Pornography (porn) & young people for healthcare providers

Key points about pornography & young people

  • Young people are now facing a new online sexual world and, with high exposure and unlimited access to pornography, porn is influencing youth sexual culture in new and diverse ways.
  • Find out what you need to know to be equipped to provide effective porn conversations and care.
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‘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 10 years in terms of:

  • how much porn is available
  • the content in porn
  • ease of access across porn sites and mainstream social media platforms
  • how frequently young people engage with it.

Mainstream porn now contains an increasing amount of content with problematic messages around coercion, aggression, condom-use, gender, racism and diversity. A 2019 content-analysis looking at the 200 most popular porn videos watched by New Zealanders indicated that 35% showed coercive behaviour and 46% had incestual themes. Other research suggests that aggression is now normalised in porn and is almost always targeted at females, who frequently respond with pleasure, providing confusing messages to young viewers around sexual aggression and pleasure. Same sex porn contains similar themes to heterosexual porn including dominance, aggression and coercion.

In Aotearoa New Zealand young people report that porn is easier to find than avoid. Porn is now free, accessible online without any age verification, and most young people have easy and anonymous access through 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.

Porn is now available across unlimited free porn sites and accessible through most mainstream social media platforms. Pornhub, one of the most popular porn sites today, has approximately 130 million views each day and over 40 billion views per year.   

A recent New Zealand study indicated that 75% of boys and 58% of girls had seen porn and 25% of boys aged 17 years old watch it regularly. 71% of the young people first saw porn by accident and 25% were exposed at 12 years of age or younger.

There's now a body of research suggesting porn can shape some young people’s sexual expectations, attitudes and experiences of sexual relationships. Early and/or frequent exposure to sexually violent porn can impact on the following areas:

Gender attitudes and sexual expectations

  • Increase the likelihood of developing negative gender attitudes and viewing women and non-binary people as sex objects.
  • Shape sexual expectations, particularly when porn is viewed as a ‘realistic’ template for sex, gender, and bodies.
  • Be associated with casual attitudes towards consent, acceptance of rape myths, and/or an acceptance of sexual aggression in relationships.

Sexual attitudes and behaviours

  • Increase the likelihood of risky sexual behaviours such as choking, rough sex, condomless sex, group sex and rapid penetration.
  • Increase an acceptance of sexual violence towards women.
  • Increase the likelihood of aggressivecoercive or controlling behaviours, or forced sex.
  • Be associated with casual, confusing or blurred attitudes towards consent and aggression.

Mental health  

Porn use can be associated with some negative mental health experiences, including:

  • Feeling uncomfortable with something seen in porn.
  • Feelings of shame, distress, and anxiety related to usage, especially when porn is viewed as taboo.
  • Feeling triggered by porn, experiencing intrusive images, or being preoccupied with porn.
  • Negative body image, feelings of physical and sexual inferiority.
  • Struggling to cut down on viewing porn or Problematic Porn Usage (PPU) presenting as impaired control, real life impacts, narrowing of interests and risky use (despite harm to self or others).

Note: Mental health issues are complex and can be related to multiple factors, and in some cases, be exacerbated by the way a young person engages with porn and the beliefs they hold around porn.

Sexual health and wellbeing issues

  • Lower sexual health outcomes, such as decreased real-life sexual satisfaction or preference for porn over real-life sex.
  • Porn-associated sexual dysfunction, reliance on porn to become or remain aroused, and decreased intimate behaviours (such as kissing).
  • Relationship issues related to a partner’s porn usage, pressure to watch or re-enact porn, and/or struggling with porn-related expectations and performance.

Note: There are multiple other factors contributing to a young person’s sexual attitudes and behaviours and the likelihood of impact varies on factors such as usage patterns, content type, age, sexual experience, and if porn is viewed as a ‘realistic’ template for sex.

Young people tell us that they want and need better adult porn conversations, information and support. A healthcare provider's approach to porn conversations and care can significantly influence a young person’s willingness to discuss and seek help for any concerns.

