Last week saw the publication of a paper Multi-person Sex among a Sample of Adolescent Female Urban Health Clinic Patients in the Journal of Urban Health (sadly not open access). This tackled the issue of young people having Multiple Sexual Partners (MSPs) and in particular raised concerns over coercive sexual practices.

Predictably the media reported on this story with scary headlines like:
Teen girls who engage in group sex are often coerced, study says – NY Daily
Group sex is the latest ‘trend’ for teenage girls, disturbing report reveals – Daily Mail (The research excited upset the Mail so much they ran coverage of it twice)
Teens as young as 14 engaging in group sex, study finds – ABC News
‘Sexting’ is related to teen group sex trend, says study – New Jersey News Room (the study doesn’t say this at all, in fact recent research suggests the phenomena of teen ‘sexting’ is over exaggerated).

While we sadly are used to the mainstream media sensationalising sex research (particularly on young people), other sex blogs and medical news outlets covering this study have been equally remiss at reading the original research and critiquing it. Which is depressing.

So let’s do the job the mainstream media should have done. Let’s critically appraise the research and see if we do need to worry about MSPs and young people.

First, a quick disclaimer. Researching young people’s sexual experiences is important. Such work should focus on their needs, report faithfully any adverse issues they may be at risk from, and take their mental and physical wellbeing seriously. Research on teens should always involve young people at all levels and avoid being a top-down process where adults define teenagers’ experiences. In critiquing this research I am not suggesting young people are not experiencing problems within their relationships. I am also not saying the researchers were anything other than well intentioned.

Strengths of the research
The paper’s plus points are that it tackles a topical issue. While group sex among young people is (as this paper acknowledges) pretty unusual, it is something that has gained media interest over the past few years. So trying to collect any data about this phenomenon is important to reassure and also to direct sex education and public health programmes. The researchers seem to have developed the study over time, basing the survey they used on a series of in-depth qualitative interviews. The paper does acknowledge early on that multiple sexual partner experiences may be consensual and non consensual (more on this in a bit).

Sampling and sample size
Participants were recruited from a youth sexual health clinic. This is not unreasonable at all. It’s an excellent place to find out about young people’s sexual health. But it does mean those going there may be in need of help or support so might not be representative of teens generally.

The authors acknowledge this but I suspect that fact will pass a lot of journalists by when they report this. Media focus, I imagine, will be on all teens, rather than a subset of teens.

The paper tells us researchers were aware of 1224 female clients at the youth clinics, with 747 identified suitable for the study. Why the other clients attending the clinic weren’t suitable for the study is not explained. That, I think, is a problem. Information about participants who were unsuitable for the study, or who refused to participate (and why) should have been clarified just to help us interpret this data. I’m surprised reviewers didn’t ask for it to be included in the demographics table as is standard practice. Of the 747 clients identified, 495 (65%) agreed to take part. A 65% response rate on a sensitive topic is not a problem, but it does reduce the number of people responding further, which in turn affects how representative the sample is.

It is not declared whether the participants were Cis or Trans Women. This would have been helpful to disclose.

Table 1 in the paper provides details of 328 participants. I’m unsure if these were the final sample that was used in the study/analysis. Regardless of all this we learn right at the end of the paper only 24 of those who completed the survey had had a Multiple Sexual Partner experience. And of those, their analysis indicates, 35% said the experience was consensual.

Does this represent a major new trend in youth behaviour?
No. The paper reports of the patients attending the youth clinic very few of them had experienced non consensual group sex. It does not mean we should not be very concerned about these young people or others like them. But it does mean journalists covering this story should put this into context. The study is not showing a major trend in teen girls being forced to have group sex. It is saying non consensual group sexual activity among teens does not seem to happen often, but when it does it is highly distressing and increases the risk of psychological and physical ill health.

My worry is the media coverage of this will not read the original paper and will suggest there is an outbreak of teen sex parties happening regularly, that young girls are forced to participate in. The study did not find this and nor has it identified a major public health problem. But I doubt that will be made clear. This in turn will worry parents, mislead teachers and healthcare professionals, and probably lead to slut shaming of young women (as this kind of coverage invariably does). All the while ignoring the role of boys at best, or presenting them as gang rapists at worst. None of which is directly helpful to the needs of young people.

Problems with phrasing and terminology
The paper seems to use terms like ‘sex parties’, ‘multiple sexual partners’ and ‘gang rape’ interchangeably in places. This is confusing for the reader but I imagine also for participants in the study. This is recognised as a limitation later in the paper where the authors talk about participants who’ve experienced gang rape not necessarily seeing what they experienced as a multiple sexual partner act.

The focus of the study appears to be on heterosexual teens, although this is not really clarified.

The age range of 14-20 is important as this is a wide age range in terms of young people. While some 14 year olds may be mature and some 20 year olds immature, in general the needs and experiences of those who are in the younger age group in this study will be very different from older participants. Any of these participants could be exploited, abuse has no age barrier. However, older teens/young adults may well be better able to consensually engage in sexual behaviours younger teens cannot. This was not explored in enough detail in this paper.

The main drawback with the study, to me, is the question used to identify if participants had engaged in Multiple Partner Sex. It asked:
“Have you ever had sex (vaginal, oral, or anal) with more than one person at the same time or with more than one person at the same place? (This might be called group sex, a threesome, an orgy, or pulling a train).”
The paper doesn’t clearly explain how participants were invited to answer this question, although does suggest it was via a yes/no response (or similar). Imagine I said ‘yes’ to this question. What am I saying ‘yes’ to? That I had vaginal, oral or anal sex? The wording of this question means there’s no way of differentiating between participants who had all of these experiences and those who had one of them.

There is also no way of identifying how often participants had engaged in these various activities and whether they experienced them positively or negatively. It could be completely possible for a participant to have experienced oral sex positively but vaginal sex negatively (or vice versa). But the question phrasing does not allow for this to be explored. It also doesn’t allow participants to indicate if they were giving or receiving these sexual activities (or both).

Once you get past this confusion participants are still being asked about these sexual activities AND whether they’ve done them with more than one person. How do you answer if you’ve engaged in said activities but with only one person? The question doesn’t allow for this.

Participants could also easily be confused by a question that doesn’t make clear if the mention of ‘sex’ here refers to penetrative sex (and if so is it via a penis, finger or sex toy) or oral sex. That is important as we know from sex research unless you are very specific about what you’re asking about you’ve no real idea what participants are reporting.

The question is also confusing a group sex act (i.e. having sex with more than one person at a time) with multiple partner sex over a period of time (i.e. sleeping with more than one person in a day, evening etc). In fact this becomes more confusing as these behaviours are asked as if they’re the same thing but with no time period specified. Most of us who’ve had more than one partner could easily answer ‘yes’ to the question, assuming you have been intimate with different partners on different occasions in your home.

