Pornography and young people for healthcare providers

Pornography (porn) is much easier for young people to access these days, and is now a primary sex educator for young people. Find out what you need to know to be equipped to be part of the porn conversation with young people.

What do healthcare providers need to know about porn? 

Pornography refers to media such as sexually explicit images or videos primarily intended to sexually arouse the audience. The porn landscape for young people has changed dramatically over the past 5 years in terms of how much porn is available, ease of access, how frequently young people watch it and the type of porn that is considered normal. 

A 2019 content-analysis looking at 200 popular porn clips indicated that 35% of porn showed coercive behaviour and 46% had incestual themes. Aggression is almost always aimed at females, and they most often respond with pleasure.

Heterosexual and same sex porn show the same types of dominance, aggression and coercion. Only 2–3% of scenes show safe sex practices like condom use, and performers often have to play into racist stereotypes.

How common is exposure of young people to porn?

Children and young people nowadays have easy access to pornography due to the digital world they live in. Pornography is free, easy to access online without age restriction, and most young people have easy access to smartphones or devices.

They may accidentally come across it, seek it out or have friends who show it to them. 
Online filters and restricted access settings can block out some pornographic content, but this doesn’t provide complete protection.

Pornhub, one of the most popular porn sites today, has 115 million views each day and 42 billion views in 2019. There were more than 6 million new pornography videos uploaded in 2019.  

In New Zealand, children as young as 8 years old are exposed to pornography and have started to engage with it. In fact, research shows it has become a primary form of sexual education for young people.

In 2018, a New Zealand study found 75% of boys and 58% of girls had watched pornography and 25% of boys aged 17 years old watched regularly. 71% of young people in New Zealand have discovered pornography by accident and 25% of those who have watched pornography were exposed at 12 years or younger.

These studies show the number of young people who have access to pornography these days is more than we think.

How is porn impacting children and young people?

According to a recent survey done in New Zealand called 'Porn and young people – what do we know?', 94% of stakeholders, including youth health professionals, school staff, youth workers and whānau were concerned about pornography as an issue for young people. They observed changes in young people's sexual attitudes, beliefs and behaviours, which are believed to be influenced by the normalisation of pornography and high pornography usage among young people. 

The potential harms and impacts that pornography has brought to young people include:

  • incorrect sexual attitudes and beliefs
  • poor real life sex outcomes
  • poor mental health outcomes
  • inappropriate and sexually aggressive behaviours
  • compulsive pornography usage. 

Incorrect sexual attitudes and beliefs 

Studies have shown exposure to pornography can increase the risk of young people, regardless of their gender, viewing women as sexual objects and holding negative gender attitudes. 

Poor real-life sex outcomes 

Young people are less likely to enjoy intimate behaviours such as cuddling and kissing due to increased usage of pornography. They also found it difficult in the transition from pornography to real-life partners and to remain aroused during sex. High pornography use can also increase the risk of young people developing porn-induced sexual dysfunction, eg, erectile dysfunction. One study found 14% of adolescent boys had sexual abnormalities with moderate (less than once a week) pornography usage compared to 25% of them with weekly or more usage. 

Poor mental health outcomes 

High pornography use is associated with depressive symptoms, less social integration, decreased emotional connection with caregivers and higher levels of delinquent behaviour. Another study showed that 56–68% of young people believe that pornography has imposed pressure on girls and boys to look a certain way, and cause negative body image and physical inferiority. 

Inappropriate and sexually aggressive behaviours 

Young people tend to imitate sexual acts in pornography. A New Zealand study found that 1 in 3 boys who watched pornography wished to imitate what they saw in pornography and 36% of girls aged 17 years old had acted out something they had seen. Inappropriate or risky sexual behaviours were also seen with high pornography use, with less usage of condoms and increased number of casual sex and sexual partners.

Sexually aggressive behaviours such as forced sex, inter-partner sexual violence, sexual harassment and the perpetration of sexual coercion and abuse are strongly associated with regular pornography usage. Another literature review found people who have frequent pornography usage are 4 times more likely to be sexually aggressive.  

Compulsive pornography usage 

Young people and adolescents are most vulnerable to problematic porn use. Some young people describe an inability to stop watching pornography even when it's impacting their schoolwork, friendships, social life or partner. Their preference for the type of pornography also has changed with more frequent usage to increasing violent and extreme pornography in order to get aroused.

One study found 42% of teenagers would like to watch less pornography but find it hard not to. Another study found 53% of frequent pornography viewers 'think about sex almost all the time' whereas 10% of young people aged 12–13 years feared they were 'addicted' to pornography. The World Health Organisation International Classification of Diseases has now identified 'Compulsive Sexual Behaviour Disorder', which can include addictive pornography use. 

How can healthcare providers help young people with the effects of porn? 

Healthcare providers can help by encouraging and equipping young people to develop pornography literacy skills. This enables them to critically examine and identify the negative messages in pornography.

It is also crucial to help them differentiate between the messaging in pornography and real-life sexual experience in the aspects of consent, respect, emotional connection, safety and health to minimise the potential harm pornography can bring to young people. 

