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An Information-Motivation-Behavioural Skills model analysis of young adults' sexual behaviour patterns and regulatory requirements for sexual consent in Canada.

Sexual consent has been defined as the unambiguous willingness to engage in sexual activity that is expressed or verified by sexual partners. Despite the importance of expression and ascertainment of sexual consent, there is a marked disconnect between required elements of sexual consent in legal provisions and administrative policies, on one hand, and how individuals actually engage in their sexual interactions, on the other. We also lack an integrated theoretical model of factors that contribute to sexual consent expression and ascertainment to employ as a conceptual foundation to guide sexual consent promotion intervention efforts. This article adopts the perspective of the Information-Motivation-Behavioural Skills (1MB) model of sexual health to organize an overview of research concerning how individuals currently engage in what they view as "sexual consent" behaviours and how regulatory bodies conceptualize and regulate sexual consent, with a specific focus on the Canadian setting. According to the 1MB model, deficits in consent related to information, motivation, and behavioural skills are responsible for the lack of sexual consent behaviour enactment, and research that identifies such deficits is discussed throughout the paper. The 1MB model and the obstacles to sexual consent expression and ascertainment which are identified have implications for sexual assault adjudication, sexual assault prevention education, and sexual consent-related policy. Understanding how and why individuals currently ascertain and express consent is the crucial foundation upon which sexual consent education and regulation must be built.

KEY WORDS: Consent behaviours, miscommunication hypothesis, sex education, sexual assault, sexual consent, sexual script, token resistance

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The topic of sexual consent is of rapidly increasing media prominence. For example, sexual consent is the core concern of the global #MeToo movement to fight sexual assault and is central to highly-publicized criminal trials that hinge on whether or not consent was present in a sexual interaction (e.g., R v. Ghomeshi, 2016; Ryan, 2011; Shields, 2013; University of Ottawa Hockey Team, 2016; Wilson & Glater, 2006). Alongside recognition of the importance of sexual consent is a dramatic push to incorporate sexual consent requirements into administrative regulations, legal stipulations, and sexual assault prevention education (e.g., Bill 132, 2016; Senn et al., 2015; The White House, 2014). However, there is currently no integrated theoretical model of factors that contribute to the enactment of sexual consent behaviours to guide regulation and prevention education. The current paper addresses these limitations by conceptualizing existing research on sexual consent within an Information-Motivation-Behavioural Skills (1MB) model framework. The 1MB model provides a comprehensive perspective for understanding and guiding the development of public policy and educational strategies. This perspective can strengthen performance of sexual consent behaviours and reduce non-consensual sexual interactions.

Research that has examined sexual assault prevalence across multiple methodologies and inclusion criteria has supported the oft-cited 1 in 5 statistic, indicating that 20% of women experience sexual assault during their undergraduate university years (Muehlenhard, Peterson, Humphreys, & Jozkowski, 2017). Looking specifically at forced or while incapacitated sexual penetration rates, around 11.3% of female undergraduates surveyed reported being victimized since entering college/ university in the U.S. (Cantor et al., 2015). Forced or incapacitated penetration rates have also been reported to be 2.9% for men and 15.2% for gender non-binary individuals (Cantor et al., 2015). Although difficult to directly compare due to differing definitions of sexual assault and specific populations under study, sexual assault rates on university and college campuses are generally reflective of general incidence rates in individuals between 15-24 in Canada (Conroy & Cotter, 2017; Perreault & Brennan, 2010). Non-consensual sexual interactions (i.e., sexual assault) have substantial individual, social, and economic costs (Day, McKenna, & Bowlus, 2005; Varcoe et al., 2011; Wells, Boodt, & Emery, 2012). In Canada, sexual assault costs upwards of $7 billion per year in public and private expenditures, including costs for crisis interventions, police and judicial services, health care, and absence from work (Varcoe et al, 2011; Wells et al., 2012), not to mention unquantifiable individual psychological trauma. Regulatory bodies of all types--institutional, legislative, and judicial--face increasing pressure to appropriately and effectively address the problem of sexual interactions that take place in the absence of consent. Numerous institutions have responded to this demand by promoting public awareness about proceeding with sexual activity only in the presence of affirmative consent, which is clear, unambiguous, verbal, and ongoing (Bill 132, 2016; Criminal Code, 1992; Office for Civil Rights, 2017; The White House, 2014).

The purpose of this review is three-fold: 1) to identify information, motivation, and behavioural skills strengths and deficits connected with the expression and ascertainment of sexual consent; 2) to contrast normative patterns of sexual behaviour with formally articulated requirements for sexual consent; and 3) to create the conceptual basis for understanding and promoting sexual consent behaviours in sexual interactions. To achieve these aims, we will first review the literature concerning ways in which individuals currently deal with sexual consent in their sexual interactions. An 1MB model (Fisher & Fisher, 1992; Fisher, Fisher, & Shuper, 2014) conceptualization of sexual consent will be advanced to organize these findings. Regulatory requirements for sexual consent will then be reviewed with a particular focus on the Canadian context. The lack of fit of individuals' consent-related actions and the legal and regulatory requirements for affirmative sexual consent is discussed throughout the paper and suggestions are made for addressing this gap in sexual assault prevention initiatives.

Defining Sexual Assault and Sexual Consent

In Canada and many other jurisdictions (Office for Civil Rights, 2011; Office for Civil Rights, 2017), sexual assault is the legal classification of non-consensual sexual contact, which can range from non-consensual touching to non-consensual penetrative sex (Criminal Code, 1992). In sexual assault cases, the sexual act is usually established. Instead, whether or not consent was present in the sexual act is typically questioned, and sexual consent is the central factor distinguishing between sexual assault and consensual sex (Gotell, 2008). There are no universal actions that are specified to indicate consent or non-consent to a sexual interaction, complicating binary "guilty" or "not guilty" legal decisions.