Deconstructing this question may seem like nit picking but in fact is very important when we are designing surveys. Unless our questions are meticulously phrased we have no real idea what participants are responding to. This in turn makes a difference to the conclusions and recommendations we can make.

Elsewhere in the paper the researchers conflate group sex and an orgy (which usually involves several people) with a threesome. They also don’t clarify who might be participating in these activities. The assumption seems to be that it’s a girl and all boys. But it could well be all girls or a mix of girls and boys.

Does ‘pornography’ and ‘sexually explicit’ mean the same thing?
Participants were also asked
“Many people come into contact with pornographic, x rated, or other sexually explicit material. How many times in the past 30 days have you viewed pornographic, x rated, or other sexually explicit material?”

This is an interesting but again problematic question. What do the researchers mean by ‘pornographic’ or ‘sexually explicit material’? Are they the same thing? Are they including explicit mainstream media such as music videos or magazine articles talking about sexual positions? That could be considered sexually explicit but not necessarily pornographic. Is this a particularly accessible question to ask a young person? Asking how often they’ve viewed such material also isn’t clear. Do they mean how often someone has watched pornography/sexually explicit material and masturbated? Simply seen it in passing? Or perhaps laughed at it with friends (as is very common among teens)? Was it watched alone or with a partner? What did it feature?

This information IS important because the researchers did find an association with multiple sexual partners and reported porn use, but it isn’t clear what relationship the young women in the study really had with porn. In order to better educate women about issues around porn we need to know more about what they are watching and how they feel about it. It is worth noting if participants said anything other than ‘no times’ they classed this as having viewed porn. So that means someone might have seen porn once in passing and be categorised in the same way as someone who viewed porn regularly and was aroused by it and someone who was forced to watch porn occasionally but against their will.

Another question asked
“Has anyone ever insisted (without using force or threats) that you do sexual things they saw in pornographic or x-rated magazines, websites, or movies when you did not want to?”

This is not an unreasonable question, but it is not necessarily something that’s easy for a teen woman to answer. For example they may well have been coerced to do something they did not want to do, but unless they asked the person coercing them if they had seen this in porn they would not necessarily know for sure this was the case. They may have a good instinct they were being asked to perform something inspired by pornography, but they wouldn’t know for sure – and would not be in any position to ask if they felt threatened.

Given the age of participants it may be someone did coerce them to do something they didn’t like but had not got the idea for this from porn. They may have got the idea from a sex tips feature in mainstream magazines like Cosmopolitan or Men’s Health, or from their peers, or from a TV show. Much of the mainstream media talks about anal sex, threesomes, oral sex etc so this could have just as easily informed the coercive behaviour.

I would have liked to see more focus on the nature of the coercive behaviour, why participants felt this was linked to porn, and if it wasn’t linked to porn where they felt the driving force behind the coercion came from. I say this not to dispute porn may play a part, but to identify exactly what is driving coercive behaviour as if it’s features in mainstream magazines or peer pressure we need to tackle this just as urgently as any perceived threat from porn.

The focus here seems to present young women’s relationship with porn as something that is done to them by young men. Young men are presented as the consumers of porn and use it to get ideas to coerce young women into doing things they don’t want. This does not explore where young women may like or dislike porn, or young men having a critical view of porn. It does not include young people who have little or no exposure to porn. It presents young women as passive, as victims. And as heterosexual. This is often taken up by the media who use debates on sexualisation or pornification to demonise or ignore young men and victimise and slut shame young women. In both cases we find it becomes a situation where adults (either academics, medics or journalists) speak for young people.

Multiple Sexual Partners – a problem in itself?
In their reporting of the results the authors say:
“While there may be a subset of girls who initiate or make self-actualized decisions about MPS participation during adolescence, it is important to consider whether social norms that encourage hypersexuality may contribute to expectations about sexual activity that make it very challenging for adolescents to resist engaging in MPS, even though they would not perceive their MPS participation as nonconsensual. The strong association between exposure to pornography, having been forced to do things that their sex partner saw in pornography, and MPS suggests that pornography may have influenced directly the sexual experiences of the girls in this sample, as has been found elsewhere. Importantly, even if participation in MPS is voluntary for some adolescents, it is crucial to know how this early experience shapes their sexual behavior trajectory and affects their lifetime risk for negative sexual, reproductive, and other health risk behaviors”.

This statement concerned me for three reasons. Firstly it suggests a kind of false consciousness idea that no young woman could ever really consent to a MSP experience. This is disingenuous to the participants in this study who stated they had willingly enjoyed a MSP. I suspect it betrays more of the researchers own values about MSPs.

Secondly it implies that even if a young woman does consent to a MSP this will be because pornography has informed her choice. Yet we know from the way they asked about porn they don’t really have strong enough data to make this conclusion. It would have been interesting to explore if mainstream media might have influenced their choice as well, but not to have decided for participants that they didn’t really know their own minds.

Thirdly there is the implication that having a MSP as a young person will inevitably lead to problems in future relationships. That seems like a leap beyond the data and also I suspect unfair to those who consensually, as adults, explore non monogamous relationships. Moreover we know many people who never have MSPs as young people (or adults) have problems in their relationships as adults. So to make this claim really requires more than a small sample of 24 participants who were asked some confusing questions. The researchers do say this ought to be followed up in future research and I don’t disagree there, but I hope they would be less judgemental and aware of sexual diversity in doing so.

Where are the experiences of young men?
There is no focus on young men in this paper and I think any study that is tackling coercion in heterosexual youth (as this paper appears to be doing) really needs to also study young men. The assumption is they are coercing young women, but are young men also feeling coerced in relationships? Is the pressure of masculinity leading to risky sexual behaviours or are they acting respectfully with their partners? Are the experiences of young gay or bi men different from their heterosexual peers? How do young men feel about being portrayed as sexually coercive? Are there issues around communication and consent we need to focus on with young men and women – and how should we be addressing this issue?

I worry media coverage will report this as though young men have been included or present young men as predators, when again the number of participants reporting negative experiences from forced group sex or pornography was low.

Should this paper have been published?
I critically appraised this paper, but does not mean I think it should be ignored. Had I been asked to review it for publication I would have asked for major revisions (based on the comments above). I find many Public Health studies on youth sexual behaviour (and sexual behaviour in adults) are well intentioned but often problematic due to heteronormative approaches. In this case this can be seen with the focus on heterosexual activity and underlying subtext that group sexual activity is never truly consensual and non monogamous relationships are not presented positively. This can alienate or pathologize many people inadvertently, while trying to help another group of people. A better awareness of thinking around diverse sexualities would help ensure generalisations about group sex among consenting adults are not pathologised while trying to tackle gang rape of teens.

