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Legal definitions of sexual consent emphasise 'freedom' as central to valid consent; however, power inequalities may complicate freedom. This paper discusses findings from a two-stage focus group study with young people (aged 13–23) in England exploring the implications of power inequalities for sexual consent. In Stage 1, 77 participants explored and ranked the types of power inequalities they felt were common within young people's sexual relationships, with age, gender and popularity being identified as the most common power inequalities. In Stage 2, 43 participants discussed power inequalities using scenarios based on the Stage 1 findings and considered their implications for sexual consent. Thematic analysis of the data produced two themes: powerless and powerful roles in consent communication and power inequalities implicitly constrain freedom to consent. Consent communication was constructed as a unidirectional process whereby those with more power initiate, and those with less, gatekeep. Such roles require deconstruction to position consent as mutual and actively negotiated by partners. Further, since power inequalities were seen to place implicit constraints on freedom to consent, we advocate for an explicit exploration of power and privilege within Relationships and Sex Education to equip young people to recognise, challenge and negotiate these constraints. [ABSTRACT FROM AUTHOR]

Most research on capacity to consent to substance-involved sex has focused exclusively on the implications of alcohol with little attention given to other or additional psychoactive drugs. This study aimed to explore people's understanding and experiences of the capacity to consent to alcohol- and/or drug-involved sexual activity. UK adults (N = 354) completed an online mixed-methods survey on sexual consent during sober, alcohol- and/or drug-involved sex. Qualitative data were analyzed using thematic analysis. Themes for capacity to consent were: (1) "There is no normative understanding of substance-involved sexual consent," (2) "Moving beyond the binary of consciousness versus incapacitation" and (3) "Substance-involved sexual decisions are viewed as irresponsible." The findings illustrated that capacity to consent is nuanced and multidimensional, and that people's understandings and experiences of capacity to consent to substance-involved sex are not solely individual, but rather, they are also shaped by their environment. We call for a multidimensional view of capacity to consent, where a standard of "unimpaired," rather than sober, is used and modeled by academics, legislators, and educators. [ABSTRACT FROM AUTHOR]

In recent years, there has been an increase in women obtaining donor sperm via unregulated websites and social media. In this article, we bring together the disparate evidence in this emerging field to consider whether restrictive UK policies and practices for regulated clinical donor insemination (DI) are a potential explanation for the growing use of the currently unregulated, online route to donor insemination. To this end, we examine the nature of the National Institute for Health and Care Excellence (NICE) guidelines, recent data provided by the Human Fertilisation and Embryology Authority (HFEA), and prior research on who uses online sperm donation and their reasons for doing so. In addition, we highlight why this issue is important by outlining some of the benefits and drawbacks of the unregulated route. We argue that, whilst there are many factors driving the unregulated route to DI, restrictive UK policies and practices for regulated DI might be one of these. We conclude that turning our attention to structural barriers, such as regulated DI policies and practices, is necessary to produce more definitive evidence of this potential issue, and that adopting a Reproductive Justice framework could lead to more equitable provision of regulated DI services., Competing Interests: AP is the Chairman of the External Scientific Advisory Committee for Cryos (2020-2021). GJ is the Specialty Chief Editor for the Quality of Life section of Frontiers in Global Women's Health. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Taylor, Turner-Moore, Pacey and Jones.)

Background and Aims: The incidence of inflammatory bowel disease [IBD] diagnosed before adulthood is increasing worldwide. Transition from paediatric to adult health care requires certain skills. The aim of this study was to identify factors affecting these skills., Methods: This review was registered on the PROSPERO database [CRD42019152272]. Inclusion criteria were: 1] studies of factors affecting transition readiness skills in patients with IBD; 2] written in English; 3] published since 1999. MEDLINE, CINAHL, and PsychINFO databases were searched between 1999 and 2019. Quality was assessed using the Joanna Briggs Institute critical appraisal tools., Results: Searches identified 822 papers. Sixteen papers were included. Age was positively associated with skills including disease knowledge and performing self-management behaviours [14 studies]. Improvement often occurs at 18; however, skill deficiency may still remain. Increased self-efficacy [confidence] was associated with greater disease knowledge and performing self-management behaviours [three studies]. Self-efficacy was positively correlated with transition duration [two studies] and health-related quality of life [r = 0.57, p <0.001] [one study], negatively correlated with depression [r = -0.57, p <0.001] and anxiety [r = -0.23, p = 0.03] [one study], and was associated with higher education level [two studies] and a family history of IBD [one study]. Females had higher self-management scores [three studies], and greater health care satisfaction was significantly associated with higher knowledge [one study]. Greater transition communication improved knowledge, self-management, and overall transition readiness [two studies]., Conclusions: Potentially modifiable factors have been identified that could be supported in the transitioning IBD population, to improve transition readiness. Identification of those with non-modifiable characteristics associated with poor readiness may aid targeted support., (© The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Introduction: There is limited evaluation of clinical and theoretical claims that sexual thoughts of children and coercing others facilitate sexual offending. The nature of these thoughts (what they contain) also is unknown., Aim: To examine the relation between child or coercive sexual thoughts and sexual offending and to determine the nature of these thoughts and any differences among sexual offending (SO), non-sexual offending (NSO), and non-offending (NO) men., Methods: In a cross-sectional computerized survey, anonymous qualitative and quantitative self-reported sexual thought and experience data were collected from 279 adult volunteers composing equal numbers of SO, NSO, and NO men recruited from a medium-security UK prison and a community sample of 6,081 men., Main Outcome Measures: Computerized Interview for Sexual Thoughts and Computerized Inventory of Sexual Experiences., Results: Three analytical approaches found child sexual thoughts were related to sexual offending; sexual thoughts with coercive themes were not. Latent class analyses identified three types of child sexual thought (primarily differentiated by interpersonal context: the reporting of own emotions, emotions of others, or both) and four types of sexual thoughts of coercing others (chiefly discriminated by the other person's response: no emotional states reported, consent, non-consent, or mixed). Type of child sexual thought and participant group were not significantly related. Type of coercive sexual thought and group were marginally related; the consensual type was more common for the NO group and the non-consensual type was more common for the SO group than expected statistically., Conclusion: Child sexual thoughts are a risk factor for sexual offending and should be assessed by clinicians. In general, sexual thoughts with coercive themes are not a risk factor, although thought type could be important (ie, thoughts in which the other person expresses an enduring lack of consent). Exploring the dynamic risk factors associated with each type of child and coercive thought could lead to more targeted treatment., (Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)