Is Pornography Creating a Public Health Crisis?

flying cadeuciiWell, it’s not Zika and it won’t kill you, but pornography is being discussed—seriously—as a public health problem, even a “crisis.”

The path to this claim is a long one, with a slow burn over many years.  It was kicked into higher gear in recent months with:(a) legislative action in one state;(b) a coverstory in TIME magazine (April 11 issue);(c) a Washington Post op-ed piece by anti-porn advocate Gail Dines; (d) a response to that in Atlantic Monthly; and (e) the publication of two books that discuss at length the effect of porn and the new sexual culture on teen girls—American Girls-Social Media and the Secret Lives of Teenagers by Mary Jo Sales and Girls & Sex-Navigating the Complicated New Landscape by Peggy Orenstein.

The legislative action took place in Utah.  The Republican-led House of Representatives in that state became the first legislative body in the nation to pass a resolution declaring pornography “a public health hazard leading to a broad spectrum of individual and public health impacts and societal harms.” Dines and her fellow anti-porn crusaders want to carry that fight to other states.

This is going to be fun to watch! (Pun intended.)

But is the allegation serious?  Is there any solid science suggesting porn is a public health problem, let alone a crisis?  Or is this just the latest sexual/cultural battle (a la sex education, abortion, LGTB rights) to emerge from our puritanical history, with social conservatives leading a mostly religious-based campaign to quash modernity, social progress, and personal freedoms of the fun kind.

Normally, I’d side pretty quickly with those dismissing the porn-public health connection.  But the above referenced articles, and especially the excellent TIME magazine piece, give one pause.There’s something going on here that’s not so easy to dismiss.

I won’t repeat stats from TIME or the other pieces or books.  You can read them or google all that.  We all know how ubiquitous porn is.  Gail Dines cites research indicating that porn sites get more visitors each month than Amazon, Netflix, and Twitter combined.   I believe it.  And millions of us are still a little astounded at….well, shall we just say the variety of human sexual expression you can see on the internet after just a couple clicks.

The central contentions in the porn-is-a-public-health-crisis movement are these:

  • Porn is disruptive to the “normal” sexual development of young teens (boys and girls) and feeds a pernicious and precocious hook-up/sexting/Tinder/Grindr culture.
  • Porn can be addictive, not purely in a physiological sense like heroin, crack, or opioids but psychologically and perhaps partially physiologically (via pleasure-inducing brain chemicals that get released when watching it).  Your brain on porn, so to speak.
  • Porn leads men to sexually harass, exploit, assault or rape women.
  • Porn is disruptive to marriage, mental health, and the establishment of healthy and stable sexual relationships as men (mostly) crave the intense sexual arousal it can generate, and then become unable to bond and perform sexually with women due to a sort of subtype of erectile dysfunction (ED).
  • Workers in the ever-expanding porn industry (which draws on professionals and “amateurs”) are at risk of STDs, abuse, and trauma.

I haven’t reviewed the literature on any of these issues. But the aforementioned articles (TIME and Atlantic Monthly), citing selected studies and experts, concur that the research is mixed.  That is, there are studies supporting and undermining each of the above contentions (which the notable exception of the last: porn industry workers are at higher risk of STDs).

The social/cultural debate over porn focuses primarily on studies linking it to misogynist and criminal behavior.  And recent surveys on sexual predation on college campuses are certainly disturbing—with 1 in 4 women reporting unwanted and uninvited physical sexual contact, actual assault, or rape.

But there’s no conclusive proof porn is a major trigger of such behavior, and you could argue that it might prevent aggressive acts by being an outlet for hormone-driven sexual desire (of the teenage and early 20s urgency kind).  Indeed, European studies strongly suggest as much.

It’s also worth noting in the context of the public health crisis thesis that as the hook-up/sexting/Tinder culture has spread, the incidence of teen pregnancy and STDs has actually declined.  Hmmm.  More careful useful of condoms?  Yes.  A wider variety of non-intercourse behavior, some of it learned from porn?  Quite possibly.

Medical researchers are primarily interested in the addiction hypothesis, and rightly so.  There’s undeniably something of interest going on there and we’re sure to see further research parsing how the human brain responds (perhaps uniquely) to porn.  Is there a “neural model” of porn dependency different from other kinds of psychological or physiological dependencies?  Possibly.

In the meantime, though, calling porn viewing (even a lot of it) an addiction is misleading.  That plays into the hands of anti-porn advocates and isn’t based, yet, on conclusive research.  It also risks stigmatizing millions of people—who are, of course, free to do with their time what they want.

