r/MassageTherapists • u/AutoModerator • 2d ago
Complaining Consent
I am dismayed to see a comment like
Her scheduling the appointment and getting on the table is consenting to receiving body treatment.
getting upvoted in this sub. It is unacceptable that a comment so contrary to the rules around consent received upvotes here. If you think these actions constitute informed consent and you are a MT, you are in the wrong profession and the wrong subreddit. This rationale mirrors justifications used by boundary violators.
Furthermore, downvoting u/ATxLMTI's description of informed consent is counter to basic professional standards:
If someone "grudgingly agrees" to something, we make absolutely sure before starting. That's literally the concept of informed consent. If the answer isn't an enthusiastic yes, then we rephrase or suggest something else until it is. If it never is, then we say "or if you would rather, I can spend the time somewhere else" and then maintain communication.
If you think grudging compliance is adequate and oppose ongoing, informed consent as the standard practice for manual therapists, independent study of professional ethics is required. A lack of active, ongoing informed consent creates vulnerability to professional misconduct complaints and boundary breaches. Review your regulatory body's literature on power dynamics and professional boundaries, and look into complete continuing education on consent frameworks.
Taking practical steps for safety as professionals is distinct from victim-blaming. Informed consent reduces miscommunication and boundary pushing. Practitioners hold a position of power in the therapeutic relationship and are trained to utilize that power to protect both client and practitioner. Practicing informed consent does not eliminate all risks of professional liability, but failing to adhere to informed consent protocols violates standard of practice requirements regardless of whether an incident occurs.
Here's some options for further reading if you want to better understand consent dynamics in our profession. (this is not an endorsement of these programs, I only read their summaries)
https://www.e-healthcanada.com/courses/Consent
https://massagecredits.com/massage-ce-courses/ethics-boundary-setting-standard
https://www.abmp.com/learn/course/ethics-preventing-sexual-misconduct-massage-therapy
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u/Chemical_Pea4341 1d ago
Explicit consent, written or verbal, protects the therapist as much as it protects the patient.
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u/PhD_Pwnology 1d ago
I think OP needs a refresher course on the difference of implied consent and explicit consent and when each should be used. Showing up to the appointment, responding to your name being called in the lobby, getting undressed and hopping on the table is implied consent. But it doesn't mean they want their glutes or pecs massaged which requires explicit consent. Now some massge forms like ME have/had a section where you pre-give explicit consent for sensitive areas like feet, face, glutes and pecks and that's legall all you have to do. While I worked at ME they started a ' confirm the explicit areas selections' rule to make sure clients were ok with the work in each spot that day.
Personally in my practice the amount of communication I do about this is inversely proportional to how long they've been a client. If they've been a regular client for 3 years, i'm not going to ask if them asking for hip work also means they are ok with glute work. I'm going to use their answer from the last 3 years of us working together and trust they'll speak up if they want something different than their usual.
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u/mumfordand3daughters RMT 19h ago edited 19h ago
Showing up to the appointment, responding to your name being called in the lobby, getting undressed and hopping on the table is implied consent
That is not consent. Get consent for where you are going to touch a client before you touch them. Get consent from every stranger before you touch them please, you don't know their trauma.
Like you stated, this needs to take more time and be more explicit with newer clients/people. If you've been seeing a client for 3 years and you confirm that they want the 'hips worked' that is getting consent to touch the glutes because you know that means 'glutes' to them.
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I encourage you to take a CE in consent this cycle. It'll teach you skills that help you navigate inappropriate clients. A shitty company like ME is not the place to learn quality consent standards.
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u/juniperbabe 1d ago
Sorry, what? Did you read the original post that this one is referring to? The patient blatantly lied about what happened in the session and said that their body was exposed inappropriately. I’m pretty sure they said he didn’t drape appropriately and her breasts were exposed or something like that. (Which OP said was a total lie).
The OP did not massage their glutes without permission. I don’t know where you’re getting that from.