I hope coverage of this will be responsible but fear it will not. I suspect it will be further used to demonise young people and worry the public. In turn ignoring the fact most young people are not engaging in group sex or coercive behaviour. In fact that most aren’t having sex at all. They may well have questions and worries about sex, but these may not be addressed while we focus on more sensational topics.

Creating a moral panic in which we shout a lot about the behaviour of young people but do very little to actually help them. And in cases where research is poor or ambiguous it may direct our efforts to help young people in the wrong direction.

There’s been a substantial amount of media attention today for a survey by BBC Radio One’s Newsbeat and the Portman Clinic. Suggesting porn ‘use’ among men is endemic and in many cases problematic.

It’s led to a slew of scary headlines including:

Men view two hours of porn a week – The Sun
Young men worried about the amount of porn they watch – Mirror
Men ‘worried’ about heavy online porn use

What did this survey cover?
This survey heard from 1057 18-24 year old women and men (no information available about how many males and females made up the final sample). They completed an online survey via TNS Market Research Company between March 18-21 2011. It asked about their porn consumption and attitudes to porn and relationships.

What were the main findings?
8/10 men and 1/3 women had looked at porn online
The most popular place to access porn was free websites
The ‘average’ man in study (no figures given for this) looks at porn for 2 hours a week, the average woman around 15 minutes
4% of male respondents ‘used’ adult sites for more than 10 hours per week – these were reported as having a ‘problematic and potentially compulsive’ condition
¼ men said they were worried about the amount of time spent looking at porn
¼ men said they were worried about the content of porn
61% of respondents (gender unspecified) said porn could make you less interested in sex with a partner

Should we be concerned about these findings? Not until we’ve looked more closely at this survey.

Problems with the survey
It is not clear exactly how participants were recruited/heard about this research. Market Research Company TNS administered the online survey but it’s unclear who responded, the characteristics of those who didn’t respond, and how representative of the wider population respondents were. The survey was only run over a three day period which is not unusual in commercial online surveys, but doesn’t always allow for generating reliable data – particularly about sensitive issues.

The full list of survey questions have not been made publicly available. Without these you can’t work out what people were asked. Whether questions were leading, potentially distressing, counteracted/contradicted each other, were confusing or didn’t match the final data reported.

I’ve spoken to nine journalists from different broadcast outlets about this survey over the past two days. All have called me for comment about the survey. All have taken it at face value. None had seen the original survey questions. None had asked to see them either.

This isn’t something unique to this Radio One survey however. Most commercial and academic surveys don’t make their original survey questions available when press releasing their work. It remains a problem as you cannot make any judgements about how useful a survey is without seeing what people were asked. This survey may have been amazingly well designed, carefully piloted, developed and run. Or it may not have been so stringently managed. The problem is without making both the methodology behind the research and the survey questions public it is impossible to know whether to trust in the data or not.

One question was reported in the Radio One report of the study. It asked ‘How have you ever looked at porn?’ It then gave respondents the choice of magazines, DVDs, TV, Free and Pay websites, mobile phones and file sharing.

The problem with questions phrased like this is they may look sensible at first glance, but actually are highly problematic and potentially meaningless.

If we take ‘ever looked at’ first, what does that mean? Ever looked at as in sat down, watched a lot and masturbated yourself stupid? Or ever looked at as in was shown by some mates for a laugh, or ever looked at as in accidentally found when looking for something else online or on TV?

‘Ever looked at’ seems to be taken here to mean regular porn use, or at least some porn use. Whereas it doesn’t tell us anything about the context people are viewing porn – or the amount. I may have ‘ever looked at’ porn once ten years ago and never again. But this survey would put me in the same category as someone whose ‘ever looked at’ definition included looking at porn several times a week over months or years.

The lack of clarity in the question also doesn’t explain whether people are looking at porn alone, with a partner, when single or a relationship. Nor address whether their porn ‘use’ is consistent over time or varies depending on their relationship status or other life events.

Also what does ‘porn’ mean in this survey question? Is it an erotic scene in a movie shown on mainstream TV? Tuning into Babestation? Reading Nuts, Zoo or Cosmo? Visiting YouPorn? This survey asked respondents to state the format in which they access porn, but they are not asked to explain what they mean by porn. That means we’ve no idea what it is they’re looking at.

This is a classic problem in poor survey design. That terms used aren’t operationalised. Meaning neither the respondents or the researchers actually have any idea what it is they’re asking about, or what the data means when it comes back.

‘Heavy’ porn use was described in this survey report as 10 hours or more. But it is not clear how this was decided upon as a measure of ‘heavy’ use.

¼ male participants stated they were worried about the amount of time they spent looking at porn. But since we don’t know what they were asked we can’t tell if this was based on a leading question, or whether they would have said they were worried if not prompted. It doesn’t tell us what exactly they were worried about (i.e. did they think they were spending too much time in general online, or had a specific concern re porn use).

¼ respondents also said they were worried about what they were looking at, but we can’t tell from this whether this meant they’d already stopped looking at the problematic porn. ‘Worried’ by content doesn’t tell us whether they had issues over the wellbeing of actors in porn; a person’s sexual prowess in comparison to what they were viewing; or whether their gender, sexuality or relationship was being challenged by the things that they found a turn on. In short we may know a fair number of participants expressed concern, but we’ve no real clue about the source or magnitude of that worry.

Usually with media surveys of this kind the standard approach is back of the envelope question design, based around a predetermined angle that’s being picked to generate publicity. Radio One aren’t unique in this approach (although they do have form for running similarly questionable sex surveys in the past). It is likely this current survey is more about generating publicity for Radio One and Newsbeat than really addressing issues about our relationship with sexually explicit materials. It seems the main purpose of the survey was both to inform a report for Newsbeat and draw attention to said programme.

Unusually this research has teamed a media outlet (Radio One) with clinicians from an NHS trust. Specifically practitioners from the Portman and Tavistock NHS Trust who apparently designed the survey.

This raises more complex issues than just the usual shoddy media approach to surveys. If NHS staff are involved in research they ought to be grounding this within a critical appraisal of the published evidence in this area. They also ought to ensure they employ research tools correctly (in this case completing a quality survey, piloting and reviewing it – or better still basing it on an existing measure). And if they’re doing the work on NHS staff or patients or in their role as an NHS clinician then it ought to be subject to ethical approval.