That said, the genuine self-identified suffering of some men who view porn excessively (as in, hours every day) and get “hooked” on it—to the extent that it disrupts their relationships—deserves clinical attention.  That attention needs to come from doctors, psychologists and support groups.I spoke with two pediatricians and both said they agreed it was an issue they should speak with their teen patients about.  Couples also need also to face it forthrightly.

But excessive porn viewing does not, in my view, warrant the attention of an overly stretched and chronically underfunded public health system.  Not yet, and probably never.  Likewise, state actions such as those in Utah are unlikely to serve a useful public health (or any) purpose.

As quoted in TIME, clinical psychologist David J. Ley, author of The Myth of Sex Addiction, makes this common-sense observation: “The overwhelming majority of porn users report no ill effects.  A very, very small minority are reporting these concerns about ED.”

I would go further.  While the widespread viewing of porn raises legitimate issues that merit further research and public discussion, we would be remiss if we did acknowledge and study it’s positive impact as well.  Much internet porn is misogynist, but far from all. There’s lots of good well-filmed and sensitive porn out there that’s increasingly tailored tomainstream tastes.   They may be acting, but the participants in some porn I’ve seen sure look pretty lovingly into each other (sorry, pun intended again).

I also think it’s beyond argument that the advent of internet porn over the past 15 years has opened our eyes and imaginations to alternative sexual practices, ones that were taboo just a decade or two ago.   And some of those have now become mainstream, enriching the intimate lives of millions of people, including many an old fuddy-duddy married couple.

Historians and sociologists (the liberal ones anyway) have long observed that the U.S. has a history of sexual hang-ups.  Anyone who has spent time in Europe knows citizens in many EU countries are much more blasé about sex.  In contrast, we Americans have struggled with the whole subject, on many different levels, social and personal.  That’s now changing slowly, for the better.  Healthy sexuality (including homosexuality) is being increasingly embraced as an integral part of a meaningful and joyful life even into one’s senior years.

Porn is arguably a positive part of that change—albeit one that warrants continued scrutiny.

Steven Findlay is an independent journalist and editor who covers medicine and healthcare policy and technology.

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16 replies »

  1. Research has suggested that excessive consumption of pornography can be a contributing factor to erectile dysfunction (ED) in some individuals. Here are some ways in which pornography consumption can potentially trigger ED:

    Overstimulation: Viewing pornography can provide an intense and unrealistic level of sexual stimulation that can desensitize an individual to normal sexual cues and experiences. This can make it difficult for an individual to become aroused in real-life sexual situations, leading to erectile dysfunction.

    Addiction: Viewing pornography can lead to the development of addiction-like behaviors in some individuals. This can lead to a loss of control over pornography consumption, as well as a reduction in sexual desire and function.

    Psychological factors: Frequent and prolonged exposure to pornography can also lead to changes in an individual’s attitudes and beliefs about sex, relationships, and body image. These changes can lead to psychological factors such as anxiety, guilt, and shame, which can contribute to the development of ED.

    Performance anxiety: In some cases, viewing pornography can create unrealistic expectations for sexual performance and experience, leading to performance anxiety and ED.

    It is important to note that not all individuals who consume pornography will develop erectile dysfunction, and there are many other factors that can contribute to the development of ED, such as stress, anxiety, and physical health issues. However, it is important to be aware of the potential risks associated with excessive pornography consumption and to seek help if it is impacting your sexual health and wellbeing.
    I had to undergo treatment (gainswave therapy) to get rid of erectile dysfunction. And I am inclined to believe that I got this dysfunction because of frequent viewing of pornography

  2. Did you know that atching pornography may shrink the brain and dull responses to sexual stimulation, researchers have suggested.

    Scientists have found for the first time that regularly viewing sexual images could be physically harmful.

    Researchers from the Max Planck Institute in Berlin found that a part of the brain which activates when people feel motivated or rewarded, shrinks and works less efficiently.

  3. Crisis? Bless you all for whom pornography has not been a crisis. I wish I could say the same.

    Rather, for me I have struggled through nearly three decades battling this. And my negative behavior with porn has nearly derailed me several times. It nearly blew up my marriage and has stolen thousands of productive hours. And you debate whether this should be called an addiction? I grimace and ask you how this isn’t an addiction for millions of people like me who choose to view pornography instead of reading our kids bed time stories or snuggling with our spouses or solving big problems, or maintaining healthy sleeping patterns. We excessive porn consumers crave it. We need it and we will go to great lengths to get it. And some, if abstaining from porn will even have physical withdrawal symptoms just like other addictive substances.

