Constructing a crisis: porn panics and public health

Who has the luxury to worry about porn's impact on health? And who has the power to define what is ‘healthy sexuality’?

Labelling porn a public health crisis has become the newest tactic for anti-porn activists seeking to curtail pornography distribution. Thus far, seven American states have declared pornography a public health crisis and four more have filed similar bills. Hearings on the matter were held in Canada, although the final decision was that the evidence was too contradictory to draw any conclusions. Lobbyists in Australia and the United Kingdom are asking their governments to investigate not so much whether there is a public health crisis, but to leap ahead and determine how to solve the crisis of pornography. Yet not one global health agency – the usual experts to identify and define the scope of a public health issue – supports their claims. Traditionally, the field of public health has concerned itself with disease prevention by addressing the systemic causes of pervasive health problems that impact either a significant majority of people (e.g. sanitation systems or childhood vaccinations) or the most marginalized segments of a population (e.g. HIV prevention or safe injection sites). Pornography consumption meets neither of these criteria. Why then has this debate occupied valuable government time and resources?

Treating pornography as a ‘public health crisis’ is a gross misallocation of priorities. We do not believe such claims are motivated by a desire to ensure the physical and social well-being of the populace. Rather, employing the language of ‘public health’, ostensibly apolitical and objective, is a well-devised strategy to impose sexually conservative moral imperatives. The fact that the public health argument is operationalized primarily by moral activists with a retrograde understanding of both health and media scholarship, not by public health professionals or people involved in the pornography industry, should be enough to give any person pause. Thus, the pieces in this special forum do not engage with the question ‘is porn a public health crisis’ so much as they critically reflect upon the catalysts and consequences of this particular turn to public health discourse by anti-porn groups.

It is our contention that framing pornography as a health issue is a privileged and politically motivated misdirection of public health resources. As such, we want to claim our own space here not to debate on their terms the data, definitions, and untested assumptions embedded in that frame. Rather, we regard this effort as an opportunity to diversify the limited narratives of pornography consumption that presently dominate. The call for specific types of ‘evidence’ grants us opportunity to conduct research that makes visible the experiences of sexual subjectivities which are so often silenced. Indeed, as Filippa Fox argues, the maintenance of the theory that pornography damages the public's health requires the wilful exclusion of the voices of sex workers. This denial that sex workers are in fact part of ‘the public’ has real and direct consequences on sex workers’ ability to access adequate and respectful healthcare, while health questions of actual relevance to sex workers’ lives go unanswered.

Cicely Marston demonstrates that much of the public health rhetoric about pornography begins from the assumption that a healthy sexuality is one that conforms to the social and cultural conventions of white, settler, heterosexual, middle-class, monogamous propriety. It also singles out pornography as a uniquely and exclusively negative form of media. Katie Newby and Anne Philpott present ways to think about how explicit sexual content could be ethically produced and incorporated into sexual health curricula, especially to discuss consent, safer sex, and distinguishing between visual fantasy and real-life sex. These efforts by public heath scholars to integrate critical media studies of sexuality into their research opens up an exciting new vista of academic collaboration long missing from the media effects models that have dominated public health and social psychology studies.

If porn is a public health crisis, then, what exactly are the health outcomes of watching too much pornography? That is the fundamental stumbling block of anti-porn advocates. David Ley, an American sex therapist, outlines a series of epistemological and methodological fallacies that are central to anti-porn claims about the health risks of porn. While the science of porn addiction and negative neurological effects is contentious at best, there is something well worth studying here: that is, the shift in political lobbying from claims of undiagnosable ‘harms’ to women and children, to insisting that young men are the unwilling victims of a runaway epidemic of pornography. Very little of the public health debates even acknowledges that porn may be consumed by young women, or that it has particular and distinct saliency for LGBTQ2IA+ youth. Indeed, as Madita Oeming points out, the conversation of porn's supposed harms revolves largely around the mainstream white, heterosexual, cisgendered male, a victim of his own limitless capacity for porn consumption. Diseases of over-consumption are quintessentially moral, not health crises. They require and invoke a class of passive and entitled consumers whose supposed well-being outweighs any public or occupational health programmes to support porn workers, a phenomenon Heather Berg unravels in her contribution to this forum.

To suggest that a conversation on the health effects of pornography is a privileged one is not to say that we do not welcome complex and even contentious academic debate on sexuality. Sexual norms and cultures are important for health outcomes and therefore require balanced, thoughtful discussion and consideration of the relationship of sexual media to sexual health. Indeed, critical media and cultural scholars have been engaged in this work for decades. Sophisticated qualitative methods for understanding how youth negotiate their media viewing and integrate it with their sexual becoming is easily accessible but still poorly integrated even by public health scholars who contest the anti-porn arguments. Research on sexting (Burkett 2015; Albury 2017), online communication (De Ridder and Van Bauwel 2013; Keller 2015; Naezer 2017), media sexualization (McRobbie 2008; Attwood 2010; McKee 2010; Smith 2010; Duits and van Zoonen 2011), and porn consumption (Attwood 2005; McKee 2007; Smith 2007; Paasonen et al. 2015) that assemble multifaceted analytical frameworks serves to locate pornography within a complex matrix of sexual media production, distribution, and consumption. Furthermore, it provides opportunities to integrate sexual media into debates on media literacy and digital citizenship as something other than a risky behaviour to avoid (Keller and Brown 2002; Jones and Mitchell 2016). Frameworks already exist to educate children and youth on healthy media usage, rights and responsibilities of social media engagement, critical meaning-making, and identity self-construction. As these issues spill over into sexual education curricula, it becomes more urgent that we talk about ethical production and consumption of sexual media. Yet educational, medical, religious, and other social systems (not to mention families) still revert to hand-wringing over media access rather than considering the wider economic, sociocultural, and historical contexts in which sexual media are embedded. Without these contexts, we cannot have important conversations about the realities of porn's pervasiveness in society – what Brian McNair calls ‘the pornosphere’ (2002, 35) – and how porn can contribute to broadening, rather than narrowing, the possibilities for safe and fulfilling sexual lives.