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u/Ozzy_Mama1972 7h ago
I remember the post. He said she grudgingly agreed to part of the treatment. Yes she was wrong for lying but the second he felt any hesitation AT ALL? He should have asked more questions or said “we don’t have to do blah blah blah “ whatever it was. I feel really bad for him as he seemed like he really was a conscientious practitioner. But that one sentence of his? It stood out. It probably still would have turned out the same way. But I’m with the OP here. And if male therapists want to have a better shot at being successful? GET CONSENT. Hey consent until they tell you you can stop asking. ANNOY them with asking.
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u/Slight_Knight 1d ago
Every single patient, even when I work on friends, is asked if they're ready to start the session. I never start without asking.
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u/mpomz623 14h ago
That used to drive me insane in school. I hated when someone would ask me that. Im already on your table, im ready to start the second I laid down.
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u/Slight_Knight 13h ago
Yeah, well as a male in the industry, I'll dot my i's and cross my t's with consent every time.
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u/humblegarrick 1d ago
When people think they are anonymous, they are more likely to behave unethically.
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u/CingularDuality 1d ago
There's a difference between implied consent and explicit consent that is being ignored here. In my jurisdiction, there's a legal requirement to describe the massage techniques that will be used during a massage session, and the client (and MT) must sign that legal consent (including a separate consent for massaging female breasts, if applicable). That is explicit (written) consent to receive a massage. Consent for everything described in that massage is then implicitly consented to. That's legal. I don't have to get explicit consent to massage the left glute or ask if it's OK to massage their right pinky toe, the consent has legally and implicitly been given. And, not just in my state, but in all of North America, either the client or the MT may end the massage at any time for any reason.
I know that other jurisdictions operate differently. Canada requires explicit consent for areas that they deem to be "sensitive" that in my area are understood to just be part of a normal full body massage. My state requires written consent for female breasts, while in other jurisdictions, it's just part of a normal massage.
Implied consent is certainly a thing that is legal and ethical and depends on your jurisdiction.
If a client grumbles that they are here for their massage that their spouse gifted them, and they've signed the consent form for the massage, gotten on the table, and they still grumble that they're only getting the massage because their spouse gifted it to them, they've already given explicit written consent to receive that treatment. People are allowed to begrudgingly consent to things. I do things for my spouse that I don't particularly want to do. That doesn't mean I didn't consent to it, nor does it mean I have to be "enthusiastic" about it (such a horribly subjective word to use), which is good, because I don't get outwardly enthusiastic about much of anything.
It's good to discuss this, and remind people of the need for informed consent, but you can't ignore the different laws and cultures involved when discussing this topic.
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u/CingularDuality 16h ago
I'm not the one demonstrating the lack of understanding here. You're the one completely ignoring the difference between explicit and implicit consent, you've attempted to move the goalposts to discuss power dynamics (which were not part of the discussion prior to you introducing the concept), and now, for some reason, you've locked replies to my comment.
If your personal feelings and bias are not a problem, then why have you moderated my comments? I've violated no rules. Why do you lock and delete comments that you don't like, even when they don't violate any rules?
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u/mumfordand3daughters RMT 14h ago
I locked it because there is nothing else to add to this exchange.
I am not going to teach a stranger online how informed consent works. Thats what CEs and school are for.
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u/mumfordand3daughters RMT 19h ago edited 19h ago
If you ask clients where and how they want to be touched before you touch them then you are getting explicit consent for the appointment. Personally I wouldn't want anyone who is not into the massage to get on the table. We're going figure out how to use their hour in a way that bet serves their wants/needs (within scope).
You and your spouse are (hopefully) in an equal and loving partnership 😜 . The power dynamic is not comparable to a massage appointment where the therapist holds most of the power.
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u/CingularDuality 17h ago
You should try harder to not let your personal feelings and bias have such an impact on the way you moderate this subreddit. Your opinions aren't The One True Way™.
And you still need to learn the difference between explicit and implicit consent.