Emphasis on affirmative consent is reflected, to a degree, in the legal definition of consent that is embedded in the Criminal Code of Canada. Currently, the Criminal Code of Canada defines consent as the "voluntary agreement of the complainant to engage in the sexual activity in question" (Criminal Code, 1992). The Supreme Court of Canada found no defence of prior consent, indicating that consent must be operative and ongoing for the duration of the sexual contact (R. v. J.A., 2011). Additionally, an individual must have the capacity to consent, which is limited by intoxication due to drugs/ alcohol, age, mental ability, and certain power differentials in relationships (e.g., persons in positions of trust are assumed to have so much power that they impair the ability to consent). The Criminal Code further defines what consent is not, based on legal precedent. For example, consent cannot be obtained if the agreement is expressed "by the words or conduct of a person other than the complainant" (Criminal Code, 1992). Non-consent can be expressed either by "words or conduct" (Criminal Code); therefore, consensual sexual activity cannot continue if the person expresses verbally or by their actions that they do not wish to continue with sexual activity. Despite a clear outline of what consent is not, the Criminal Code of Canada is less clear regarding what behaviours constitute consent to sexual activity.

In an attempt to operationalize sexual consent, Muehlenhard, Humphreys, Jozkowski, and Peterson (2016) suggest that consent can be described in three ways: "... as an internal state of willingness, as an act of explicitly agreeing to something, and as a behaviour that someone else interprets as willingness" (p. 462). An internal state of willingness is an important aspect of sexual consent, but is difficult to operationalize in a sexual encounter and may or may not be visible or discernable to a sexual partner. Further, actually explicitly agreeing to engage in sexual activity (e.g., stating "I agree to have sex with you") may be rare in interpersonal relationships, and may not necessarily indicate freely-given consent (e.g., explicit agreement in the presence of coercion). Instead, individuals usually rely on nuanced, indirect, "coded," and ambiguous cues to indicate willingness to engage in a sexual interaction (Shumlich & Fisher, 2018). In general, individuals--and administrative and legal judgements--strive to interpret how sexual partners' outward behaviours indicate the presence or absence of an internal state of willingness to engage in a sexual interaction. Consequently, research generally focuses on how individuals express and interpret consent-related behaviours.

Sexual Consent in Interpersonal Sexual Interactions

Overall, communication of sexual consent is conveyed most frequently through non-verbal behaviours (Beres, Herold, & Maitland, 2004; Hall, 1998; Hickman & Muehlenhard, 1999; Jozkowski, Sanders, Peterson, Dennis, & Reece, 2014b). Such nonverbal behaviours include a cluster of actions related to participation in sexual activity (e.g., not resisting a partner's sexual attempts) and increasing the level of intensity of sexual activity (e.g., continuing and escalating a sexual interaction). These nonverbal behaviours appear to be necessary but profoundly insufficient for the occurrence of a consensual sexual interaction. For example, lack of resistance may communicate consent or, alternatively, incapacitation due to intoxication or abject fear of a sexual partner. However, Muehlenhard et al. (2016) note that, when communicating consent to sex, participants typically use non-resistance together in conjunction with "more active signals of consent" (p. 479), such as participating in increasing levels of sexual activity. Interpretation of non-resistance as consent can be ambiguous and problematic, yet in accords with "no means no" messaging, which suggests that a verbal rejection is required and that sexual activity may proceed in its absence (Carr et al, 2014; Hall, 1998).

Despite the lack of clear behavioural distinction between consenting and refusing sexual activity, both men and women consistently state that they are capable of tacitly knowing when sex is consensual (Beres, 2010)--in other words, verbal communication is unnecessary because it is "obvious" and they "know" when someone is consenting to sex. Further highlighting inconsistencies in sexual consent behaviour, Hickman and Muehlenhard (1999) asked undergraduates to rate indications of sexual consent in hypothetical scenarios. These researchers found that undergraduate participants rated direct verbal statements of consent to be most indicative of consent, yet they personally used this method of conveying consent least frequently. Conversely, not resisting a partner's attempts was rated as the least indicative of consent and at the same time their most frequently used signal of sexual consent.

Research supports a gendered aspect of sexual consent behaviours, fozkowski, Peterson, Sanders, Dennis, and Reece (2014a) found that, to indicate consent, female participants report using more verbal strategies than males and male participants report using more nonverbal strategies than females. In contrast, however, Burrow, Hannon, and Hall (1998) found that, compared to male participants, female participants reported using more nonverbal behaviours to indicate consent. These inconsistent findings may be due to the different ways that verbal behaviours were defined. In Burrow et al.'s (1998) research, verbal behaviours indicated more direct willingness (e.g., "I really want to have sex with you"), whereas Jozkowski et al. (2014b) described verbal behaviours as including a wide range of direct and indirect indications of willingness to engage in sexual activity (e.g., "Want to go back to my place?"). In accord with traditional gender roles, female sexual partners may be less willing to explicitly agree to sex than male sexual partners (Grose, Grabe, & Kohfeldt, 2014). Similarly, more males than females report that they express consent by initiating sexual activity and through borderline pressure to engage a partner in sexual activity (e.g., taking their partner somewhere private, closing the door, etc.; Jozkowski et al., 2014b). More women than men indicated using passive behaviours (e.g., not resisting a partner's advances, letting the sexual encounter proceed to intercourse) to convey consent. Although these behaviours are not necessarily indicative of consent, they are ways that have been used to indicate interest in sex.

While both males and females agree that directly asking for consent is important, females more strongly agreed with this idea than males (Humphreys, 2007). Additionally, while agreeing that asking for consent is important, more male than female participants agreed that it was okay to assume sexual consent unless otherwise indicated, thus expressing males' inclination to understand non-resistance as consent (Humphreys, 2004). In a survey of 514 Canadian undergraduates, Humphreys (2004) found that, compared to female participants, more male participants agreed that consent to intercourse implies consent to other sexual behaviours, like petting and fondling, and that consent at the beginning of a sexual interaction implies consent throughout a sexual encounter. These research findings focused on men's and women's beliefs regarding sexual consent and are not necessarily indicative of the consent-related behaviours they enact in their sexual interactions.

