consent Self-Efficacy

Self-efficacy to seek sexual consent from a partner was assessed with two items designed by the research team. The structure of the items was adapted from the Self-Efficacy in Using Condoms Scale (Basen-Engquist, 1999) with the topic of the items adapted to address sexual consent. Specifically, participants were asked the following two questions about the next time they want to engage in sexual activity with someone: “How confident are you that you could ask them for consent before starting any sexual activity?” and “How confident are you that you could check in with them to make sure they are enjoying the sexual activity?” Responses were on a 4-point scale from 1 = not at all confident to 4 = very confident, with higher scores indicating more consent-seeking self-efficacy (α = 0.85).

Sexual Consent Behavior

To assess the degree to which participants engage in consent-seeking behavior, participants were instructed to “Think about when you have engaged in sexual activity, in general” and indicated their agreement with the 5-item Ongoing Consent subscale of the Process-Based Consent Scale (Glace et al., 2021). Items include “If my partner seems less than excited about sexual activity, I stop and ask if they want to be sexual with me” and were rated on a 7-point scale (1 = strongly disagree; 7 = strongly agree) with higher scores indicating a greater tendency to engage in ongoing consent-seeking during sexual behavior. Only participants who indicated previously engaging in sexual activity (including sexual touching, oral sex, vaginal sex, and/or anal sex) were shown this measure (n = 241). Given that responses were highly negatively skewed (range = 1–7, M = 6.19, SD = 1.02, skewness = −1.66), the total scale score was dichotomized to create a measure of consistent consent-seeking behavior. We note limitations regarding this dichotomization and areas for future research to avoid such skewed responses in the discussion section. Participants with the maximum value (i.e., those who responded “strongly agree” to all items) were given a score of 1; all others were given a score of 0.

Analytic Plan

First, means and standard deviations or percentages were derived for each variable by gender and sexual orientation groups. To address H1a, H1b, and H2, chi-square tests of independence were used to compare demographic groups (i.e., gender and sexual orientation) on the dichotomous consistent sexual consent-seeking behavior variable; ANOVAs with pairwise comparisons were used to compare demographic groups on the two continuous consent variables (self-efficacy and attitudes). For analyses assessing consent-seeking behavior, only adolescents who indicated prior sexual activity, including experience with sexual touching, oral sex, and/or penetrative sex (vaginal or anal), were included (n = 241). Exploratory models also examined if the interaction between gender and sexual orientation predicted consent cognitions and behaviors; a statistical interaction term between gender and sexual orientation was included in a binomial logistic regression model predicting consistent consent-seeking behaviors and ANOVAs predicting consent self-efficacy and attitudes. This analysis included and compared heterosexual cisgender boys (n = 172), heterosexual cisgender girls (n = 196), sexual minority cisgender boys (n = 52) and sexual minority cisgender girls (n = 237). Gender minority participants were not included because too few (n = 3) identified as heterosexual.

To address H3 and assess associations between consent attitudes and self-efficacy and consistent consent-seeking behavior, a hierarchical logistic regression model was conducted with consistent consent-seeking behavior as the outcome. In the first step we entered covariates of gender (reference group: cisgender girls), sexual orientation (reference group: heterosexual), and age. In the second step we entered consent attitudes and consent self-efficacy. Analyses were conducted in R version 3.6.1.

Results

Descriptive Statistics and Group Comparisons

Table 1 presents participant demographic characteristics. On average, adolescents reported high consent self-efficacy (M = 2.92, SD = 0.73, range = 1–4) and positive consent attitudes (M = 6.19, SD = 1.06, range = 1–7). Of the sexually active participants (n = 241), 38% (n = 92) reported consistent ongoing consent-seeking behavior. See Supplemental Table 1 for bivariate correlations and Supplemental Table 2 for item-level information (e.g., mean, skew) regarding consent-seeking behavior.