    Ask my wife whether she thinks porn has been a good thing for society or even more relevant, how it has impacted our marriage and she will either cry you a river or rage in anger. She now suffers from severe migraines, depression, and anxiety and most of that is a consequence of the trauma she has not handled well that is related to me and my crappy behavior. This disease has destroyed countless lives all around me and why don’t we hear more about it? For decades those who suffered from this disease have consumed it in private rooms behind closed doors. If they were odd people who spoke about it as an addiction, they were given a label and discriminated against. Daddy’s dirty magazines were pushed under the bed and never talked about. And so, the disease perpetuated itself in the dark corners of society as its victims told themselves lies that, “Only one more time would not hurt” or “No one will ever know about this. It doesn’t hurt anyone else anyway” or “I will stop tomorrow.” With each failure, they lost credibility and resolve to fight against it and many have given in to this addiction in dramatic ways leading some to believe that porn is a gateway to much worse things.

    One more look is just like one more drink or one more drag or one more shot, and this disease for most will go on and on until its victims hit rock bottom and lose something big like a job, a spouse, or until their addiction becomes public. Most addicts need an outside intervention to wake up and change their behavior. Even then recovery is hard work. Such was my case when I hit my own rock bottom. For me that was the end of what I call the “year of tears” as I and my wife had cried and argued and fought to the point that we had almost destroyed our marriage. As a near last ditch effort, she forced me into a recovery program. I fought against her saying that I could overcome this alone. Like so many of my peers, I drug my feet. For 3 years I paid the therapy fees and I sat in 12-step groups with my “fellowship” and with every relapse my wife would ask me why I would go back to it. Why would I put at risk our marriage, my job and my future that in clear thinking moments I acknowledged that I did care about? My answer was crap but all I could make sense to say to her was that I couldn’t think straight in those addictive moments. My brain was foggy and filled with haze and in those addictive moments, I wasn’t thinking about all that mattered in life. Only after I got my ‘lust hit’ would I wake up and feel a sense of deep guilt, but even that stopped happening after a while as I became numb. Three years into recovery and I was still an addict. And who was I hurting? My wife was only sticking with me for the kids. My kids didn’t like me all that much and would rather that I wasn’t there. My employer didn’t know that I’d take breaks to sneak in some of my drug. My brain was only half there most of the time. And the women I lusted over who were in the porn were victims too and I was feeding an industry that was destroying lives.

    Still society acted then and still does act today as if this is okay. I can’t count the times I have listened to late night talk shows drop porn into their punch line as if it was the thing that all guys did. And the crowd laughed. Along the way I have watched plenty of documentaries that spotlight the porn stars after they retire. They tell the truth to this business. Many of them are on drugs or forced by the money to do things they do not want to do. The happy faces and tender moments are just an act. Well the tolerance for porn will either stop or the problems will persist and those problems will become more evident. I for one hope that we are at a turning point in which addicts like me will speak up and seek help. I hope for my two sons and two daughters that they can avoid this addiction at all cost.

    How do I measure the problem? In the US alone there are some 17 Million addicts as measured by the therapy association iitap.com focused on sex addiction. For me, I think of the more than 6,000 hours I spent over the last 30 years consuming porn. What is the opportunity cost of those hours? Enough to buy a whole lot of something real, something tangible or better yet to spend on things that have long term value like my wife, my children, my community.

    I remember a peer once sharing a newfound yet ironic insight. For so long he told himself that porn was free. He had never paid for it online but had consumed it for free for decades. But there he sat in a group therapy session that he was paying plenty for and as if the truth appeared in front of him at that moment he said, “What the hell am I saying? Porn isn’t free. Look at me. I am on my 3rd marriage. I never chose to have children. I have a crappy job and I sacrificed a real career because I was too consumed with this stuff.” Porn was not free for him or for me and its consequences are devastating. The truth: porn is not free. Its costs are very real for me and for society.

  4. Thanks for the comments. Dr. Palmer raises a question about fertility rates and porn. I can’t imagine that porn would be linked to increased or decreased rates. People like to have sex and procreate with or without porn. ? Again, porn has not been linked to an increase in STDs. Nor has it been linked to my knowledge to any mental illness, or increase or decrease any mental illness. With the exception of porn-related OCD, which my blog discusses. The piece and the articles it cites also discuss porn’s possible link to erectile dysfunction and sexual performance anxiety. The anti-porn folks have linked it to a host of “social problems” among young men and women and also marital problems among people of all ages. That’s in large part what the controversy is about.