The context of a sexual relationship and relationship length also influence sexual consent behaviours. Undergraduate students report that they feel more comfortable directly discussing consent with a long-term partner, but at the same time felt that doing so was also less necessary than in a shorter term sexual interaction (Shumlich & Fisher, 2018). Conversely, it was seen as more important to discuss consent with a first-time partner, but perceived to be more awkward to do so (Shumlich & Fisher, 2018). Longer relationships are associated with greater acceptability of ambiguous sexual consent cues and increased perceptions of clarity in understanding a partners' sexual consent or non-consent (Humphreys, 2007). Further, the context in which sexual contact occurs appears to influence the understanding of sexual consent behaviours. University students discussed the perception that people who are at a bar are looking to hook-up and are therefore implicitly consenting to sex (Shumlich & Fisher, 2018). It is also assumed that sex is going to happen if you go back to someone's house from a bar or party. Other behaviours, such as talking about STIs and birth control, were ways that individuals discussed as being indirect communications of sexual consent (Shumlich & Fisher, 2018). Although these situational characteristics and discussion are not directly relevant to sexual consent to specific activities at a specific time and place, they illustrate different contexts that may influence perceptions of a partner's willingness to engage in sex.

Overall, research to date indicates that numerous behavioural cues--many of them ambiguous--are utilized to enact and interpret sexual consent. Further complicating matters is the fact that there are no specific behaviours that universally indicate consent. Instead, individuals rely on a sequence of behaviours that vary widely and that appear to differ by gender, in the context of heterosexual interactions. Although there is increasing research on sexual consent among heterosexual individuals, there is a continuing dearth of research about the behaviours that are used to express sexual consent and behaviours that are interpreted as sexual consent in non-heterosexual and non-binary populations.

An Information-Motivation-Behavioural Skills Model of Sexual Consent

Numerous theoretical models (e.g., Theory of Reasoned Action, Fishbein & Ajzen, 1975; Transtheoretical Model, Prochaska & Velicer, 1997; Information-Motivation-Behavioural Skills Model; Fisher et al., 2014) have been applied in efforts to understand, predict, and promote sexual health-related behaviour. The 1MB model has been selected as the conceptual framework for understanding and promoting sexual consent behaviours on the basis of its comprehensive capture of the cognitive, motivational, and skill elements believed to be the foundations of affirmative sexual consent and because of its empirical support across a diversity of sexual health-related behaviours and populations of interest (see Fisher et al., 2014 for a review of this literature).

Applied to sexual consent expression and ascertainment, the 1MB model asserts that actionable information regarding sexual consent, personal and social motivation to act on this information, and behavioural skills for acting effectively, are fundamental determinants of sexual consent behaviour. All else being equal, well informed, well motivated, and behaviourally skilled individuals will actively engage in clear sexual consent behaviours in their sexual interactions. Conversely, poorly informed, unmotivated, and behaviourally unskilled individuals are unlikely to engage in affirmative consent practices. The 1MB model further specifies that the effects of consent information and consent motivation generally work through consent-related behavioural skills to affect affirmative consent behavioural enactment when affirmative consent behaviours are novel or complex, precisely as they currently appear to be for affirmative consent (See Figure 1). The degree to which a well-informed and well-motivated individual can effectively engage in sexual consent behaviour is dependent on that individuals behavioural skills for enacting affirmative sexual consent practices, including expression and ascertainment of consent to a sexual interaction. If and when sexual consent behaviours are simple and familiar, information and motivation factors may directly influence engagement in sexual consent behaviours.

Sexual Consent Information

The 1MB model of sexual consent asserts that information that is relevant to engaging in clear and unambiguous sexual consent behaviours and readily translated into behaviour--that is, actionable sexual consent information--is a fundamental prerequisite for engaging in these behaviours. Information can include knowledge of the actions and words that might be required to unambiguously express consent and the means to ascertain consent from a partner in a fashion that minimally negatively affects an ongoing sexual interaction. Information about specific and relevant legal and policy requirements concerning affirmative consent can also contribute to enactment of consent behaviours and reduction in non-consensual sexual interactions. Failure to engage in affirmative consent behaviours may be due to a combination of inaccurate information about requirements of consent and the failure of sex education programs and regulatory bodies to promulgate accurate information about sexual consent (Anderson & Whiston, 2005; DeGue et al., 2014). Individuals have wide and sometimes contradictory definitions of what comprises consent (Beres, 2007), suggesting that there is a lack of well-informed public understanding of consent. For example, individuals might assume that willingness to engage in sexual intercourse means willingness to engage in other behaviours, such as oral sex (Beres, 2014; Humphreys, 2007; Muehlenhard et al., 2016).

Inaccurate and misleading cognitive heuristics--cognitively low effort decision rules relevant to sexual consent--and naive theories of sexual consent may also influence individuals' likelihood of engaging in sexual consent behaviours. For example, cognitive heuristics characterize views that non-resistance or "she didn't say no" equals consent, which may affect sexual consent behaviour. Another example is the perception of "implicit" knowledge of a partner's consent to sex (Beres, 2014). For example, the cognitive heuristic that "I just intuitively know" or "They agreed to come home with me" means consent to sex (Beres, 2014), and common information elements that, while not necessarily accurate, if believed, can contribute to absence of clear and unambiguous sexual consent behaviours.

The sexual script or schema that prescribes the pre-determined way in which sexual interactions are supposed to play out (Gagnon & Simon, 1973) is a particularly relevant cognitive heuristic. Evidence to date strongly suggests that active, verbal, clear, unambiguous, and ongoing expression and ascertainment of sexual consent is not uniformly part of current sexual scripts. Moreover, sexual script theory suggests that men and women are socialized to behave differently and to the ostensible advantage of each in sexual encounters. The traditional sexual script suggests that men initiate sexual activity and press for its occurrence often using indirect or duplicitous means (Pascoe, 2005; Struckman-Johnson, Struckman-fohnson, & Anderson, 2003; Sweeney, 2014; Wiederman, 2005), whereas women generally send messages that are consistent with traditional gender roles, including "feminine passivity" and indirect means of expressing both consent and non-consent to sexual interactions. The traditional sexual script promotes the expectation for women to be sexual gatekeepers, limiting sexual access and preserving their reputations (Fine, 1988; Grose et al., 2014), and reinforcing the belief that "failure to resist" indicates a woman's consent.

