Let’s Talk About Consent

Teenage girl talking with mother.

A girl pinches a boy on the playground and we laugh and say that means she has a crush on him. A dispute arises between two adolescents and we ask them to “hug it out.” An old family friend insists on squeezing your child’s cheeks in greeting, and we brush off the complaints, explaining it is just a sign of affection.

Every time we discount a young person’s discomfort with the way others interact with their body, we send a message that they must submit to unwanted touches. As adults, we can instead teach our children the companion concepts of “consent” and “body autonomy” so that they understand they are in control of their body.

Teaching these concepts from an early age can empower young people and make them less likely to become victims of sexual harm and domestic violence; they are also more likely to tell a trusted adult about any abusive events that do happen to them, says Raenetta L. Liberty, RN, BSN, who serves as The University of Vermont Medical Center and Vermont State coordinator for the Forensic Nursing Program. The program provides sexual assault exams and domestic violence screenings to all Vermonters.

April is Sexual Assault Prevention Month, a welcome opportunity to underscore the need for open conversations about healthy and unhealthy touch, says Liberty. Sexual violence, defined by the Centers for Disease Control and Prevention (CDC) as “sexual activity when consent is not obtained or freely given,” is shockingly common. More than one in three women and one in four men have experienced sexual violence involving physical contact during their lifetimes. Nearly one in five women and one in 38 men have experienced completed or attempted rape, and one in 14 men was made to penetrate someone (completed or attempted) during his lifetime, according to the CDC.

The short-term side effects of sexual assault are pain, guilt, fear, shock and a feeling of isolation. Long-term effects can be health risks, PTSD, depression, pregnancy, sexually transmitted infection, HIV and suicide.

What Is Consent?

“We need to stress to our kids that consent applies to everyone, no matter their gender or orientation,” Liberty says. “And you need to ask permission for hugging, kissing ... anytime you’re touching somebody’s body in any way. I even do that now when I'm caring for a patient. I say, ‘Is it alright if I touch your arm to do a blood pressure check?’”

The ground rules of consent:

  • Consent is not the absence of a “no.”
  • It has to be an explicit and enthusiastic “yes.”
  • Permission can be withdrawn at any time, so the “yes” needs to be continuous.
  • Someone who is intoxicated is incapable of giving consent.

Liberty points out the very real dangers of “drug-facilitated sexual assault” and says that everyone must play a role in speaking up for those who are unable to protect themselves.

“Be that good bystander who says, "Hey, I don't think this is OK. I'm going to take this person home, and I'm going to make sure they’re safe.’"

Candid Conversations About Consent

As one of UVM Medical Center’s 15 specially trained, on-call Sexual Assault Nurse Examiners, Liberty provides patient-centered, trauma-informed care to an average of 150 to 200 women, men and children who have been sexually or physically assaulted each year.

“Where I feel we fail as health care providers, but also as parents, is in talking to our older teen and young adult children about what consent means and how it applies to them,” she says. “And if we’re going to improve, we’re going to have to normalize the conversation about what's healthy in sexual relationships and what’s potentially harmful or dangerous.”

If this makes parents feel queasy, Liberty advises, “It’s perfectly fine to be honest and say, ‘I’m not really comfortable talking about this, but I think it’s important that we talk about this.’”

To aid these conversations, Liberty recommends the following resources for caregivers, parents and their children:


Healthy relationships for young adults: www.loveisrespect.org


  • “Girls and Sex: Navigating the Complicated New Landscape,” by Peggy Orenstein
  • “Boys and Sex: Young Men on Hookups, Love, Porn, Consent, Navigating the New Masculinity,” by Peggy Orenstein
  • “Our Body, Ourselves,” by the Boston Women’s Health Book Collective (updated version)
  • “The Gender Identity Guide for Parents: Compassionate Advice to Help Your Child Be Their Most Authentic Self,” by Tavi Hawn

Discuss Unsafe Sexual Practices

Increasingly, Liberty and her team of forensic nurses are seeing strangulation in young adults who present in the Emergency Department. “The literature is showing this is because a lot of our youth – and I’m going to say primarily males – are learning about sex on pornography sites. I did a quick Google search and there are so many websites on choking for pleasure and how to choke your girlfriend so she doesn't pass out,” Liberty says. “I see young people come in and disclose that they were choked or they were strangled, and they'll often say, ‘It started out consensual, and then I got really scared because I couldn't breathe, but I couldn't stop the situation.’”

A patient who has been strangled may not show obvious signs of injury, but there could be delayed stroke and even fatality, Liberty says. She acknowledges specifics like this are not always easy to talk about. But she urges all parents to try.

“We teach our children not to touch fire,” she says. “We also need to teach them that sexual practices like strangulation are never OK.”

Where to Get Help

New York


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