Table 2 presents means and standard deviations of sexual consent attitudes and self-efficacy, and percentages of consistent sexual consent-seeking behavior separately by gender and sexual orientation. In Table 2 we present omnibus tests of group differences and indicate pairwise comparisons using superscripts (see Table 2 note). As expected, cisgender boys indicated the least positive attitudes towards consent, followed by cisgender girls, with gender minority (including transgender, nonbinary, and questioning) adolescents reporting the most positive attitudes towards consent. Cisgender boys were also least likely to report consistent consent-seeking behavior. However, there were no differences in consent-seeking self-efficacy across gender. Thus, H1a and H1b were partially supported. Heterosexual youth reported less positive consent attitudes, less sexual consent self-efficacy, and lowest likelihood of engaging in consistent consent-seeking behavior relative to sexual minority adolescents, supporting H2. Effect sizes ranged from small to medium for significant effects (see Table 2). Exploratory analyses examining intersections of gender and sexual orientation (among cisgender girls and boys, given very small cell sizes for gender minority youth reporting a heterosexual identity) found no significant interaction predicting consistent consent-seeking behavior (b = 0.07, p =.93), consent attitudes: F(1,651) = 0.01, p =.92, or consent self-efficacy: F(1,649) = 0.12, p =.73.

Table 2.

Descriptive statistics and between-group comparisons

Total n Consent attitudes M (SD) Consent self-efficacy M (SD) Consistent consent-seeking behavior n (%)
Gender
 Cisgender girls		 433 6.27 (0.96)ac 2.92 (0.70) 56 (40.0)a
 Cisgender boys 224 5.75 (1.30)ab 2.90 (0.79) 9 (17.3)ab
 Transgender, nonbinary, and questioning 176 6.58 (0.69)bc 2.96 (0.73) 27 (55.1)b
Group Comparison F(2,826) = 35.66, p <.001 F(2,826) = 0.32, p =.72 χ2(2) = 15.74, p <.001
η2 = 0.08 η2 < 0.001 Cohen’s f = 0.26
Sexual orientation
 Heterosexual		 371 5.83 (1.27)a 2.86 (0.77)a 25 (27.4)a
 Sexual minority or unsure 462 6.48 (0.74)a 2.97 (0.71)a 67 (44.7)a
Group Comparison F(1,829) = 86.98, p <.001 F(1,827) = 4.51, p =.03 χ2(1) = 6.38, p =.01
η2 = 0.09 η2 = 0.005 Cohen’s f = 0.17
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Note Percentages for consistent consent-seeking behavior are within group among the sexually active participants (i.e., those with experience engaging in sexual touching, oral sex, and/or penetrative [vaginal or anal] sex) n = 241; e.g., percent of sexually active cisgender girls who report consistent consent-seeking behavior). Note that consistent consent-seeking behavior is categorized as 1 = maximum (i.e., “perfect”) score on the consent-seeking behavior scale, 0= all others

abc

superscripts indicate that groups within the category (gender or sexual orientation) report significantly different levels of the outcome (consent behavior, attitudes, or self-efficacy) after a Bonferroni-adjustment for multiple comparisons

Associations Between Consent Cognitions and Behavior

Table 3 presents the results of a hierarchical logistic regression model predicting consistent sexual consent-seeking behavior. Both consent attitudes and consent self-efficacy were related to higher likelihood of consistent consent-seeking behavior, with the addition of these variables producing a more predictive model above the demographic covariates (based on BIC and Nagelkerke’s R2). Effect sizes were large; there was an increase of over 500% in the odds of consistent consent-seeking behavior (aOR = 6.51) with a one-unit increase in consent attitudes; whereas there was an increase of over 200% in the odds of consistent consent-seeking behavior (aOR = 3.62) with a one-unit increase in consent self-efficacy. Thus, H3 was supported.

Table 3.

Hierarchical logistic regression models predicting consent-seeking behavior

b (aOR) p Model statistics
Step 1
 Gender -- Cisgender Girl		 1.07 (2.91) 0.01
 Gender -- GM or Questioning 1.53 (4.63) 0.002
 Sexual Orientation -- Sexual Minority 0.40 (1.50) 0.20
 Age 0.06 (1.06) 0.76 Nagelkerke’s R2 = 0.10
BIC = 329.47
Step 2
 Gender -- Cisgender Girl		 1.11 (3.03) 0.03
 Gender -- GM or Questioning 1.39 (4.00) 0.02
 Sexual Orientation -- Sexual Minority 0.08 (1.08) 0.85
 Age − 0.18 (0.84) 0.45
 Consent self-efficacy 1.29 (3.62) < 0.001
 Consent attitudes 1.87 (6.51) < 0.001 Nagelkerke’s R2 = 0.45
Δ Nagelkerke’s R2 = 0.35
BIC = 260.65
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Note Reference group for gender is cisgender boy; reference group for sexual orientation is heterosexual