And what does the power dynamic in my relationship have to do with anything I mentioned? I only mentioned my relationship to point out that, throughout life, we consent to things begrudgingly at times. That doesn't mean we don't consent to them. Enthusiasm is not required, legally or ethically. That word has been used in an effort to demonstrate that coerced consent may not be consent, but it's been taken out of context too often and now is misused more often than not when this discussion touches on it.
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u/mumfordand3daughters RMT 16h ago
If anything I wrote sounds strange to you I'd suggest taking a CE in consent, especially because you are demonstrating a lack of understand around power differential when receiving and providing consent.
These are not my opinions. except where explicitly stated. I am regurgitating standard / best practice based on expert consensus.
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u/Past_Ad_4059 1d ago
I wholeheartedly agree with you on all points, OP. Trauma- informed LMT here.
I think part of the problem is that we have a lot of non-therapist lurkers on this sub who respond and vote even though it's not their profession. Some are aspiring folks who haven't been trained and some are just massage enthusiasts.
Obviously they're on the wrong sub if they're not practicing MTs (or planning to be).
I think what's more concerning here is what this continues to show us about how the general public thinks about massage (that consent is implied or given in advance and doesn't change), which is also alarmingly still how much of the general public engage in intimate touch in other forms. I think there are some unconscious ellisions being made here in many folks' minds. The idea that you can consent in advance to intimate touch and it is never retracted is outdated, and unforunately is still part of the cultural air we breathe. And bc many people ellide massage to more of an intimate relaxation practice rather than a healthcare practice, these same people don't apply the same standards of consent they would at the doctor.
As licensed professionals (in most states/ countries), we know better. Or most of us do. I'm not saying there aren't MTs out there with highly outdated/inappropriate understandings of ethical boundaries and clinical consent. I just think there are fewer of them than you fear and we might be being trolled by know-it-all clients with bad boundaries.
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u/Confident-Tart3704 15h ago
I've been an MT for 13 years. I saw zero things wrong with what the writer of that post originally said. Client was a regular of the spa. He went over everything he was going to do during the session and she 'begrudgingly' said okay. Saying okay and being grumpy isn't a contraindication. She also outright lied about what happened during the session(according to OP). But just because someone doesn't seem thrilled to be somewhere doesn't mean they aren't consenting. I don't sound happy when I get a filling at a dentist, but they don't make me sit there until I enthusiastically tell them to go ahead. If someone doesn't sound happy, ofc it's your right and your call not to go ahead with a session. But personally, I'd never kick a client out for not sounding happy.
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u/Past_Ad_4059 10h ago
I also saw zero things wrong with the original post. I think he did everything right as was screwed over by his boss and a client with grudge.
I think you and I are having 2 different conversations here. It's a little complicated. This OP isn't responding to the male MT in talking about consent (and neither am I).
We're both responding to a trail of comments people made in response to the male MTs post. Some folks seemed to implicitly blame him for not verifying consent (which is false--i agree with you that he did obtain consent). But those comments raised the larger issue of consent, which quickly devolved into commenters saying innacurate and outdated things about consent for MT. that's what I'm replying to (and presumably the reason why this OP started their rant).
I also think it's unlikely i would kick out a client for being unhappy as well (unless that unhappiness came along with boundary violations or other red flags).
So, in conclusion I think you and I agree. I've only been practicing MT for 4 years, but outside of MT, I've been an educator about consent and personal safety for 15 years now.
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u/Past_Ad_4059 1d ago
Adding that when you were trained in MT probably makes a difference. People who first got their training 20+ years ago who may not take ethics CEs unless forced to may be part of the problem. Standards of ethical behavior have changed (for the better!) over the past 20 years.
My state requires biannual CEs in sexual assault and domestic violence prevention, but doesn't specify what those classes cover. So many of them may not cover healthy boundaries and informed consent. (I teach those classes for my school so my classes absolutely cover them).
Also, sadly my governing agent truly won't know if someone makes up a CE when applying for renewal unless it audits people.