Use these tips to talk to young people about pornography:

  1. Get prepared – learn about the facts of pornography before talking to young people if you haven't spoken to young people about pornography before. 
  2. Prepare to be unshockable – use an open and non-judgmental approach when talking to young people about pornography. Try not to be surprised and avoid words like bad or wrong about what they are going to tell you. 
  3. Good rapport – build a good rapport with the young person you are talking to so that they feel safe and secure to talk to you. 
  4. Choose the right time, place and environment – find out where and how would young people like to talk about pornography. Some will prefer to talk one-on-one while some prefer to talk in a group. Sometimes, talking while doing an activity can be less intense or confrontational.
  5. Consider other things and issues – some young people are too embarrassed to talk about pornography due to negative experiences despite wanting to talk about it. Common pornography-related issues can include out-of-control use, preference for increasingly violent pornography themes, pressure from partner to act out something from pornography, pressure to send nude photos or to watch pornography, bad experience or traumatised by pornography due to prior history of sexual abuse.. 
  6. Get their opinion – ask how best you can keep the conversation going, eg, through text, face-to-face or phone calls.
  7. Offer help and support – offer help and support if you think they may need it, so they know they have been heard. 
  8. Thank them – thank them for being honest in such a hard and awkward conversation. Let them know you are always there to help and they are always welcome to talk to you about this topic. 

Examples of opening lines and questions you can ask during a conversation with a young person: 

  • "I heard that most young people are learning about sex through porn now. What do you think?”
  • “Are your friends talking about or watching porn? What do you think about porn?”
  • “I heard about research suggesting that watching porn can affect your sex life. What do you think?”
  • "What's the difference between porn sex and good real-life sex?"
  • "What kind of sex is porn teaching us?"
  • "Porn and body image – are porn bodies real?"
  • "Is porn realistic?"
  • "What's the impact of porn in the bedroom?"
  • "Look after your sex drive, you'll need it in the future."

If you are a parent, you may also find our tips to talk to your kids about pornography helpful. 

Support 

Below are some support services or helplines you can refer a young person to:

For more support services, visit The Light Project, NZ

Learn more

Here are some youth-friendly resources to help you have a conversation with young people about pornography:

Porn – the facts The Light Project, NZ
Great sex vs porn sex The Light Project, NZ
Can porn affect us? The Light Project, NZ

References

  1. Information for health professionals The Light Project, NZ  
  2. Porn Hub insights NZ, 2015  
  3. Pearson L, Powell M, Denholm N, Robertson J. Porn and young people – what do we know? NZ Youth Stakeholder Survey, The Light Project, 2018
  4. Office of Film and Literature Classification. (2018). NZ youth and porn: Research findings of a survey on how and why young New Zealanders view online pornography Wellington, NZ: Office of Film and Literature Classification. 
  5. Hooley EM. The relationship between transmission of sexual knowledge, sexual attitude, and culture Andrews University, 2017
  6. Lim MS, Agius PA, Carrotte ER, Vella AM, Hellard ME. Young Australians’ use of pornography and associations with sexual risk behaviours Australian and New Zealand Journal of Public Health. 2017 Aug;41(4):438-43.
  7. Peter J, Valkenburg PM. Processes underlying the effects of adolescents’ use of sexually explicit internet material: The role of perceived realism Communication Research. 2010 Jun;37(3):375-99.
  8. Owens EW, Behun RJ, Manning JC, Reid RC. The impact of Internet pornography on adolescents: A review of the research Sexual Addiction & Compulsivity. 2012 Jan 1;19(1-2):99-122.
  9. Bridges AJ, Wosnitzer R, Scharrer E, Sun C, Liberman R. Aggression and sexual behavior in best-selling pornography videos: A content analysis update Violence Against Women. 2010 Oct;16(10):1065-85.
  10. Gorman S, Monk-Turner E, Fish JN. Free adult Internet websites: how prevalent are degrading acts? Gender Issues. 2010 Dec 1;27(3-4):131-45.
  11. Wright PJ, Tokunaga RS, Kraus A. A meta-analysis of pornography consumption and actual acts of sexual aggression in general population studies Journal of Communication. 2015 Dec 29;66(1):183-205.
  12. Pizzol D, Bertoldo A, Foresta C. Adolescents and web porn: A new era of sexuality International Journal of Adolescent Medicine and Health. 2016 May 1;28(2):169-73.
  13. Doornwaard SM, van Den Eijnden RJ, Baams L, Vanwesenbeeck I, Ter Bogt TF. Lower psychological well-being and excessive sexual interest predict symptoms of compulsive use of sexually explicit Internet material among adolescent boys Journal of Youth and Adolescence. 2016 Jan 1;45(1):73-84.
  14. Parker, I. Young people, sex and relationships: The new norms Institute for Public Policy Research, UK, 2014.
  15. Van Oosten JM, Peter J, Boot I. Exploring associations between exposure to sexy online self-presentations and adolescents’ sexual attitudes and behavior Journal of Youth and Adolescence. 2015 May 1;44(5):1078-91.
  16. Stanley N, Barter C, Wood M, Aghtaie N, Larkins C, Lanau A, Överlien C. Pornography, sexual coercion and abuse and sexting in young people’s intimate relationships: a European study Journal of Interpersonal Violence. 2016 Mar 6:0886260516633204.
  17. Ybarra ML, Mitchell KJ, Hamburger M, Diener‐West M, Leaf PJ. X‐rated material and perpetration of sexually aggressive behavior among children and adolescents: Is there a link? Aggressive Behavior. 2011 Jan;37(1):1-8.
  18. Donevan M, Mattebo M. The relationship between frequent pornography consumption, behaviours, and sexual preoccupancy among male adolescents in Sweden Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives. 2017 Jun;12:82.
  19. National Society for the Prevention of Cruelty to Children. Always there when I need you: ChildLine review: What’s affected children in April 2014–March 2015.
  20. World Health Organization. (2018). International statistical classification of diseases and related health problems (11th Revision). Retrieved from https://icd.who.int/browse11/l-m/en
Credits: Health Navigator Editorial Team.