Not all health research is subject to peer review, but usually if a survey is going to be made public – either through publication in a journal or through a report launch or similar – then you would expect a thorough peer review of the work before it hit the headlines. Peer review here could have helped spot potential problems in both survey design and delivery, and ensure the relevant background literature (of which there is a lot in this area) had been carefully consulted. It would also have guarded against making claims that go beyond the data.

This may have happened in the case of this survey but that information has not been made transparent. If that is the case it is a pity since it doesn’t put the research in context nor show it in a good light. If these checks and balances hadn’t been put in place again transparency might help us assess whether this work is reliable or not.

Given the example of the questions asked of participants along with conclusions drawn it does raise serious questions about the quality of the survey. Along with the ethics of using such a tool to draw clinical conclusions – as has happened around the diagnosing of those with ‘heavy’ porn use.

Journalists I spoke with about this survey felt the inclusion of medics in the survey meant it was more trustworthy. One said to me that because a doctor had designed the survey it had to be good. As someone who’s been teaching medics internationally how to evaluated, design and use surveys in health research for the past fifteen years; I can confidently report most are pretty dreadful at this craft. Indeed, as with any other social research skill it takes time to learn how to create a quality questionnaire. Without disrespecting the skills of the medics in this survey, you cannot conclude because a doctor helped put the survey together that it’s automatically accurate.

There are in fact many people actively studying pornography – some of whom can be found here. All of whom Radio One could have teamed up with had they genuinely wanted to explore our relationship with porn. This IS an important area that is worth studying and is currently hampered by a lot of poorly conducted academic studies, mostly based on undergraduate student samples. So we need to have more quality work conducted and there are plenty of people Radio One should have involved. The fact that some of the leading names in this area weren’t even mentioned or consulted points to either a lack of awareness of the subject area. Or deliberately avoiding to engage with those who may not be fitting with a predetermined porn/shock angle. Radio One should have been clearer about why did they pick this particular team from the Portman to collaborate with? Were there any agendas there? Certainly given the worries over medicalising our sexual behaviour one might argue it could be in a clinic’s interest to set up a figure of ¼ men being anxious about porn use. After all if you’ve identified a problem you are in a very good position to offer a cure.

Finally there’s no real context about why Radio One thought this was a major area worth studying. Given it’s a youth channel it could have easily picked up on numerous other social issues – poverty, employment, education, university fees. Or if they wanted to be sex campaigners to perhaps look at the issue around how sex education is haphazardly (and often poorly) delivered in schools. Are all young people really worried about online porn, or are there other things directly affecting their lives that may be more relevant (but perhaps less publicity generating?).

Despite all the percentages shown in this report and warnings about ‘heavy’ porn use there seems to be no take home message for people about what this means. If you suspect, after reading about/hearing Newsbeat’s survey, that you have a ‘problem’ – what should you do? If you have questions about porn, where could you ask them? In this case the audience are given some dire warnings but no referrals to sources of help or advice. Which again makes the overall purpose of this research unclear.

I may be being very disingenuous about the researchers from the Portman. But it worries me that their relationship with this research has not been fully declared. No doubt they acted with good intentions, and obviously drew upon their experiences as psychotherapists (one author has written about internet porn and psychoanalysis). But it is concerning that journalists covering this story didn’t think to ask more about who was doing the research, and what their motivations might have been.

Which brings us on to…

Problems with media coverage
I’ve already mentioned how the journalists I’ve talked to hadn’t seen the survey nor saw this as important. What was more worrying was the unquestioning pickup of this story. Journalists weren’t asking what was asked in the survey, of whom and why. What they were doing was accepting the figures from the survey – particularly the amount of time men were spending looking at porn, and how they were worried about porn use.

They were then using this as a jumping off point for other discussions. For example to talk about porn addiction, how pornography use could change men’s brains, what women felt about men who used porn. As a psychologist they wanted me to come and talk about neurological changes from porn use, and as a female psychologist they wanted an insight ‘as a woman’ to talk about how all women felt about their men’s porn use (more on this later).

What journalists didn’t want, was me talking about this survey from the perspective of someone who teaches survey design. They didn’t want the survey critiqued because their editor/producer had already fixed it as their angle. Indeed they’d already accepted it as ‘true’. Most worryingly those from the BBC seemed least keen to critique the research. One researcher calling from BBC Radio 5Live Drive Time confirmed they didn’t want to question the survey because it was done by Radio One – and as such they couldn’t challenge the output from a sister station.

It really does beg the question what is going on with the BBC College of Journalism that such problematic research can be put together to begin with – and how it can continually be endorsed even when flaws are being pointed out. (Sadly I’ve tried previously to help the BBC College of Journalism to think more critically about sex research but have got nowhere. I have alerted them to the current Radio One survey and uncritical coverage on twitter today. Let’s hope they decide to take this further) .

This case has been a useful example in seeing how journalists lack the understanding to critique research, but also the practical reasons they’re unable to do so. Moreover it gives us an ….

Insight into journalists views of sex/pornography
If you look at the press coverage of this survey (alongside reflecting on the discussions I had with journalists today) some very definite patterns of how journalists/the media see sex/relationships and porn.

The view from medialand is as follows:

Who looks at porn? Well, it’s men. They are all straight and the porn they are seeking out is also heterosexual. Women are constructed as having problems/concerns about pornography – but only in relation to their (male) partner’s use of it. ‘Pornography’ as a term is used to mean one genre from one format (the internet). Looking at mainstream porn in moderation is okay, but if you do it often then it becomes a problem. Quite often described in the medicalised language of addiction.

Men are naturally sexual and so can’t help liking porn, but if they do look at it they’ll become abusers or change their neurological makeup or sexual behaviour. Women don’t like porn, those who do are presented as being in a minority, probably deluded, or liking romantic/couples-based/equality-based/feminist porn. Porn within relationships is only permissible if it’s to spice things up (or encourage reluctant wives to get in the mood). LGBT folk aren’t even thought about.

Alongside this is a widespread acceptance that porn influences sexual behaviour (i.e. shaving pubic hair, trying anal sex, different positions etc). There is no insight from journalists or often the public that these issues all have – and continue to be – widely covered in mainstream media, not just porn.

If you’re starting from this as your standard position it makes thinking critically about pornography difficult. It means journalists will be tasked (or choose) to find evidence to stack up this world view. It also means it’s risky to find other ways to think about/explore porn for fear of being seen to endorse it.

Why is coverage of porn research so poor?
Coverage within the media tends to be poor because journalists are always on tight deadlines, lack skills to evaluate both research and critically reflect on their own assumptions about ‘normal’ sex. Finding experts who can talk clearly on the topic or searching through evidence is often difficult. And not helped when the standard way to approach this issue is in a false debate format where you have to find a pro and anti porn person in the mistaken belief there are clearly defined ‘sides’ in this area.