Aspects of the traditional sexual script--particularly its gendered nature--are often critiqued as incorporating elements of rape myths, which are pervasively held beliefs and attitudes used to justify rape and sexual aggression (Bohner, Eyssel, Pina, Siebler, & Viki, 2009; Brownmiller, 1975; Ryan, 2011). An example of a rape myth is the idea that if a woman dresses a certain way or consents to come to a male's residence, then she is "asking for it" or implicitly agreeing to a sexual interaction. The assumption that women are responsible for sexual gatekeeping may promote victim blaming and the false assumption that a woman always has the capacity and capability of saying no. As noted, this assumption may also strengthen men's sense that passivity or non-resistance indicates that gatekeeping has been abandoned and consent has been given. Although considerable research has utilized script theory in the study of heterosexual couples, minimal research has been dedicated to looking at scripts within same-sex couples. Klinkenberg and Rose (1994) found that dating scripts for homosexual and bisexual respondents were similar to dating scripts for heterosexual couples, including some gendered aspects. Same-sex male couples were more likely to become sexually intimate on the first date, whereas same-sex female couples were more likely to wait to develop an emotional bond to become sexually intimate. Unlike heterosexual couples, however, no gatekeeper and initiator roles were present within same-sex relationships. The absence of gatekeeper and initiator roles could leave room for the utilization of clearer communication of sexual consent cues.

Additional potentially influential heuristics and naive theories involving token resistance, miscommunication, and perceptions of how a victim is "supposed" to act after being assaulted, also appear to contribute to non-consensual sexual interactions. In the traditional heterosexual script, it is a woman's responsibility and burden to say no to a man's advances even when they mean yes--a phenomenon known as token resistance (Burkett & Hamilton, 2012; Fine, 1988; Grose et al, 2014; Muehlenhard & Hollabaugh, 1988; Muehlenhard & Rodgers, 1998). Conversely, men's consent is generally assumed (Burkett & Hamilton, 2012). Both of these sets of beliefs can contribute to non-consensual sexual interactions. Individuals who believe in token resistance believe that a woman's resistance is not genuine but strategic in order to preserve her reputation. If men believe that a woman's resistance is merely "for show" and to protect her reputation as being selective and not "easy" he may disregard it (Muehlenhard & Hollabaugh, 1988). As a result of beliefs about token resistance, men may continue to pursue sex in the hopes that the woman will change her mind (Jozkowski, 2013) or that a woman's resistance can be "worn down" (Muehlenhard & Hollabaugh, 1988). Correspondingly, if a woman believes that men are stereotypically always open to sex, she may not believe that ascertainment of consent is relevant or necessary.

Between 37-68% of heterosexual women and between 21-83% of heterosexual men report that they have offered token resistance in sexual interactions, depending on how token resistance is operationalized (Krahe, Scheinberger-Olwig, & Kolpin, 2000; Muehlenhard & McCoy, 1991; Shotland 8r Hunter, 1995; Sprecher, Hatfield, Cortese, Potapova, & Levitskaya, 1994). However, participants often describe token resistance situations as involving a change of wantedness to engage in a sexual interaction, suggesting that actual token resistance per se was rare (Muehlenhard & Rodgers, 1998; Shotland & Hunter, 1995) but potentially reinforcing the view that initial resistance was indeed token. Muehlenhard and Rodgers (1998) found that participants who said that they have said "no" when they meant "yes" described situations in which they had fully intended to refuse sex, but also felt ambivalent about the situation. For example, one male participant described wanting to have sexual intercourse, but decided not to as birth control was unavailable. Taking these situations into consideration, the researchers found the percentage of men and women who used genuine token resistance was greatly reduced, from 66.7% to 15.4% of women and from 82.5% to 12.5% of men. Although there is no clear way to distinguish between resistance that is truly token and that which is reflective of a true unwillingness to engage in sexual activity, it appears that the overwhelming majority of men and women who say or indicate no actually do not wish to engage in sexual activity. Nonetheless, the belief that resistance is merely token complicates the interpretation of sexual consent and may contribute to non-consensual sexual interactions (Brownmiller, 1975).

The need to subjectively interpret a partners behaviours in order to make inferences about his or her willingness to engage in a sexual interaction is the foundation for an additional belief relevant to sexual consent that researchers have called the miscommunication hypothesis. This perspective suggests that sexual assault can often be attributed to "miscommunication" rather than ill-intent (Bart & O'Brien, 1985; Burkett & Hamilton, 2012; O'Byrne, Hansen, & Rapley, 2008), especially under the conditions of high sexual arousal, which reduces sexual self-restraint and self-control and may result in poor sexual decision-making (Shuper & Fisher, 2008; Skakoon-Sparling & Cramer, 2016; Skakoon-Sparling, Cramer, & Shuper, 2016). The desire for a sexual interaction may result in biased interpretation of a partner's nonverbal, indirect, "coded," or even quite direct behaviours in response to sexual overtures.

Despite assertions of "miscommunication," researchers since the 1980s have shown that female and male participants agree on methods of sexual consent communications (Byers, 1980) even if they are far from universally employed. Participants have indicated that they understand when a partner does not consent to a sexual act, even with subtle, indirect, or softened cues (Beres, 2010; Hanson & Gidycz, 1993; Hickman & Muehlenhard, 1999; Kitzinger & Frith, 1999; O'Byrne, Rapley, & Hansen, 2006). This understanding suggests that clearly perceived refusal of sex may not be believed (i.e., belief in token resistance) or that sexual aggressors reinterpret sexual signals to their own advantage or use misinterpretation as an excuse for sexual assault (Hickman & Muehlenhard, 1999). Alternatively, the perpetrator may not care about the refusal (Hanson & Gidycz, 1993; Hickman & Muehlenhard, 1999). For example, the assaulter may claim ignorance, a lack of understanding of consent signals, or "misinterpretation" of consent signals, which may falsely suggest that miscommunication is an important factor in sexual assault (O'Byrne et al., 2006, 2008). These claims contrast with evidence that communication of non-consent is accurately perceived.