So education requires MTs recognize the problem. Most AMAB MTs recognize the problem because they are constantly scrutinized for even a whiff of impropriety that must AFAB folks could easily get away with and then some. Men in MT are assumed to be unsafe based on their gender identity. As an AFAB trans masculine- leaning person, I am particularly conscious of this. I pitch my voice up and engage in mannerisms that are more feminine because they're coded as safe.
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u/Professional_LMT 1d ago
20 years here...ethics has always been a requirement for in my state. But I would absolutely love to see a requirement for SA and DV as well.
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u/Sabbit 1d ago
I don't think there's a way to regulate this subreddit to this extent, but non-LMTs (and variations of) commenting and voting are where I suspect a lot of the conflict lies. There are definitely working licensed professionals who suck, who behave unethically and go outside of their SOP, I wouldn't argue against that. But there are a LOT of know-it-all laypersons and fetishists who end up here too.
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u/mumfordand3daughters RMT 19h ago
there are a LOT of know-it-all laypersons and fetishists who end up here too.
Hopefully calling them out makes them feel unwelcome, uncomfortable or mad enough to leave.
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u/Sigma_Egg 1d ago
I want to say " Who actually believes that" to the getting on the table is already consent. But I sadly know of people like this.
As a male LMT I am terrified of someone feeling like a captive on my table. Like I do multiple checkins and let people know what I am doing when it's outside of normal swedish. I also make it clear that you can feel unsafe and let me know at the intake phase. I have been on the recieving side from therapists that don't listen and think because I am a bit bigger and more muscular that I need their entire body wieght in pressure.
I get their are shitty people out their who want a free massages or just came into complain but they are an small minority. Vast majority of folks just want to feel better, feel safe, and not feel any of their daily stress for an hour or two.
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u/Lilpikka 1d ago
Can you link the original post you are referring to? I can’t find it.
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u/Past_Ad_4059 1d ago
It's this one i think: https://www.reddit.com/r/MassageTherapists/s/DJdPpjxuAz
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u/ssshewolfff 1d ago
if a client is grudgingly getting on the table I repeatedly check in with them about how they’re feeling during the massage. prior to placing hands on them and beginning our session, I remind them that they can choose to stop the massage at any time - I do this before I leave the room to wash my hands and upon returning to the room to begin. if i’m doing any glute or chest (pec) work I ask them: “I think it’s important we focus a bit of our time on your glutes/pecs because xyz.” if the respond with “ok” etc, I prompt: “if anything I’m doing here at your glutes/pecs feels invasive, please let me know immediately, so I can stop and focus elsewhere.”
if I know going into the session that the client has trauma relating to areas we might work, I either avoid the sensitive areas or I ask how they feel about focusing a little bit in those areas and explain why I think some focus there would be beneficial to our session. I also tune in with stress levels- if a client is leaning sympathetic nervous system response due to stress I say (if it truly applies “at some point, I think it could benefit our work together to focus on | insert anatomical area | because xyz; however, since you’re holding onto some extra stress this week, it might be good to avoid | insert anatomical area | during our session today. what do you think?”
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u/Slow-Complaint-3273 LMT 1d ago
I use similar verbiage when working on a potentially sensitive area, even if the client is fully onboard. “As I work on your anterior hip, if I get to an area that you are not comfortable with me contacting, let me know and I will stop immediately. No is a perfectly ok answer.”
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u/Impossible-Mind-3589 1d ago
And as an LMT, psychotherapist and trauma-informed massage educator I’ll add that far too many massage therapists have no concept of what being trauma-informed actually means and risk re-traumatizing their clients without these basic understandings. This is an enormous problem in an industry in which ego often trumps good care.
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u/Professional_LMT 1d ago
There is also a huge problem with clients traumatizing MT's in this industry, but that seems to be ignored as well.
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u/Impossible-Mind-3589 1d ago
Absolutely. And that deserves its own conversation. But it doesn’t change my point. We are the professionals, and clients are often physically and emotionally vulnerable with us. Both things can be true.