The pressure from editors to fit particular (and usually sex negative) agendas leaves little autonomy for journalists to tackle problems they may spot with research. Freelancers in particular may struggle as if they don’t write what the editor wants they won’t get a commission. Staffers may struggle with bullying if they don’t deliver an angle to deadline.

Journalists are not impartial. Many lack basic sex education or have particularly sex negative views. It is threatening for them to have this questioned – especially when on deadline. And if something seems intuitive then it won’t be questioned. Indeed if you try you’re more likely to be seen as a crank. Or unhelpful.

Part of our problem is there is a lack of funding to really investigate porn use in sensitive and open ways. Where quality research is undertaken in this area it’s often more nuanced and doesn’t lend itself well to scary headlines and battle of the sexes style debates. This means quick and dirty studies get completed and hit the headlines far more readily, and inform public opinion more often. That can be dangerous and misleading, particularly when behaviours that may not be a problem become medicalised.

What can be done about this issue?
Offer better training for journalists to understand surveys and other social methods. You might find these guidance papers I’ve written on the topic helpful:
Administering, analysing and reporting your questionnaire
Selecting, designing and developing your questionnaire

Reaching beyond the white middle classes

Make editors and broadcasters more accountable – challenging them when they run poor research or give bad science uncritical coverage.

Require media outlets that create surveys need to be completely transparent about the work they’ve done (as we equally should with academic researchers).

Encourage the public to engage in discussing and critiquing sex research from media outlets via social media. Today we saw two things happen. The media lost the news, while the public via social media (particularly on twitter) got to the bottom of a problematic story and had a much more interesting time doing it than if they’d relied on old media coverage alone.

This year seems to have just flown by, and what a busy one it was for research and stories about sex. From philandering footballers to STI statistics we certainly got to hear a lot about relationships.

Here are some of the main stories I think made up the year in media, sex and science.

The year began with the launch of the Home Office’s report on Sexualisation of Young People a problematic review which received lots of media coverage but very little critical attention from the press. It sadly overshadowed a far more detailed and useful similar report that came out just beforehand on Sexualised Goods, Commissioned by the Scottish Parliament. (You can find discussions critiquing the Home Office review here and here with a history of sexualisation reviews from other countries and open access tools to evaluate them here)

January was also noteworthy for being the month all our G spots went missing. Who knew?

Did you know Facebook caused syphilis? No, well nor did I until in March the press went crazy for the ‘Facebook linked to a rise in syphilis’ story. This was based on some opinions from a public health practitioner who should have known better, but who press released speculations about sexual health and social media. Cue plenty of irresponsible media coverage.

It provided an opportunity for sex educators to challenge these claims and also to promote health advice about syphilis, STIs and safer sex. Worryingly many sexual health charities and public health organisations failed to engage with the story in a timely fashion, completely missing the opportunity to share information with the public. An account of how this story unfolded, the heroes and villains of the piece can be found here.

The BBC produced a groundbreaking and sensitive drama ‘Five Daughters’ in April, based on the tragic story of five women from Ipswich who were victims of a serial killer in 2006. It retold the stories of Anneli Alderton, Paula Clennell, Gemma Adams, Tania Nicol and Annette Nicholls, plus the role of the police and support agencies. It was praised for its accuracy, respectful approach and depicting the female characters in a humane way, particularly focusing on their friendships and families. A discussion of why and how the series was made can be found here.

April also saw the bizarre case of Clitoraid unfold. What began as a request via twitter and facebook to ‘adopt a clitoris’ soon was a more complex case involving a cult, unclear activities in Burkina Faso, and the support of sex educators and a sex store. A summary of the story can be found here, hereand here. Many questions about Clitoraid still remain unanswered, and have caused rifts between sex educators, activists and health/development practitioners. This bad feeling was distressing, particularly since many involved were highly respected within the field of sex education and activism – and because basic respectful approaches to international practice were ignored.

What do you do if your girlfriend ditches you and goes out with someone else? Mope? Call up your mates and hit the town? Go visit your mum? Listen to sad music? Or cut your girlfriend’s face so nobody else would ever want to date her? If it’s the latter then you’ve clearly been taking your relationship advice from actor Danny Dyer and Zoo magazine. In May Dyer’s advice column contained this shocking suggestion, which was noticed by @sarahditum and quickly spread across twitter. Dyer blamed Zoo, Zoo blamed Dyer. Nobody took any responsibility for anything. But action did get taken, primarily when people stopped complaining to the magazine and editor and started targeting advertisers with the magazine. Dyer was sacked. Zoo was forced to write an apology and feature about domestic violence. The whole sorry saga is summarised here and here.

The same month saw Project Prevention gain notoriety in the UK with largely uncritical media reports like this. Through countless chat shows, broadcast and print news the organisation suggested drug/alcohol and reproductive health services (plus other support services) were failing to manage drug/alcohol users getting pregnant. And suggested cash incentivised sterilisation programmes were the answer. (Project Prevention are only focused on sterilisation or adoption of long acting hormonal contraception. They are not interested in supporting drug/alcohol users after this – in terms of sorting out any addiction, housing/family issues, or safer sex concerns. Moreover they fail to address repeat pregnancies can be a sign of domestic abuse. Their focus is solely on preventing drug/alcohol users getting pregnant).

The media provided no real discussion of what services already exist, what they offer, how they work, where they could be improved. Without this, discussions on Project Prevention were meaningless but this didn’t stop media approaching the issue of drug/alcohol abuse and incentivised sterilisation as though this were a necessary and beneficial option, required because of gaps in existing services. Since no services were seemingly assessed it would be difficult to draw these conclusions but it didn’t stop the media. Who also ignored the concerns of drug/alcohol charities, human rights groups, and healthcare practitioners.

Nor was much investigation carried out into Project Prevention, or their previous incarnation CRACK (Children Requiring a Caring Kommunity) despite numerous publications on them in health/legal journals (see here, here, here, here, here and here)

Blogger Stuart Sorensen emerged in this debate as a voice of sanity and tireless campaigner against Project Prevention. Inviting the UK representative of Project Prevention to explain their plans for the programme in the UK then creating resources for practitioners and the public around how to tackle the organisation (all his writing about Project Prevention can be found here and on twitter)

Despite some journalists and bloggers writing about Project Prevention as though it were an established and worthwhile UK organisation, in fact it is not. Ethically in the UK practitioners cannot sterilise people who’ve been financially incentivised or who are drug/alcohol dependent. They can, with the person’s consent, suggest long acting reversible contraception (LARC), although Project Prevention do not appear linked with any existing drug/alcohol or reproductive health services. Currently they are requesting monetary donations to fund getting people onto LARC which can already be freely offered via the NHS. But the media and uncritical bloggers haven’t really considered the ramifications of this at all. The project and messages behind it are popular with media and some quarters so it continues to require vocal opposition. Not least because its focus on the poor, vulnerable and socially excluded feels like eugenics to many people. Rather than giving Project Prevention a platform we would do better to explore complex cases around reproductive health and drug/alcohol abuse, and ways to ensure services can better support addicts and their families.