Here are some tips on how to best approach any porn conversations or care

  • Reduce shame: Take a curious, questioning and non-judgmental approach. Avoid language such as ‘good/bad’ or ‘right/wrong’.
  • Listen well: Allow a young person to share their perspective and experiences. Use open questions that start with ‘what’ and ‘how’, and listen with empathy.
  • Prepare: Having knowledge around porn, and common porn-related youth issues, will help with any porn-related conversation or care. Common youth concerns include:
    • shame
    • body image and mental health issues
    • pressure to try something from porn
    • porn affecting relationships
    • being confused or triggered by something seen in porn
    • difficulty managing porn usage.
  • Take the lead: If you think a young person is experiencing any porn-related concerns, take the lead as many young people feel awkward or ashamed about raising the topic of porn – but this doesn't mean they don't need or want support. 
  • Tailor your approach: Each young person's experience with porn will be different so take into consideration factors such as their age, sexuality and gender, sexual experiences and knowledge, faith, culture and porn usage patterns.
  • Practice: Consider some professional face-to-face training with your organisation or team if you want to practice porn conversations in the workplace and increase your confidence.
  • Sexuality and gender diversity: Always model respect for diverse sexualities and genders as some Rainbow young people may be accessing porn as part of a ‘coming out’ process and may need support with this.
  • Reflect: Any personal, cultural, or faith-based views and experiences of porn can inform and impact on the way we engage with young people, so take time to reflect on these before any conversations.
  • Cultural safety: This should be a key consideration so, if appropriate, ask a young person to share what is culturally important to them, and how this should shape, inform and strengthen any porn conversations or care. 

Read more about understanding and navigating the issues of youth and porn.(external link)  

Examples of general questions you can ask during an initial conversation with a young person:  

  • A lot of young people come across porn these days – what are your views on it?
  • Some young people use porn to learn about sex – what do you think it teaches us about sex?
  • Do you think porn can influence our real-life sex (ideas, experiences)? In what ways?

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

After a conversation about pornography is underway, the focus can shift towards fostering critical thinking skills to help young people develop resilience to some of the problematic messages in porn.  

Taking an ‘ethical sexual citizenship’ approach is recommended which moves beyond the simplistic ‘good or bad’ porn dichotomy and draws on young people’s existing critical thinking. This approach involves using open-ended questions to explore themes in porn such as aggression, consent, power, gender and inequities from a personal ethical perspective. Through this, young people are encouraged to develop alternative ways of thinking, ultimately strengthening their own sense of ethical sexual agency.  

Here is a porn literacy tool(external link) for healthcare providers with question prompts to help young people build critical thinking and ethical sexual agency.

An increasing number of New Zealand young people are presenting at services seeking help for porn related concerns. The NZ Youth and Porn: Understanding and Navigating the Issues(external link) kit has been developed to equip healthcare providers with information, tools and strategies to integrate into workplace practice. The kit includes guiding principles, HEeADSS assessment, conversation tools, porn literacy frameworks, case studies and assessment tools and pathways for problematic porn usage.

Below are some support services, sites or helplines you can refer a young person with porn-related concerns to:

For more general youth support services, visit:

For more youth-friendly resources to help you have a conversation with young people about pornography:
In the Know(external link) 
Porn – the facts(external link) The Light Project, NZ
Can porn affect us?(external link) The Light Project, NZ
How to talk with young people about pornography(external link) Te Mana Whakaatu, NZ

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  2. Porn Hub insights(external link) NZ, 2015  
  3. Pearson L, Powell M, Denholm N, Robertson J. Porn and young people – what do we know?(external link) 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(external link) Wellington, NZ: Office of Film and Literature Classification. 
  5. Hooley EM. The relationship between transmission of sexual knowledge, sexual attitude, and culture(external link) Andrews University, 2017
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  12. Pizzol D, Bertoldo A, Foresta C. Adolescents and web porn: A new era of sexuality(external link) 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(external link) Journal of Youth and Adolescence. 2016 Jan 1;45(1):73-84.
  14. Parker, I. Young people, sex and relationships: The new norms(external link) Institute for Public Policy Research, UK, 2014.
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  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(external link) Journal of Interpersonal Violence. 2016 Mar 6:0886260516633204.
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  18. Donevan M, Mattebo M. The relationship between frequent pornography consumption, behaviours, and sexual preoccupancy among male adolescents in Sweden(external link) 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 link) 
  21. Vera-Gray F, McGlynn C, Kureshi I, et al. Sexual violence as a sexual script in mainstream online pornography(external link) Br J Criminol 2021;61(5)
  22. Fritz N, Malic V, Paul B, Zhou Y. A descriptive analysis of the types, targets, and relative frequency of aggression in mainstream pornography(external link) Archives of Sexual Behav 2020;49(8):3041-3053

Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Nikki Denholm, Director, The Light Project

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