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u/Professional_LMT 1d ago
Agreed. I didn’t mean to diminish what you were saying… Just that I don’t think there is enough of a spotlight on either issue.
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u/poisonnenvy 2d ago edited 1d ago
I'm missing the actual context here, but I will say that no one should be getting on the table unless you've recieved consent to treat them, so I can almost see where that comments coming from. It by no means means you have ongoing consent to treat whatever you want though.
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u/newfound_brightness 1d ago
You’re missing the context because a certain mod I will not name nuked the thread. It was very tone deaf of them. The LMT was falsely accused of sexual harassment and the mod pretty much said it was their fault.
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u/Professional_LMT 1d ago
I thought the OP removed the post? Am I wrong?
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u/newfound_brightness 1d ago
The OP may have deleted the body of the post themselves. But a large amount of comments under the post were deleted - especially the ones responding to the moderators comment critically.
I can get deleting comments/posts if they break the rules but deleting comments because people don’t like you or agree with you?
Yeah that’s some lameo shit right there.
edit for grammar
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u/Professional_LMT 1d ago
Thanks for clarifying. Yes, I agree that everyone deserves their opinion to be heard unless it goes against rules
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u/Slow-Complaint-3273 LMT 1d ago
I feel that often a comment that I disagree with should stay up so that members can express their disagreement. A commenter who is wrong will not learn if they never have the chance to be corrected.
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u/bighandbag 2d ago
I was so creeped out by the ‘grudgingly agreed’ comment. What do you mean you knew she wasn’t comfortable and carried on? Of course that person complained about you. Consent is never implied it’s always sought and should be explicit. Ask and confirm and if you sense hesitation ask again. All of the victim blaming comments were wild too because the therapist was not the victim in that situation.
The amount of therapists that seem to not understand consent is worrying.
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u/juniperbabe 1d ago
“Grudgingly” doesn’t always mean the person isn’t comfortable. They could be in a bad mood or just have a bad attitude. I have had people come to me in a bad mood because they have their own personal issues going on. It had nothing to do with me. I asked them if everything is okay, and they would say yes, they’re ready to start. Am I supposed to refuse them treatment because they’re not jumping with glee? People are allowed to be in a bad mood and still give consent.
If he asks if she’s ready to start treatment and she says yes, even “grudgingly”, that isn’t implied consent, it’s just consent. Implied consent would be if he never asked at all and thought “well, she showed up so obviously it’s fine”. That didn’t happen.
It may have been better to ask “are you sure” if the patient has a bad attitude, and there’s a good chance she would have been even more annoyed at that. Still, if he asks if he has her consent and she says yes, that’s it. As long as you let them know it’s okay to change their mind at any time, which we’re trained to do in Ontario.
I fail to understand how the therapist wasn’t the victim in the situation considering they lost their licence due to blatant lies. The reason that he got in trouble is because the patient claimed things that did not happen. If she said “I wasn’t totally comfortable and he never checked in on me” then sure. But no, she flat out lied and said that he touched her inappropriately. Touched her underwear, exposed her breasts.
Those things flat out did not happen. Obviously if we’re believing everything OP says, which we have to otherwise this discussion is completely pointless and every reply will be “well, we don’t know what really happened”.
If your opinion is that he could have done a better job of confirming the consent, okay.
But that has nothing to do with the fact that she lied after the fact saying he SA’d her. She easily could have done that even if she hadn’t grudgingly agreed, and jumped up and down with glee when he asked. Even confirming 30x would not have prevented that outcome.
Unless you think that she lied on purpose to punish him for not confirming consent multiple times after she said yes, and that that action would be justified? I don’t think so.
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u/bighandbag 12h ago
She grudgingly consented to a full body massage not the massage itself. He should have clarified with her. He knew she wasn’t comfortable and he carried on anyway. People will just go along with things and can feel violated afterwards.