In the midst of this we had a general election. Labour lost. The conservatives and liberal democrats formed a coalition. Many long term labour supporters, myself included, had become disenchanted with many of the actions of the labour party. Particularly around its use and neglect of scientific evidence to inform policy and law. (I wrote about my direct experiences of this here). The Liberal Democrats were eager during electioneering to persuade scientists to focus on ‘geeking the vote’ and made many promises around healthcare, education, academic funding, university fees and supporting science. Perhaps unsurprisingly many working in academia and science were persuaded to vote for them on this basis (I certainly was, something I am still regretting – and you’ll understand exactly why when you read this – the most personal post I’ve ever shared on this blog). For some the subsequent backtracking and u-turns of the Liberal Democrats have come as no surprise, to others of us it has come as a dreadful shock. And a sad let down not only to see the behaviour of the Liberal Democrats since they became part of the coalition, but also to note many of those who so actively courted the academic and science vote have dropped contact with us. Leaving us feeling cheated on many levels. A truly depressing turn of events.

June saw the FDA reject the drug Flibanserin – the female ‘desire drug’ despite months of media hype about this being the next ‘female viagra’ (as the media consistently and incorrectly described it). Shortly after drug development was discontinued, while later in the year Ray Moynihan’s fantastic book Sex, Lies and Pharmaceuticals highlighted further the problem of medicalisation of female sexual functioning by the pharmaceutical industry.

Also over the summer we saw a scandal break around off label use of the drug dexamethasone given to pregnant women to prevent congenital adrenal hyperplasia (CAH) in girls. CAH is a disorder that affects the adrenal glands, so a person will not make enough of the hormones aldosterone and cortisol, but will make too much androgen. One of the results of this can be girls with CAH having ‘ambiguous genitals’. Using dexamethasone to prevent CAH (and particularly to prevent girls developing male genitals) is a standard practice for some clinicians, as is offering genetic testing to parents with a history of CAH. Many endocrinologists and medics have argued prescribing dexamethasone should only happen within a controlled, supervised, trial programme (which is currently not the case). The real scandal around CAH came from a clinican who was prescribing ‘dex’ to not only prevent CAH but also to prevent lesbianism.

This case was broken by Alice Dreger and colleagues and quickly spread to the media who focused on the need for using dex to treat CAH and the circumstances under which it might be used (see here and here for examples). The media, while expressing dismay, were not as critical about the use of dex to ‘treat’ both gender and sexuality as bloggers were. The blogosphere (particularly writings from trans and intersex people) took a more politicised, critical and wide ranging approach to this story (see for example this post from Mark Simpson assisted by @quietriot_girl, which links to other discussions about dex, sexuality and CAH).

Around the same time, a separate story was broken by Dan Savage which also involved Alice Dreger and colleagues. This time alerting practitioners and the public to research being undertaken at Cornell University by Dr Dix Poppas. Poppas’ research focused on ‘treating’ young girls judged to have oversized clitorises by performing clitoral reduction surgery on them. And testing for post operative sensitivity with manual stimulation and the use of a vibrator. Unsuprisingly this led to an outcry, primarily from bloggers (rather than the mainstream media who didn’t give it as much attention). Bloggers and activists saw the research as child abuse and female genital mutilation/cutting (examples here, here and here). It also led to wider discussions around surgical interventions and intersexuality within forums and on twitter – some of which became pretty heated but were definitely of interest. Sadly even within these discussions some intersex people felt they were (as so often happens) being spoken for or spoken over. The CAH and particularly Cornell case showed us we still have a long way to go around open and respectful dialogues in this area.

While it was right to focus on both the CAH/dex/lesbianism and the Cornell /cutting stories, what proved interesting about both was they recieved far more attention and debate across the blogosphere than within the mainstream media. But both these cases still received masses more attention in both blogs and the mainstream media than the clitoraid case. Despite the Clitoraid case being equally troubling on many levels. Those of us involved in challenging Clitoraid were left wondering whether it was simply the case that when it came to the rights of African women the press and bloggers just weren’t as interested. Not a comfortable feeling.

The media tend to view the summer months as ‘silly season’ and they certainly didn’t disappoint in August, with a spectacular misunderstanding of public health data and wild claims that not only were dramatic numbers of 11 year olds on the pill, but the belief they were all using hormonal contraception because they were sexually active. In reflecting on the story health practitioners began to realise just how little journalists covering stories like this understand about young people, puberty and hormonal contraception. Or that very few young women are prescribed the pill – and if they are it’s usually for things like acne or heavy periods. A rundown of the story in its full ridiculous glory can be found here

Not to be outdone by the press, MP for Peterborough Stewart Jackson decided the best use of twitter was to insult his followers who questioned his anti sex education statements. By calling them ‘sex obsessed leftie weirdos’ and other choice insults. Accounts of which can be found here and here .

In the US a spate of suicides of teens bullied over their sexuality led to Dan Savage establishing the It Gets Better project aimed at providing messages to young LGBTI people that things can improve. Numerous celebrities, politicians, activists and members of the public have posted their stories to the project in an attempt to highlight for many young people suffering homo/transphobic bullying that life can change and is worth living. There are too many to share here but the notable and moving contributions (in my view) to discussing how ‘it gets better’ came from Councilman Joel Burns

and the staff at Pixar

This programme was unusual as it took a slightly different approach to the usual anti bullying approaches, by taking a positive and hopeful view. Perhaps unsurprisingly some critics felt it oversimplified problems, suggested that things always worked out okay, and that adulthood is an automatic escape from homo/transphobia. In particular the message that it was worth enduring hardship/distress now because a brighter future awaited proved problematic for many. (This is explored in more depth here). Debates began about whether the project was a good idea. Blogger Furrygirl robustly responded to feminist critics of the scheme. While thoughtful writer Tania Glyde took a different view, thinking around why sometimes things don’t get better – and why that happens. And how often this may not be under your control. Her amazing and moving post on this is here.