Discussion

Our study addresses consistent consent-seeking behaviors and cognitions among a diverse group of adolescents. Research on sexual consent among youth, especially regarding seeking ongoing consent from partners, is nascent, despite calls to promote active consent processes in order to reduce sexual violence (Righi et al., 2021; Santelli et al., 2018). We hypothesized that cisgender girls, gender minority adolescents, and sexual minority adolescents and would report more positive consent attitudes, more consent-seeking self-efficacy, and more ongoing consent-seeking behaviors than cisgender boys and heterosexual adolescents, respectively. We also expected that positive consent attitudes and higher consent-seeking self-efficacy would be related to more consistent ongoing consent-seeking behaviors. Overall, results suggest an important finding: adolescents across demographic groups report positive attitudes towards consent, high self-efficacy to seek consent from a partner, and high levels of ongoing consent-seeking behaviors. Indeed, consent-seeking behavior scores were so skewed that we had to dichotomize this variable to reflect consistent (i.e., reporting a maximum score on the scale) consent-seeking behaviors. This ultimately meant that those assigned a score of “inconsistent” consent-seeking behaviors includes both some youth engaging in very infrequent consent-seeking behaviors, but many who engage in frequent (but not maximally consistent) consent-seeking behaviors.

Although levels of these variables were high across groups, results also suggest small significant differences in adolescent consent attitudes and consistent consent-seeking behaviors by gender and sexual orientation. SGM youth reported the most positive consent attitudes compared to their cisgender and heterosexual counterparts, consistent with previous research suggesting that SGM adults feel more positively about consent (Glace & Kaufman, 2020). Further, our findings indicated that sexual minority adolescents had more consent self-efficacy, as well as a higher likelihood of engaging in consistent ongoing consent-seeking behavior, compared to their heterosexual peers. SGM adolescents’ sexual experiences likely do not conform to cis-normative, heteronormative traditional sexual scripts and the lack of clear scripts for this group may force them to communicate more directly with partners. These results highlight a strength of SGM youth in the face of the challenges of consent negotiation. Notably, however, SGM adolescents report higher rates of sexual violence compared to heterosexual and cisgender peers (DeKeseredy et al., 2017; Mitchell et al., 2014). Thus, for SGM youth, other issues, such as those related to minority stressors, may underlie violence rates more than challenges with consent communication. Future health programming efforts should not only be inclusive of a diverse range of sexual orientations and gender identities (Goldfarb & Lieberman, 2021; McCrimmon et al., 2023), but may also benefit from emphasizing and capitalizing on the unique strengths among SGM youth.

In contrast, despite reporting overall very high levels, cisgender boys and heterosexual youth reported the lowest consent cognitions and consistent consent-seeking behaviors compared to other groups. These results are aligned with prior work indicating that cisgender boys hold less favorable attitudes towards consent than cisgender girls (Javidi et al., 2020) and that sexual minority adults report more support for consent than heterosexual adults (Glace & Kaufman, 2020). Despite the traditional script that boys in heteronormative sexual encounters should initiate sex (Simon & Gagnon, 1986), these results indicate that this group may be least equipped to seek ongoing consent throughout a sexual encounter—a behavior not typical of the traditional sexual script. Further incorporation of consent education into current sexual education curricula or media interventions that destigmatize active approaches to seeking or providing ongoing consent may have benefits for adolescents’ consent-seeking. Importantly, given that ongoing consent was overall high among this sample, it is critical that future work identify and predict youth at-risk of engaging in very low consent-seeking behaviors. Although interventions reinforcing the importance of consent may benefit all youth, those engaging in infrequent consent-seeking behavior are likely at highest risk and can benefit most from targeted interventions.

Results also provide evidence supporting the applicability of the Theory of Planned Behavior to the context of adolescent sexual consent. Both consent attitudes and self-efficacy were associated with adolescents’ consent-seeking behavior. These findings align with the growing body of literature emphasizing the importance of promoting more positive attitudes toward consent among adolescents in order to prevent sexual violence and coercion (Javidi et al., 2020; Shafer et al., 2018). Notably, these results were in the context of controlling for demographic differences, indicating that promoting positive sexual consent attitudes and self-efficacy among all adolescents may offer benefits to consent-seeking behaviors, with potential implications for sexual violence and well-being among youth of diverse identities. These models also indicated that gender identity was still significantly associated with ongoing consent-seeking behaviors after controlling for attitudes and self-efficacy, suggesting that other, unmeasured factors may be important to assess in future research. For example, the current study did not measure subjective norms related to peers’ consent behaviors, which is another key cognitive determinant of behavior according to the Theory of Planned Behavior (Ajzen, 1991). Subjective norms may be particularly important to measure in the context of sexual consent behaviors during adolescence, when peer influence is especially strong (Brechwald & Prinstein, 2011).