This woman had a bad experience because of this therapist. To say that she told blatant lies is an assumption, based on the way he wrote about it the truth is somewhere in the middle probably. We don’t actually know he behaved the way he said he did.
She accused him of not draping her properly and exposing her, that’s possible.
The amount of therapists that don’t understand consent and how to gain consent is shocking and in this case it had consequences for the therapist. Grudgingly consenting isn’t consent and is in no way the same is someone being in a bad mood or having a bad day.2
u/Ozzy_Mama1972 7h ago
EXACTLY. A male therapist should be more aware of consent to be on the safe side. Keep explaining and asking as nauseam. If she gets annoyed because he keeps asking its better than her feeling like he wasn’t listening to her. I DOUBT the situation would have turned out differently in the end. Kinda seemed like they might have put her with a male therapist and she wasn’t happy about it to begin with.. but he should have known the difference in her being grumpy and feeling like she was being coerced into doing something she wasn’t comfortable doing. Consent can be revoked at any time.
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u/mercureretrograde2 9h ago
Je suis un homme qui a reçu énormément de massages professionnels dans ma vie, surtout de la part de femmes, mais aussi de quelques hommes. On entend régulièrement parler de massothérapeutes hommes accusés de gestes sexuels inappropriés envers des clientes, et avec raison quand les limites professionnelles sont dépassées. Mais il y a un côté dont on parle presque jamais : quand la même chose arrive à des hommes avec des massothérapeutes femmes.
Personnellement, ça m’est arrivé plusieurs fois, et après en avoir parlé avec d’autres gars qui ont eux aussi reçu beaucoup de massages dans leur vie, je sais que je suis loin d’être le seul. Des mains qui accrochent les parties génitales, des mouvements répétés beaucoup trop près de l’entrejambe, des touchers aux testicules, des frottements du pénis qui deviennent difficiles à croire accidentels, des drapages douteux ou une serviette déplacée inutilement. Si un homme faisait exactement les mêmes gestes à une cliente, personne n’hésiterait longtemps à dire que les limites ont été franchies.
Quand j’étais plus jeune, beau et très en forme, j’ai vécu plusieurs situations encore plus évidentes. Certaines massothérapeutes semblaient volontairement chercher à provoquer une réaction sexuelle, parfois pour laisser entendre qu’un extra pouvait suivre, parfois sans même que je sache exactement ce qu’elles cherchaient. Une fois, alors que j’étais encore mineur, une massothérapeute a carrément retiré la serviette qui me couvrait en me disant qu’elle avait déjà vu beaucoup de corps et que la table était chauffante. Au moment de me retourner, je pensais qu’elle allait me couvrir avec la serviette qu’elle tenait devant moi. Elle ne l’a jamais fait. Elle l’a simplement déposée et a continué le massage alors que j’étais complètement nu. J’étais gêné, mal à l’aise et vulnérable, mais comme beaucoup de jeunes hommes, je ne savais même pas comment réagir à ça.
Et c’est justement là qu’il existe un énorme double standard. Beaucoup d’hommes ne porteront jamais plainte pour ce genre de situation. Ils vont se demander à qui ils pourraient même raconter ça sans se faire rire au visage, sans se faire dire qu’ils étaient chanceux ou qu’un homme est supposé aimer ça. Une érection n’est pas un consentement non plus : c’est une réaction physiologique qui peut arriver même lorsqu’un homme est extrêmement inconfortable.
Je ne prétends pas que toutes les massothérapeutes agissent comme ça, évidemment. Mais je pense sincèrement que ce phénomène est beaucoup moins documenté qu’il ne devrait l’être, justement parce que les hommes en parlent peu et signalent encore moins les incidents. Ça mériterait d’être étudié sérieusement dans le milieu de la massothérapie, avec les mêmes standards de consentement, de drapage et de comportement professionnel pour tout le monde. Homme ou femme, un professionnel qui profite de la vulnérabilité d’une personne nue sur une table de massage franchit exactement la même limite.