It Gets Better still requires discussion and evaluation – it would be interesting to see what a difference this grassroots project may make. But it also reminds us of the lessons many working in sexuality, sex and relationships health/education already know. Which is that we can’t give blanket messages. It is important to have positive goals, but telling people what to do rather than how to get there may not be enough. And that anti bullying messages based on oversimplistic ‘it’ll be okay’ or ‘it’s dreadful’ are unhelpful. Instead we need more tailored approaches to tackling homo/transphobia for young people, adults and families. Across schools, the legal system, media and beyond. It Gets Better may have its fans and critics, but it has reminded us many young people are at risk of bullying within the school or other spaces and we all need to take action to empower and safeguard them. Now and in the future.

During the year it became apparent that science funding and other provision for education were under threat and in October UCL scientist (and all round fabulous woman) Jenny Rohn decided to take a stand. She gathered together a merry band of scientists and practitioners and got them to back the Science is Vital campaign which resulted in a petition, plenty of blog posts on the topic, extensive media coverage, and defended science against the cuts. Oh and some really questionable singing

Oh, and this woman turned up too

November saw the 40th anniversary of Page Three – but was this a cause for celebration? Nobody seemed sure. It also marked the closure of the Teenage Pregnancy Independent Advisory Group (TPIAG) who had overseen the (then) government’s Teenage Pregnancy Strategy over the past decade. Their final report can be found here, with TPIAG warning that not taking action on teen pregnancy (and supporting teen parents) will cause problems in the future. While the Teenage Pregnancy Strategy was not without its critics (from various sources) it did commit to supporting teen mothers and identifying causes of teen pregnancy. What will happen under the Coalition in relation to support for young people, and particularly teenage parents, remains to be seen.

This month also saw the Geek Calendar project go into overdrive, with plenty of coverage, advanced orders and the opportunity to raise funds and awareness for libel reform. I was delighted to participate and hope many of you are now a proud owner of a Geek Calendar of your own!

At the close of the year the government have revisited the issue of prostitution, calling for a review into best practice in managing the issue, echoed by ACPO who have also called for a review of legal and health approaches to sex work. Media coverage on this so far has been positive, but focused more on women, not addressed male and trans workers.

The year has also ended on a similar note to how it began, with a return to reviewing sexualisation and commercialisation, this time led by Reg Bailey (chair of the Mothers’ Union) who will be looking at existing reviews in this area and deciding what else needs addressing for children and young people. Critics have already questioned why a ‘review of reviews’ need completing, and whether Bailey is the appropriate person to oversee this process.

Linked to this was the government suggestion that Internet Service Providers block access to porn which has had a mixed reception. However, debates about sexualisation continue to be a media favourite and are for the most part not based on sound research. Indeed much of it seems to just be speculation – like this claim that cheating footballers are normalising adultery. This sadly seems to be the way Bailey and others are trying to bring boys into this debate. Not exactly helpful.

During the year we’ve had to say goodbye to several people who’ve been trailblaizers in the areas of sex, education and health. Including
Claire Rayner
Professor Otto Wolff (a hero of mine who was the first and pretty much only senior health practitioner to recognise the work of agony aunts as having a relevant health role)
Actress and model Pamela Green
Cory Silverberg also pays respect to others who have passed during the year over at his blog.

Join me on New Year’s Eve when I’ll be looking back over my Sex and Relationships Predictions for 2010 and seeing how many of them came true, or where I was completely off track. And in the new year I’ll be giving you a new list of predictions for 2011.

Thanks to @bishtraining @mngreenall @SexEdUKation for their help with this blog – and checking I’d managed to remember all that’s happened this year! And for @quietriot_girl and many others who emailed me to remind me about things I’d forgotten and needed to add.

*

Amidst stories about snow and the final of The Apprentice you may have noticed yesterday’s news claiming the government wants to persuade Internet Service Providers (ISPs) to block access to online pornography.
The Sun – Porn Block on PCs
The Daily Mail – Porn, keep out! Parents to be allowed to block computers from receiving sexual material (not only do the Mail confuse the opt out/opt in system, but also seem unaware parents can already restrict access to adult content online)
The Guardian – Broadband firms urged to block sex websites to protect children (as with much other media coverage the Guardian stacks its story up with a problematic survey from Psychologies magazine, more on this later)
The Telegraph – Internet Pornography Curb By The Government

Where did this story come from?
It originated from a question asked by MP for Devizes (Cornwall) Claire Perry in a House of Commons debate on Internet Pornography on 23 November (summary here). From this Ed Vaizey (Minister for Communication, Culture and the Creative Industries) suggested a meeting with the major UK ISPs to talk about a potential blocking of access to porn and a sign up system (so those wanting to access sexual materials online would have to opt in to gain access).

You can see from the debate linked above and media coverage the focus is presenting this proposal in terms of child protection, and as a mental health issue.

As yet no meeting has been set up and no ISPs agreed formally to any proposed blocks at source. Indeed from today’s news ISPs appear to be saying the proposal is ‘unworkable’.

This proposal is, however, likely to be politically popular – at least in some quarters. It taps into fears parents may have around sexualisation and risks to young people. It appeals to sex negative/conservative voters. It also removes responsibility from parents who may lack confidence or familiarity with the internet and be uncertain what young people might be seeing online or know how to address this. Like many discussions within the sexualisation debate (which this is falling under) it may seem intuitively a good move, yet there are numerous problems associated with this proposal.

Here are some of them

What is this proposal aiming to do?
Although the proposal is suggesting a block at source, it seems this is going to be difficult to provide in practice. It is also only focusing on online pornography, not addressing other areas of sexual content young people might be accessing, nor social networking sites where young people may also be having contact with others people (sometimes in a sexual way). This doesn’t mean these other sources should also be blocked – but it does raise the question why the government is only focusing on ‘online pornography’? What evidence is there that this poses the most significant risk to young people (compared with other media), and what evidence do we have that the best solution to tackling the problem is a block at source with an opt in approach?

Despite media coverage and political debate it is not clear what is proposed (aside from wanting to meet some ISPs), and certainly no clear explanation of why the focus should be on online pornography only or the extent to which this is a major child protection issue (greater than say, addressing poverty; housing; poorly performing schools; addressing the physical and sexual abuse of children; and improving the training funding and support for social services, schools and other youth services).

Defining ‘porn’
One of my plans during my PhD (which focused on evaluating research on pornography effects) was to create absolute definitions of ‘pornography’ and ‘erotica’ as distinct and measurable categories which could be used in research, legal and health settings. In practice I found it pretty difficult to achieve (and gave up trying).