Limitations and Future Directions

Although our measures of gender and sexual identities included a diverse range of identities, due to small cell sizes, many of these categories were combined for the analytic purposes, rendering us unable to make comparisons across distinct SGM subgroups. Future studies should address differences in consent-seeking behavior and consent cognitions by specific sexual and gender identities. Second, as this study was cross-sectional, we cannot draw conclusions about directionality or causality. Although we interpret consent cognitions as predictors of consistent consent-seeking behavior, these relationships may be bidirectional or third variables may explain the observed associations. Longitudinal designs would provide valuable insights into long-term impacts of these cognitions on consent-seeking behaviors. Third, although our study utilized a national sample of adolescents, our data are not representative of all adolescents in the U.S. or globally. Fourth, this study was based on an analysis of secondary data. The existing dataset did not include subjective consent norms, precluding us from including all constructs in the Theory of Planned Behavior. Additionally, our measure of consent-seeking behaviors emphasized adherence to a partner’s sexual consent during ongoing sexual activity, and although our measure of consent attitudes exhibited appropriate psychometric qualities, we used only a subset of items from larger validated scale that all focused on positive (rather than negative) attitudes. On average, participants scored high on consent measures, potentially reflecting ceiling effects and the possibility of biased socially desirable responding. Most notably, the consent-seeking behavior scale had to be dichotomized due to significant skew and ceiling effects. Whether due to sampling bias, issues in measurement validity, and/or biased reporting, our research cannot directly address predictors of very minimal or infrequent consent-seeking behaviors. Future research would benefit from developing, validating, and using measures of consent cognitions and behaviors that are appropriately multidimensional and fine-grained to address the nuances of the complex consent process. Finally, we acknowledge there may be valid concerns, primarily among parents, regarding adolescents discussing sensitive topics such as sexuality in exchange for compensation. We believe it is important to weigh these risks against the significant benefits of gaining a deeper understanding of adolescent sexual health through participants’ honest responses. Insights gathered from the current study have the potential to inform educational programs and interventions designed to promote positive sexual behaviors and relationships, as well as broader health outcomes among adolescents. Thus, our research team (along with the IRB) concluded that the study design and its protections adequately minimized participant risk.

Further promotion of consent education is imperative to ensuring adolescents hold positive consent attitudes, build skills necessary to seek consent, and actively seek consent from their sexual partners. Nationally, sex education curricula fail to adequately address consent (Padilla-Walker et al., 2020; Willis et al., 2019). However, the current results highlight that adolescents are overall supportive of clear consent practices, and may be amenable to structured opportunities to learn consent negotiation skills. Future efforts to integrate consent into broader sexual education programs can ensure adolescents are equipped with the skills and information needed to engage in consent behaviors. Additionally, evidence-based resources and interventions may be another promising avenue to address the current gaps in consent education (Javidi et al., 2023). Furthermore, it is important to acknowledge that individual consent cognitions may be shaped by broader influences. Thus, future research should examine the role of other influences, such as peer norms or media, in consent attitudes and self-efficacy.

Conclusion

Our study extends previous research by highlighting the influence of positive consent attitudes and consent self-efficacy on adolescents’ ongoing consent-seeking behavior. By addressing these factors through targeted programming efforts, researchers can promote healthier sexual behaviors and relationships among adolescents, ultimately contributing to a broader culture of healthy, respectful, and consensual sexual interactions during a critical developmental stage.

Supplementary Material

Supplementary Material

Funding

This work was supported by the Laura and John Arnold Foundation. This material is based upon work supported by the National Science Foundation (NSF) Graduate Research Fellowship under Grant No. 1940700 awarded to Anne J. Maheux, the National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIH) under award number K99MD019060 awarded to Hannah Javidi, and the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the NIH under award number F31HD114366 awarded to Jordyn McCrimmon. Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF or NIH.

Footnotes

Declarations

Conflicts of Interest The authors declare no conflicts of interest.

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Supplementary Material
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