The appropriation of public health legislation by anti-porn advocates also illustrates the importance of public health ethics. Any interventions on private sexual practices must balance individual rights and security with the public good. It was a hard lesson learned in the early stages of the HIV/AIDS epidemic – a true public health crisis, but also one riddled with stigma and discrimination. As concern over the disease mounted, many health practitioners, decision-makers, and activists campaigning in the name of public health considered drastic violations of people's privacy and autonomy as necessary and justified. This included interventions such as mandatory testing, reporting, and quarantine, as well as the closure of community sexual spaces such as bathhouses (Herek 1999; Disman 2003). It continues today in the form of mandatory testing and reporting (Webber, Bartlett, and Brunger 2016), blood bans for men who have sex with men (Cascio and Yomtovian 2013; Arora 2017; Crath and Rangel 2017), and the criminalization of non-disclosure of one's HIV status to sexual partners (Mykhalovskiy 2011; O’Byrne, Bryan, and Woodyatt 2013). HIV is an interesting comparative case study to the current porn panic because it demonstrates how interventions ostensibly intended to protect the health of the ‘public’ deliberately privilege specific forms of sexual and relational practice. Public sexual health campaigns and policies based upon weak evidence are dangerous because they conflate moral judgment with health intervention, further ostracizing sexually non-normative populations while failing to result in any measurable improvements to public health.

As the example of HIV illustrates, it is imperative that public health always first and foremost considers the ethical implications of its own practice, in order to balance ‘the need to exercise power to ensure the health of populations and, at the same time, to avoid abuses of such power’ (Thomas et al. 2002, 1057). Public health ethics hinges upon defining the boundaries of the public/private divide. Sexuality, especially with regards to its relationship with pornography, tends to incite chaotic interpretations of ethics because of the many ways in which it brings ‘the public’ and ‘the private’ into complicated collision with one another. How the public/private divide is drawn – how the private is perceived to ooze out and corrupt the public – is an important factor in determining when and how the collective should be entitled to compel the individual towards ‘healthy’ decisions.

Tragically, the history of public health interventions on people's sexuality is rife with abuse: forced sterilizations, false mental health diagnoses, criminalization and incarceration, dangerous and untested therapeutic interventions, medical incompetence, and human rights violations. The examples are too long to exhaustively list, but some that stand out include the Puerto Rican birth control pill trials (1956), the Tuskegee syphilis experiments conducted on African American men (1932–1972), and the incarceration of ‘promiscuous’ women in Magdalene Laundries (which lasted until the 1990s in some countries). Abuses like these have disproportionately impacted racialized communities, sex workers, and sexually non-normative folks. The claims in favour of labelling porn a public health crisis promise nothing different.

Our reasons for drawing attention to dark chapters in the history of public regulation of sexuality is not to say that sex should be off-limits to public health officials and experts, but to insist that we learn from past errors and abuses. People of marginalized genders and sexualities who have historically encountered stigma and discrimination due to previous sexual health policies must be consulted and their experiences prioritized. In our own work, as a public health scholar and a media studies scholar, we seek out sex workers, LGBTQ2IA+, HIV+ people, and racialized groups unjustly labelled as ‘hypersexual’ as those who must be heard first and loudest (Webber 2017; Sullivan 2014; Sullivan and McKee 2015). They were all but absent in recent hearings in Canada, which had substantially more submissions from evangelical leaders and anti-porn organizations than they did from public health scientists or sexual health harm reduction agencies.

Health can be too easily portrayed as value-free and easily understood. Similarly, healthy sexuality is often narrowly defined to conform to heteronormative, middle-class, nuclear family-oriented ideals. When a public health debate that could potentially result in legislation begins from weak frameworks and over-simplified definitions, the consequences can be catastrophic. As Thomas et al. (2002, 1058) state, the fundamental ethical principle of public health is that ‘programs and policies should incorporate a variety of approaches that anticipate and respect diverse values, beliefs, and cultures in the community’. Porn is a factor of public sexual health, on that point we heartily concur. However, it is not necessarily intoxicating our youth or decaying social values. It is also sometimes a path to sexual self-discovery, a vehicle for safer and consensual sex practices, and a window into the spectrum of gender and sexual diversity. Thus, we can perhaps express some gratitude to those who began this debate – as deceptively as they did – so that we can begin to develop public health policies and programmes that support more expressive, diverse, and inclusive sexualities. The pieces in this forum are offered as a beginning of a new debate, thoughtfully framed and ethically accountable.

Disclosure statement

No potential conflict of interest was reported by the authors.