Motivation

Motivation to act on what one knows about sexual consent is the second critical factor in the 1MB model of affirmative sexual consent. Motivation to clearly and unambiguously express or ascertain sexual consent includes both personal and social motivation to enact these behaviours (Ajzen & Fishbein, 1980; Fishbein & Ajzen, 1975, Fisher & Fisher, 1998). Motivation to do so may also be influenced by one's generalized emotional responses to sexuality, or erotophobia--erotophilia, and consequent avoidance or approach responses in the sexual context (Byrne, Kelley, & Fisher, 1993; Fisher, 1984, 1990; Fisher & Fisher, 1998). These motivational factors will influence whether an individual will or will not engage in behaviours that clearly and directly ascertain and express consent.

Personal motivation to engage in affirmative sexual consent behaviours involves an individual's beliefs about the perceived outcomes of engaging in consent behaviours and their evaluation of these outcomes. Attitudes towards sexual consent and the beliefs and evaluations on which they are based are relevant to both engaging and not engaging in consent behaviours. Decades of research has indicated that personal motivation-in the form of attitudes towards specific acts and beliefs and evaluations of their outcomes--is associated with numerous sexual health-related behaviours, including condom use and safer sexual practices (e.g., Bryan, Fisher, Fisher, & Murray, 2000; Camilleri, Kohut, & Fisher, 2015), consistency of female orgasm (Mclntyre-Smith, 2010), breast self-examination (e.g., McDonald, Saslow, & Alciati, 2004), and adherence to HIV antiretroviral medication (e.g., Fisher & Fisher, 1998). Attitudes towards enacting affirmative consent behaviours are seen to be based upon perceptions of the outcomes of engaging in such behaviours and evaluations of these outcomes (Ajzen & Fishbein, 1980; Fishbein & Ajzen, 1975). Thus, an individual might believe that asking for consent would result in rejection of a sexual overture, a decidedly negative outcome, which leads the individual to avoid engaging in affirmative consent behaviours and relying on more indirect approaches to a sexual interaction. Other perceived outcomes that might result in failure to engage in clear and direct consent behaviours, in addition to fear of rejection, might include fear of appearing "too willing" or the fear that asking for consent would limit the "spontaneity" or "heat" of sexual activity (Humphreys & Herold, 2003).

Social motivation to engage in affirmative consent behaviours is based on the individual's perception of the social outcomes of enacting--or failing to enact--sexual consent behaviours within an individual's social circle and referent groups (Ajzen & Fishbein, 1980; Fishbein & Ajzen, 1975, as cited in Fisher, Fisher, Amico, & Harman, 2006). Social support--or social opposition--for engaging in sexual consent behaviours, and motivation to comply with referent other's wishes in this respect, can be perceived as involving the perceived responses of numerous individuals, including potential sexual partners, same-sex and opposite-sex friends, family, and educators. Social norms are critical for understanding and ultimately for promoting sexual consent (Fabiano, Perkins, Berkowitz, Linkenbach, & Stark, 2003). On one hand, perceived desire for explicit communication of sexual consent from sexual partners might motivate sexually interacting individuals to clearly communicate about this issue. Positive perceived outcomes of engaging in consent behaviours (e.g., an aroused partner's enthusiastic consent, increased partner trust, an overall better sexual relationship) will increase the likelihood that individuals will engage in consent behaviours. On the other hand, peer norms opposed to sexual consent communication, endorsing non-resistance as consent, or prioritizing sexual conquests or appearance of modesty over sexual consent might motivate avoidance of clear communication about sexual consent. As another example, if an individual perceives that verbally asking for consent (e.g., "Would you like to have sex?") is not normative within his or her peer group or will be negatively perceived by a partner, this individual might be less likely to engage in direct consent seeking or expressing behaviours. An individual may also be unwilling to explicitly say "yes" due to potential negative connotations about being perceived as "easy" (Muehlenhard & Hollabaugh, 1988). According to the 1MB model, increasing personal and social motivation for engaging in consent will be associated with increased consent behaviours (e.g., Fisher et al., 2006), whereas perceived personal and social costs likely diminish the intent to engage in consent behaviours. In addition, relaxing levels of generalized negative emotional response to sexuality--erotophobia--is expected to relax inhibitions about directly expressing or ascertaining consent to sexual interactions (Fisher & Fisher, 1998).

Sexual Consent Behavioural Skills

The 1MB model of sexual consent asserts that sexual consent behavioural skills are an essential determinant of the initiation and long-term maintenance of affirmative consent behaviours. According to the 1MB model perspective, ensuring and ascertaining sexual consent presently constitute a set of novel and complex behavioural demands that are not commonly taught or modeled and that require skilled behavioural execution. For example, self-acceptance of one's sexual activity (i.e., acknowledging "I am willingly engaging in this sexual interaction") is a necessary first step in the enactment of expressing or ascertaining sexual consent. Once an individual accepts their own willingness to engage in a sexual interaction, they are in a position to communicate with a partner to express and verify sexual consent and potentially to do so in a fashion that accentuates rather than disrupts sexual arousal and sexual flow. A behaviourally skilled individual might note that negotiating sexual consent is a natural place to discuss safe sex practices and sexual likes and dislikes. These actions might include direct discussion of willingness to engage in a sexual interaction (e.g., "I'm very attracted to you. Would you like to have sex?") and/or negotiating sexual activity with a partner (e.g., "That's good for me. Do you have a condom?"). An individual must have the requisite skills at expressing both consent and non-consent and skills for respecting consent declines (e.g., "I'm not ready for that" "OK. I'm glad we talked"). Further, self- and partner-reinforcement ensures the maintenance of consent behaviours over time (Fisher, 1990). See Figure 2 for a representation of the interpersonal behavioural sequence of sexual consent.

The 1MB model's behavioural skills component includes both objective abilities to enact a sequence of affirmative sexual consent behaviours as well as perceived self-efficacy about performing these behaviours (Fisher et al., 2006). The model specifies that both an individual's objective skills and their self-efficacy for the enactment of consent behaviours will influence the actual effective enactment of such behaviours. Individuals with strong objective behavioural skills and perceived self-efficacy for performing sexual consent behaviours will be more likely to engage in sexual consent behaviours and to do so effectively. Conversely, individuals with weaker behavioural skills and/or perceived lack of self-efficacy will be less likely to engage in sexual consent behaviours. We note the fact that individuals consistently rely on cloaked and indirect messages of consent (e.g., "Want to Netflix and chill?") and non-consent (e.g., "I have got to go home and study"). Clear and unambiguous consent behaviours are rare and demand learning and skilled enactment of a set of behaviours that may be entirely novel to the individual, not part of their sexual script, and potentially subject to negatively motivating attitudes and social norms (Shumlich & Fisher, 2018). As such, the 1MB model conceptualizes why individuals may be unlikely to engage in direct verbal consent behaviours, but also asserts that these behaviours may be amenable to interventions that inform, motivate, and provide behavioural skills coaching. Skills training does appear to be effective at increasing certain health-related behaviours (e.g., Choi et al., 2008).