    Thanks for commenting Cindy Gallop and letting folks know about your resources. I dare say many people will look at your site and conclude that it’s pretty much a porn site, too, with a cost attached….to view “real people” having “real sex.” But I appreciate that you’re trying to offer an alternative (for porn viewers and sexual exhibitionists) to the misogynist crap out there, and generally to all the professionally produced porn that presents an unreal version of what sex is for average people/the vast majority of us.

  5. Well, it might benefit the fertility rate and reduce single moms too, in which case it would be good.
    There are other things that might happen with lots of porn: a. more rapid spread of lethal STDs like HIV. Less or more total societal romance. More or less neurotic illnesses, suicide. more or less workplace success. And it could move capital expenditures around in society in ways that are good or bad.

  6. We are getting close to fertility rate = 2. The only concern I have with porn is 1. Do nations with lots of porn have a lower fertility rate?

    If this is true, it would make porn slowly suicidal, therefore really stupid and bad….unless you like societal extinction.

    Also 2. If porn increases the number of single moms, this would be bad, also, for survival and for juvenile deliquency, crime rates, etc.

    If both above are negative, porn seems irrelevant.

  7. Re-submitting my original comments of which only one line is published below.

    The issue isn’t porn, but that we don’t talk about sex in the real world. I’ve been tackling this issue for the past eight years, ever since I launched http://makelovenotporn.com/ with this talk at TED 2009: http://blog.ted.com/cindy_gallop_ma/

    This is a great summation from TechCrunch of what we are doing with MakeLoveNotPorn to help make it easier to talk about #realworldsex:


    and this is the Economist on us and why we’re doing what we’re doing:


    We fight a huge battle every day to build MakeLoveNotPorn:


    which is why it is so frustrating that the media loves shrieking and squawking about the impact of porn, but not so much covering people who are actually working hard to do something innovative and disruptive to counterbalance it – and that the tech and business world refuse to support technology that has the opportunity to not only do a lot of good but make a lot of money while doing it:


    Thank you for writing a balanced, sensible piece.

  8. Hello – I left a long reply here in the comments section as soon as my friend Jeanne Pinder drew my attention to this post, and for some reason you’ve only published one line of it? I’d like you to publish all of my comment? Please email cindy@makelovenotporn.com.

  9. My extraordinary friend Cindy Gallop is On It.

    She’s pro-sex, pro-porn and pro-knowing the difference. She’s also built an extraordinary business at https://makelovenotporn.tv/ — against crazy odds. (Her site might be NSFW, depending on your office policies.)

    Want to know more? Here’s her unforgettable Ted Talk.

    Cindy rocks!

  10. Snark-challenged, much? Should we issue an Amber Alert for your sense of humor?

  11. This post is completely out of synch with what we know about the ways that technology is driving consumer behaviors and transforming attitudes. At a time when psychologists are diagnosing device addiction, societal disconnection and we are seeing powerful changes in behavior patterns, your argument seems strangely myopic. I’m sure there are positives that can be found if you look hard enough but that surely misses the point ..

  12. The issue isn’t porn, but that we don’t talk about sex in the real world.

  13. Thank you for a very balanced and sensible piece, Steven. The issue isn’t porn, it’s that we don’t talk about sex in the real world. We’ve been tackling this issue for the past 8 years at http://makelovenotporn.com/, ever since I launched MakeLoveNotPorn – ‘Pro-sex. Pro-porn. Pro-knowing the difference.’ – at TED 2009 with this talk:


    We’re building a new category on the internet, social sex, to help make it easier for everyone to talk about sex, both publicly and privately:


    This is the Economist on us and why we’re doing what we’re doing:


    yet my team and I fight a huge battle every day to build MLNP without business support and funding:


    Everyone loves shrieking about this issue, but not supporting those of us actually doing something positive to solve it – the solution is Don’t Block Porn, Disrupt It:


    and, more broadly, supporting and funding sextech:


    More detail on everything we’re doing at our blog: https://talkabout.makelovenotporn.tv/

  14. Pssst… nobody tell the LDS Marriott Hotel Chain mgmt. They’re making too much bank with those in-room “adult entertainment” movies.