Whenever I teach my Human Sexual Diversity module, I always announce on the first day of class that we’ll be covering a wide range of sensitive topics and issues, including some of the darker sides of such as sexual , intimate partner violence, and (CSA). I convey to my students that we’ll be covering these and other important topics from both scientific and public health-related perspectives, and we’ll be applying what we learn to understand and improve our own lives and the lives of others. I note that often we’ll be discussing potentially personal and highly intimate topics in the classroom, and I lay out some ground rules for encouraging an open, honest, and respectful discussion of sexual diversity and sexual health.

So, that’s what might be called my “trigger warning” for my Human Sexual Diversity course, and I explicitly communicate this purposeful design to them on the first day of class (verbally and in the syllabus). I sometimes need to remind them of the discussion ground rules for the first few weeks, though to be honest getting them to openly discuss human sexuality at all is more of a problem than curtailing inappropriate or insensitive dialogue.

Is my explicit warning about potentially troubling content and consistent monitoring of student discussion in my course enough? Or should human sexuality instructors give continuous and ongoing trigger warnings throughout the semester, and further allow certain “personal exemptions” from required participation for particular students every single time a potentially offensive or upsetting topic is discussed?

I’m certainly not an expert on trigger warnings, but I can foresee that if I repeatedly warned/exempted students about one offensive or upsetting topic, ethically I would feel bound to do so for other equally dark, triggering parts of sexuality. Here is a partial list of topics that I cover in my Human Sexual Diversity course about which I might need to potentially warn/exempt students on a recurring basis:

Rape (personally offensive/upsetting to at least 10-25% of typical college students)

Child sexual abuse (personally offensive/upsetting to 5-20%)

(personally offensive/upsetting to 2-7%)

Physical intimate partner violence (personally offensive/upsetting to 10-25%)

Parents’ intimate partner violence (personally offensive/upsetting to 10-25%)

Parental and step-family issues (personally offensive/upsetting to 30-60%)

Abortion (personally offensive/upsetting to 50+%)

(personally offensive/upsetting to 7-15%)

Sexually transmitted infections (STIs; personally offensive/upsetting to 30-60%)

Sexual dysfunctions/disorders (personally offensive/upsetting to 14-90%)

/transgender & DSD issues as biological (personally offensive/upsetting to 1-3%)

as biological (personally offensive/upsetting to 100%)

Sex differences as biological (personally offensive/upsetting to 100%)

Religion and sexuality (personally offensive/upsetting to 50-90%)

Sex work and prostitution (personally offensive/upsetting to 1%)

and mate poaching (personally offensive/upsetting to 10-50%)

Obviously, being a sexual “victim” (whether of rape, abuse, violence, stalking, etc.) is different than having a sexual “ ” (transsexual, orientation, sex, etc.), or having a particular sexual “experience” (disease, disorder, infidelity), though as I try to teach my students victim/identity/experience issues blend together all the time in the sexual domain (e. ., sex work can include victimization, identity, and experience). And it is true that not all of these sex-related topics are equal in their potential to be personally offensive/upsetting or “triggering” overall, for either specific individuals or specific groups. Still, I wonder if privileging one group over all others is entirely justifiable. How much trigger warning is enough?

For me, I try to allow for a robust and rigorous discussion in my Human Sexual Diversity class (I’m not always successful, some semesters I find eliciting robust discussions is a genuine challenge). I wonder, though, if I continuously trigger warn by actively encouraging and advising students to leave the room every time a personally offensive/upsetting topic is about to come up in lecture or discussion (whether sexual aggression, CSA, abortion, infertility, STIs, sexual orientations, sex differences, whatever), my class would be a constant revolving door of students moving in and out of the room.

We talk about many of these topics nearly every day (not usually planned, but sensitive topics are often what students tend to be interested in and bring up themselves, and again I work to make sure the discussion is respectful, etc.). I can’t say for sure what is best for most instructors, but with respect to those who believe otherwise, it seems to me many of the “personal exemption” approaches to offensive/upsetting material seem entirely impractical for a dynamic course that allows for an honest, open, and respectful exchange of controversial ideas. You know, a university course.

Beyond offense and upset, though, there are many sexological topics that encompass experiences, and for some students confronting these topics while suffering from ( ) may not be advisable as doing so may lead to re-traumatizing effects. Even if not diagnosed with PTSD, some students may have PTSD-like symptoms that make them especially sensitive to and upset by discussing certain topics. Rape, for instance, is an acute traumatic experience for far too many college students (any more than none is far too many).

But it also is possible that past CSA, stalking, intimate partner violence, and many other sexological topics cover material that is equally distressing for certain students. Men, for instance, are more likely to report PTSD-type symptoms from CSA than rape (Vrana & Lauterbach, 1994). Women are more likely to have PTSD from stalking than (Basile et al., 2004). Abortion and parental divorce have been related to PTSD-type symptoms and are acutely on the minds of many college students. How are sexuality instructors to draw the line for some and not all potential PTSD-related topics? Are we currently ignoring the full spectrum of our students' sexually-traumatic experiences?