Within this discussion of sexual consent behaviours, it is worth elaborating on the behavioural skill demands of expressing and respecting non-consent to a sexual interaction. Just as individuals may lack models or skills for integrating expressions and ascertainment of sexual consent, they may also lack models and skills for expressing and respecting non-consent to a sexual interaction. Similar to expressing consent, refusal cues can be direct (e.g., "I don't want to have sex") or more subtle (e.g., pulling away slightly) (Beres, 2010). Direct verbal strategies are significantly more common in expressions of non-consent compared to consent (Burrow et al., 1998). However, some women have reported that expressing non-consent directly is awkward, rude, hurt their partner's feelings, or destroy chances for developing a relationship in which sex is desired at a later stage (Kitzinger & Frith, 1999). In order to avoid this, women may "soften" their refusals by delaying acceptance (e.g., "I'm not ready yet") or offering excuses (e.g., menstruation) rather than refusing sex outright. Men also reported hesitation in refusing sex. Many men said refusing was implausible due to the gendered expectation that men will always be ready to engage in sex and a wish to protect their partner's feelings (Kitzinger & Frith, 1999). Given this perception, men reported that they tend to soften refusals similarly to women (O'Byrne et al., 2006, 2008). Despite a lack of script for expressing non-consent, Burkett and Hamilton (2012) found that it is assumed to be a woman's responsibility to say "no" "otherwise it is not a man's fault should he proceed with his sexual advances" (p. 819). It seems clear that the behavioural skills demands for expression and respect of consent refusals require refinement and may be important intervention targets.

The fact that affirmative consent requires enactment of what may be a series of complex and novel actions that must be skillfully deployed may be further complicated by characteristics of the settings in which sexual interactions occur, which often involves varying levels of alcohol and recreational drug consumption, intoxication, and potential incapacity to consent or decline a sexual interaction. Sexual assault among college and university students most commonly involves drugs and/or alcohol (Cantor et al., 2015; Krebs, Lindquist, Warner, Fisher, and Martin, 2009; Muehlenhard et al, 2017). Alcohol can impair the ability to judge and avoid risky situations, to enact the sequence of behaviours involved in affirmative consent or declining a sexual interaction, or incapacitate the victim to the point where sex is by definition non-consensual (Muehlenhard et al, 2017). Given that sexual assault perpetrators are mostly male, some of the first theoretical models linking alcohol and sexual assault propose that alcohol increases the likelihood that a man will misperceive a females interest in sex (Abbey, Ross, McDuffie, &McAuslan, 1996). In other words, alcohol may make "miscommunication" regarding a female's sexual interest more likely. Other theories suggest that alcohol makes it such that men are more likely to be willing to accept and perpetrate sexual assault (Testa, 2002). The expectancy that alcohol is "disinhibitory" and an "aphrodisiac" (George, Cue, Lopez, Crowe, & Norris, 1995) may make it such that men are less likely to believe a women's "no" or indications that she is not interested in sex.

Alcohol in and of itself is not necessarily a risk factor of sexual assault; however, drinking increases vulnerability to sexual assault due to the interference of drinking with vigilance, cognitive function, and typically occurring in social situations in which there is increased contact with potential perpetrators (Testa & Livingston, 2009). Some researchers, therefore, find that "frequency of exposure to risky drinking settings, such as bars or drinking games, is a better predictor of sexual victimization than is women's actual alcohol consumption" (Testa & Livingston, 2009, p. 3) (e.g., Schwartz & Pitts, 1995). Alcohol may also directly impair individuals' ability to effectively enact sexual consent or non-consent behaviours and their ability to respect these behaviours. The incidence of sexual assault on campuses is generally reflective of the incidence of individuals in the general population from a 15-24 age range (Laumann, Gagnon, Michael, & Michaels, 1994; Perreault & Brennan, 2010). However, there are factors on university campuses that contribute to and may promote sexual assault, including the alcohol and party scene (Armstrong, Hamilton, & Sweeney, 2006), fraternity and athletic culture (Boyle & Walker, 2016; Mohler-Kuo, Dowdall, Koss, & Wechsler, 2004), and the common presence of large concentrations of relatively unsupervised young men and women living in close proximity to one another. Taken together these factors may contribute to alcohol and drug infused social and sexual interactions that may impair the enactment of behavioural skills to consent to or decline sexual interactions.

Sexual Assault Prevention Programs

Sexual assault prevention efforts are typically divided into prevention of perpetration, prevention of victimization, and bystander intervention programs (McCaughey & Cermele, 2015). Self-defense training and resistance programs appear to be effective at reducing completed rape victimization (Hollander, 2014; Senn et al., 2015; Tark & Kleck, 2014). Further, bystander programs appear effective at increasing bystander self-efficacy and intervention behaviours (Senn & Forrest, 2016). However, interventions targeting reduction in sexual assault perpetration are less promising (Anderson & Whiston, 2005; DeGue et al., 2014). While most sexual assault prevention programs are effective at increasing information related to sexual consent--consent information, as emphasized within the 1MB model perspective--this is not sufficient for promoting sexual consent behavioural change.