Especially concerning for me is that we do not have good evidence on why we should or shouldn't censor certain topics for certain students in human sexuality classes (i.e., studies of what is and is not verifiably “re-traumatizing” to discuss in class). Some claim there is evidence that avoiding a certain topic and stigmatizing it as unsafe to discuss for previously traumatized students does such students more harm than good (see here), a possibility one should be open to if not driven by political ideology or “vindictive protectiveness” (see here).

In 2018, for instance, a study found trigger warnings were harmful and inadvertently undermined some aspects of emotional . Trigger warnings increased peoples' perceived emotional vulnerability to trauma, increased peoples' belief that trauma survivors are vulnerable, and increased to written material perceived as harmful (Bellet et al., 2018).

In a follow-up, pre-registered replication focusing on the effects of trigger warnings on trauma survivors (including those who self-reported a PTSD diagnosis), Jones et al. (2019) concluded, "Trigger warnings are not helpful for trauma survivors. It is less clear whether trigger warnings are explicitly harmful. However, such knowledge is unnecessary to adjudicate whether to use trigger warnings – because trigger warnings are consistently unhelpful, there is no evidence-based reason to use them."

In 2019, another study across several negative topics concluded trigger warnings have "trivial effects—people reported similar levels of negative affect, intrusions, and avoidance regardless of whether they had received a trigger warning. Moreover, these patterns were similar among people with a history of trauma. These results suggest a trigger warning is neither meaningfully helpful nor harmful" (Sanson et al., 2019).

Harmful or negligible? It remains unclear. And we still need rigorous evidence for informed decisions about trigger warnings in human sexuality classrooms. In my view, we need to keep asking questions, not shut down debate about the real effects of trigger warnings in our classrooms as some have suggested (see Pigliucci, 2015).

I wonder whether many of our decisions regarding trigger warnings would meet our own in-class empirical standards for evidence-based knowledge and practice. Seeming to err on the side of caution may be, in fact, be erring on the side of actually harming our students. Not to mention the harm that trigger warnings might bring to effective pedagogy and faculty rights, especially the rights of our most vulnerable faculty (see here and here).

Practically speaking, I wonder when a student brings up a thoughtful sexological question about rape, CSA, or stalking during an open discussion, do we ask if other students want to leave first before everyone else talks about it, or do we tell the thoughtful questioner to close their mind as we simply don’t talk about such things on this day? With all the potentially trauma-related sexological topics in a discussion-based human sexual diversity class, how could trigger warning and personal exemption policies practically work? I don’t see how, at least from what I know so far. I look forward to learning more.

I’ve raised a lot of questions in this post, and I for failing to provide definitive answers to all of the questions. I don’t believe there is sufficient scientific evidence to answer most of them. We need to keep asking questions. In the end, regarding the key question of whether we need more trigger warnings or less, the American Association of University Professors thinks much less (as in pretty much none; see here).

Personally, I’m not sure, but I absolutely think it’s an important topic that merits more even-handed reflection and broad scholarly investigation by the academy (for an example of thoughtful discussion, see here). As Massimo Pigliucci (2015) notes “Best practice, then, means that we should reject the imposition of official policies about [trigger warnings], but also that faculty have a (moral, pedagogical) responsibility to conduct themselves in the classroom in a way that serves their students to the best of their abilities. And this may include occasional warnings for specific instances of potentially disturbing material. But bear in mind the conclusion of Gitlin’s essay… “Ye shall know the truth, and the truth shall make ye free” Not comfortable — free.”

Finally, I hope that more sexologists endeavor to address the topic of trigger warnings in human sexuality classes, in particular. I hope that sexological instructors think more clearly through the unfolding logic of their decisions (if we honestly believe trigger warnings are needed before certain lectures because the topic is so certain to be re-traumatizing, how do we practically manage open discussions of those same topics?). And I hope we employ trigger warnings (or not, depending on actual evidence) in ways that are fair, and not in any way harmful, to all of our students. For sexual diversity educators, there is much work to be done.

References

Basile, K. C., Arias, I., Desai, S., & Thompson, M. P. (2004). The differential association of intimate partner physical, sexual, psychological, and stalking violence and posttraumatic symptoms in a nationally representative sample of women. Journal of Traumatic Stress, 17, 413-421.

Bellet, B. W., Jones, P. J., & McNally, R. J. (2018). Trigger warning: Empirical evidence ahead. Journal of Behavior and Experimental , 61, 134-141.

Pigliucci, M. (2015). The false dichotomy of trigger warnings. Retrieved from https://scientiasalon.wordpress.com/2015/05/28/the-false-dichotomy-of-tr...

Sanson, M., Strange, D., & Garry, M. (2019). Trigger Warnings Are Trivially Helpful at Reducing Negative Affect, Intrusive Thoughts, and Avoidance. Clinical Psychological Science, 2167702619827018.

Vrana, S., & Lauterbach, D. (1994). Prevalence of traumatic events and post‐traumatic psychological symptoms in a nonclinical sample of college students. Journal of Traumatic Stress, 7, 289-302.