Although sexual consent is a core issue in avoidance of sexual assault, only two empirically tested sexual assault perpetration reduction programs were found that specifically involved information about sexual consent: The Sexual Harassment and Rape Prevention (SHARP) Consent 101 program and The Men's Program. The SHARP Consent 101 program is a 10-15 minute session addressing sexual consent with male and female college students. Compared to a control group of undergraduate men, those in The SHARPP Consent 101 group displayed greater knowledge of sexual consent (i.e., how well participants could identify four components of consent: seeking, receiving, expressing, and permitting sexual activity to occur). However, it is unclear how this increased knowledge may translate to actual consent-related behaviours in post-intervention sexual interactions (Borges, Banyard, & Moynihan, 2008), particularly since important motivational and behavioural skills factors were not specifically targeted. The Men's Program consists of a series of peer-presented modules, one of which focuses on consent. This program has been empirically tested in groups of men on six occasions, with varying degrees of success, measured by rates of sexual assault perpetration assessed by self-report questionnaires (Foubert, 2000; Foubert & Marriott, 1997; Foubert & McEwen, 1998; Foubert & Newberry, 2006; Foubert, Newberry, & Tatum, 2007; Langhinrichsen-Rohling, Foubert, Brasfield, Hill, & Shelley-Tremblay, 2011). Overall, DeGue and colleagues' (2014) systematic review found a null effect of the Men's Program on sexual assault perpetration.

Sexual assault perpetration and victimization prevention programs appear to be based on an "information-deficit" model that ascribes sexual assault to ignorance of accepted guidelines for sexual consent. However, given the ineffectiveness of these programs, and the demonstrated ineffectiveness of information-only approaches to sexual health-related behaviour change (Fisher & Fisher, 1992, 2000), sexual assault prevention programs should go beyond an information-only model. In order to do so, programs should prioritize sexual consent motivation and sexual health behavioural skills strengthening in efforts to promote sexual consent behaviours and minimize non-consensual sexual interactions. Moreover, sexual assault prevention programs do not directly address the discrepancy in consent negotiation ideals and how consent negotiations take place in reality. This disconnect may be an additional reason for the lack of efficacy of prevention initiatives. For example, "yes means yes" sexual consent messaging (Anti-Violence Project, 2006) may be lost on individuals since it assumes direct, verbal consent that is both asked and expressed, neither of which are commonly incorporated in individual sexual scripts (Shumlich & Fisher, 2018). Individuals may view affirmative consent as unreasonable, unrealistic, or unnecessary to incorporate into their sexual activity.

Regulatory Approaches to Sexual Consent

Changes to criminal codes worldwide reflect changing social and political norms. For example, the Criminal Code of Canada was amended to include recognition of occurrence of sexual assault within marriages, and limited the defense of "honest belief" in the consent of the victim (e.g., DPP v. Morgan, 1975; R. v. Pappajohn, 1980; Thornton, 1982). At the same time, the legal language of the Criminal Code of Canada changed to gender-neutral such that males and females can both be perpetrators or victims. Changes at this time also removed the corroboration requirement, meaning that a complainant's word became enough to secure a conviction, at least in theory. "Rape shield" provisions have also been included in numerous jurisdictions in the U.S. and Canada, which theoretically limit the use of a complainant's sexual history as evidence (R. v. Seaboyer, 1991). Changes such as these represent a shift to more progressive legislation that more appropriately and accurately reflects the ways in which sexual consent should be incorporated into interpersonal sexual activity Additionally, the public and legal ethos is shifting from predominately victim blaming to more victim supporting, bolstered by social media campaigns and leading feminist discourse (e.g., the Twitter campaign #YesAllWomen in which women shared their stories about misogyny and violence against women in response to victim-blaming and the #NotAllMen movement).

The most recent paradigm shift in Canadian law concerning sexual consent is the switch from a "no means no" requirement to the overall requirement for affirmative consent. In 1992, the Criminal Code of Canada switched to affirmative consent language that places the onus on the initiator of a sexual interaction to gauge the consent of the other person rather than on the complainant to express his or her non-consent: "Conduct short of a voluntary agreement to engage in sexual activity does not constitute consent as a matter of law" (Criminal Code, 1992; Gotell, 2008; R. v. Ewanchuk, 1999). This shift, however, appears to be mostly symbolic, which may be due to the lack of fit between the requirements of affirmative consent behaviours and individuals' inclinations to employ and decode ambiguous nonverbal behaviours as indicators of consent. Despite the discrepancy between normative sexual interaction patterns and associated consent-related behaviours, on one hand, and regulatory requirements of consent (e.g. the Antioch Code, affirmative consent), on the other hand, some academics suggest that Canadian laws are some of the most progressive in terms of sexual assault (Dijk, Kesteren, & Smit, 2007). However, affirmative consent requirements appearing in rulings (R. v. Ewanchuk, 1999) have been inconsistent (Gotell, 2008). Many sexual assault trials are "infused by myths and stereotypes that continue to prevent legal recognition of unwanted sexual intrusions" (Gotell, 2008, p. 871), suggesting an information deficit in criminal proceedings. Further, although inability to consent due to drugs or alcohol is legally considered sexual assault, such incidents are rarely reported or prosecuted due to victim blaming and testimony that is considered unreliable (Testa & Livingston, 2009). A recent investigation by The Globe and Mail found that 1 in 5 sexual assault claims are dismissed by police as "unfounded" (Doolittle, 2017).

Other cases in Canada also exemplify the prevalence of rape myths, which may influence trial outcomes in favour of the accused (Smith & Skinner, 2017). In 2014, Alberta judge Robin Camp asked an alleged sexual assault victim why she "couldn't just keep [her] knees together" (R. v. Wager, 2014). Such instances suggest that the very concept of whether or not a sexual interaction is consensual escapes the authorities who are appointed to adjudicate cases of sexual non-consent. In a mock-trial setting, jurors who endorsed implicit rape myth acceptance more strongly believed that a sexual assault was credible when victims behaved according to perceived understandings of how a victim "should" act (Ellison & Munro, 2009). The degree to which the victim "matches" the victim stereotype (Peterson & Muehlenhard, 2011) appears to influence how the sexual assault is perceived by all involved parties, including the victim, the perpetrator, and those involved in trial proceedings. These sexual assault victim stereotypes include fighting back against the assailant, having serious injuries as a result of the sexual assault, reporting the assault immediately, and appearing distressed when reporting.

A number of universities in Canada and the U.S. have implemented sexual consent policies that require ongoing and affirmative consent to sexual interactions (e.g., Antioch College, 1996; Ryerson University, 2015; The University of Western Ontario, 2014), notably in response to the Legislative Assembly of Ontario's Bill 132 as applied to campus sexual assault (Bill 132, 2016) and parallel U.S. initiatives (The White House, 2014). Perhaps the most widely discussed sexual consent policy is the Antioch College Code, which provoked vitriolic backlash by students and the media (Antioch College, 1996). The Antioch code was written by students at Antioch College, Ohio, in 1990 and was based on communicative sexuality, which refers to intentional consent in which people verbally communicate their willingness to engage in sexual activity (Remick, 1992-93; Pineau, 1989). The Antioch policy is a list of rules that requires members of the campus community to verbally ask for permission to engage in sexual activity and to do so for every unfolding level of sexual activity.

In gauging attitudes towards the Antioch code, students at a Canadian university viewed these requirements as inconsistent and incompatible with the usual progression of their sexual activity and these requirements were seen to impair spontaneity and romance (Humphreys & Herold, 2003). Most students viewed sexual consent policy as important, but also stated that they would not endorse Antioch's policy on their own university campus. The researchers suggested that sexually experienced students may find a formal policy on sexual consent less appealing than sexually inexperienced students, given that this policy may not necessarily fit with their actual sexual script regarding negotiating sexual activity or inferring consent to it (Humphreys & Herold, 2003). Given the lack of fit between regulatory approaches to affirmative sexual consent and common patterns of sexual consent inferring practice, it would appear necessary for policies and interventions to address how individuals currently navigate sexual activity in efforts to shift sexual scripts to begin to incorporate clear and unambiguous affirmative sexual consent. The challenge, moreover, is to craft sexual consent practices that are not antagonistic to current sexual consent norms that necessarily convey actionable information about consent, strengthen personal and social motivation to enact consent behaviours, and coach behavioural skills development for implementing affirmative consent practices effectively.

CONCLUSIONS AND FUTURE DIRECTIONS

Despite the importance of clearly expressing and ascertaining sexual consent, the current review identifies a marked disconnect between how individuals actually engage in sexual interactions and required elements of affirmative sexual consent advanced by legal and regulatory bodies. Emerging affirmative sexual consent requirements that do not accord with or engage the lived experience of many are unlikely to be attended to, processed, and incorporated into individual sexual activity. Numerous information deficits, problematic consent heuristics, and naive theories have been identified (e.g., lack of resistance as consent, perceived "implicit" understanding of a partner's consent) that need to be addressed. Moreover, sexual assault prevention interventions and administrative and legislative efforts need to go beyond information-only sexual consent education to specifically target motivational and behavioural skills factors that will be essential for promoting change in sexual consent practices. Understanding the fit--or lack of fit--between the way individuals actually engage in sexual interactions and the regulatory requirements for sexual consent is useful in a number of ways. First, this understanding may increase our overall comprehension of how sexual consent is or is not expressed and interpreted, and capture the information, motivation, and behavioural skills obstacles that must be targeted for change. Second, our review of sexual consent enactments should assist intervention efforts to directly address and bridge the disconnect between the actual and the ideal in sexual consent. Sexual consent regulatory policy, educational programs, legislation, and legal decisions appear to fall short of their desired impact. This lack of efficacy could be due to the gap between these policies and programs and the way in which individuals engage in sexual interactions. Additionally, the lack of an overarching conceptualization of factors that drive or deter explicit sexual consent behaviours is problematic. Given well-justified societal concerns regarding sexual assault and sexual consent, regulatory bodies need to appropriately and effectively work towards encouraging behaviours that enact, seek, and respect sexual consent in interpersonal sexual scripts. In order to be effective, these policies need to accurately identify assets that can be mobilized to strengthen enactment of sexual consent behaviours and deficits that can be targeted for remediation.

Beres (2014) has argued that the shift "towards more explicit focus on consent is occurring in a context where there is little theoretical understanding of the concept of consent and little understanding of how the concept is understood in the populations targeted by such campaigns and educational programming" (p. 373). The 1MB model perspective (Fisher & Fisher, 1992; Fisher & Fisher, 1993) conceptualizes sexual consent behaviours in relation to the accurate or inaccurate information individuals have about sexual consent, their personal and social motivation to enact indirect or direct consent seeking and verification, and their sense of self-efficacy and objective skills in doing so. Such a perspective may be used in efforts to understand, predict, and promote sexual consent behaviours. Sexual assault prevention programming applying an 1MB model intervention approach would work to empirically specify information elements essential to sexual consent behaviours, motivational factors that incline or disincline an individual to engage in sexual consent-related actions, and the behavioural skills required for actively and effectively engaging in sexual consent behaviours. The current, indirect, inferential, and coded practices that are normatively used to ensure sexual consent are exceedingly problematic and a unified conceptual approach is needed to understand and change them. Applied to sexual consent, such theory could provide the basis for effective and empirically-supported sexual consent interventions that would work toward increasing individual consent behaviours that more closely align with regulatory requirements. In line with gendered-stereotypes and actual sex differences in consent behaviours, these interventions may target active participation of both partners to clearly communicate about sexual consent prior to sexual activity.

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Erin J. Shumlich (1) and William A. Fisher (1)

(1) Department of Psychology, Western University, London, ON

Correspondence concerning this article should be addressed to Erin J. Shumlich, Western University, Department of Psychology, 1151 Richmond Street, London, ON N6A3K7, Canada. E-mail: eshumlic@uwo.ca

Caption: Figure 1. An Information-Motivation-Behavioural Skills (1MB) model of affirmative sexual consent
Figure 2. Health behaviour sequence of sexual consent

Self-Acceptance of Sexuality
"I am sexually active"

Setting Personal Sexual Agenda
"I want sexual activity to be consensual"

Bringing Up, Negotiating Sexual Consent
"Can we talk ...?" Setting limits;
Discussing Consent

Consistent Sexual Consent Behaviours,
Self-Partner-Reinforcement
Consistent enactment of consent, feelings of relief,
expression of thanks

Shifting Sexual Consent Scripts

Incorporating sexual consent into sexual scripts
Engaging in consensual sex -Not engaging in non-consensual sex
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Author:Shumlich, Erin J.; Fisher, William A.
Publication:The Canadian Journal of Human Sexuality
Geographic Code:1CANA
Date:Dec 1, 2019
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