When asked, participants would define porn as ‘dehumanising’, ‘degrading’, ‘exciting’, ‘base’ while ‘erotica’ was described as ‘arousing’, ‘mutual’, ‘equal’ or ‘tender’. In fact what people were really doing was suggesting the values they attributed to said terms. Erotica was viewed far more positively than porn.

However, when I presented the same participants with actual sexual images to talk about they couldn’t agree upon which were porn or erotica. Indeed some saw certain images as ‘erotica’ which others viewed as ‘pornographic’. Unpacking why they felt this was a fascinating part of my research, but indicated for me something that has plagued researchers and lawyers for years. Because sexual materials are usually linked to moral and/or political judgements you can end up in a situation described by Ellen Willis (1979) as “[i]n practice, attempts to sort out good erotica from bad porn inevitably come down to What turns me on is erotica; what turns you on is pornographic”

Before any blocks at source can be made there has to be some level of agreement of what ‘online porn’ is. Currently it isn’t clear what this is defined as and given the range of sexual material online it will be difficult to agree what should or should not be restricted. And who will make these decisions?

Moreover it is unclear where sex advice, art, and conversations about porn online will fall within this proposed restriction. Critics of the proposal are concerned over wider censorship issues that it raises.

What about parental control?
While in opposition the Conservative Party made much complaint about the so-called ‘nanny state’ they saw being endorsed by Labour. Frequently Conservative MPs used the mantra of ‘parent power’ to advocate not having to tackle sex education and sexual health care for young people. Ironically we now see the same party suggesting rather than parents deciding what their offspring can have access to or supervising access to the internet, this decision will be made for families by the state in collaboration with ISPs.

Parents are currently already able to limit access online. They are also able to limit what access young people have to sexual imagery from other media sources, and decide whether or not to allow a young person to play computer games or use social networking sites. Parents can also talk to young people about safety online, confidence and communication generally, and tackle wider topics around sex and relationships.

Sadly, however, many parents don’t do this. This may be down to embarrassment, time pressures, a lack of awareness of risk to young people, a lack of knowledge of about the internet, or a lack of involvement in parenting generally.

For many parents a block at source could seem appealing as it means they don’t have to set controls over what their children are accessing. They may also believe this absolves them of the task of controlling media access more generally, or having to talk about sex and relationships, or around issues of respect, assertiveness and communication.

Simply putting a block on porn access online would not prevent young people seeing imagery elsewhere. Nor would it mean they would no longer require parental support, supervision and advice.

Blocking more than ‘porn’?
One of the major concerns over this proposal is it would block more than porn. Anyone who has had the fun experience of working within organisations like the NHS (as I’ve had for many years) will recognise how intranet blocks can stop you accessing advice sites and even research papers tackling topics containing ‘naughty’ words like breasts or testicles, psychosexual problems or sex education.

A feature of blocking at source means it’s not just sexual imagery created for entertainment/arousal that is blocked, you may also find you cannot find self help, advice or educational materials.

This government proposal could mean the many young people who have questions about their gender or sexuality, are being abused or bullied, want to know about puberty, STIs, contraception or pregnancy, or have general ‘am I normal?’ worries will not be able to gain access to such information online. For many young people these questions are not always ones they can ask of teachers or parents. Parents or teachers don’t always give them the answers they need. It may be on more sensitive topics they can’t ask friends or even use internet cafes or libraries. The privacy of online advice may be the only place they can find answers. As not knowing about these issues can put young people at risk and cause mental distress it seems ironic a proposal based around safeguarding young people’s mental health could directly harm it.

Advice websites, online information forums, resources like Scarleteen that talk frankly about sex for young people could easily find themselves blocked within this proposal.

Under such a proposed scheme parents (and other adults) may also find they cannot find out information about ovarian cancer, psychosexual problems, smear tests, fertility, miscarriage, pregnancy advice, partner abuse or rape.

Young people (and adults) have a basic human right to information about their sexual lives, gender and sexuality (see here and here for two examples discussing this issue). These proposals bring up wider discussions not only around censorship, but also about open access to health information.

Do blocks and bans work?
Many adults may remember our recent history where pornography was largely illegal within the UK, or was heavily restricted in accessibility. Jokes abound about the only place to find porn – aside from under your parent’s bed – would be what you stumbled across during walks in the woods (or perhaps shared by a bigger boy at school). However this did not stop young people wanting to see, or seeking out, sexual materials.

It would be wrong to suggest availability, access and commercialisation around sexual imagery hasn’t altered. It does seem sexual imagery is more prevalent and easier to access than in the past – but not just in terms of ‘online pornography. Shifts within commercial markets have also meant more discussions about sex in the mainstream media, advertising, music and other entertainment industries – aimed at adults as well as young people.

This does not mean such materials should also be met with a blanket ban. Focusing on ways to talk about the messages shared within popular culture, from parents and peers are important. It seems peculiar this government seeks to block access to one form of sexual imagery but are less interested in addressing realistic and rights based sex and relationships education.

Generally blocking or banning one area doesn’t seem to work (research and wider issues discussed here) – people still find ways to access material, and given sexual media appears in more places than online porn it is unlikely just blocking one area will make much difference. Indeed we’re left uncertain what difference politicians expect as a result of such a block.

Moreover in discussions in this area we are not hearing about research that talks about the more complex and nuanced relationships young people have with the media (see here and here for examples). This proposal also seems to be assuming the majority of young people have some kind of private internet access at home, and this is their main source of viewing explicit material. However this may not be the case and does not guarantee young people won’t find sexual imagery in other sources. The proposal seems to be suggesting that online access to porn is causing specific harms and yet no clear evidence is being shared about what those harms may be.

It is not clear what this proposed block is for. Is it to protect young people? If so, from what? Finding out about sex? Seeing sexually violent images? Being exposed to adult content while they are still young? To prevent young people becoming sexually active? It seems to be working under an assumption that young people who see sexual images may be mentally harmed, or perhaps will become sexually active at a young age, or be coerced (or coerce others) into a sexual act they may not have previously considered. Yet within this no clear evidence is presented around whether this is being observed now and what impact this is having on young people long term.

The media’s lack of critical attention
Press coverage of this story has been largely uncritical. In that it has presented the proposals set out by the government without any real discussion of how workable they may be or the issues related to potential blocks that might put young people at risk. Moreover the media have not been particularly careful to focus on the wide range of evidence addressing media effects in this area (and particularly about young people’s use of online porn). Instead most media coverage have backed up their stories with the quote from a survey from Psychologies magazine that 1/3 of young people have seen online porn (when aged under 10).

This represents part of the problem with the media on this issue. Journalists appear to believe that online porn does cause harm to young people and therefore rather than thinking more critically about sexualised culture and youth, they accept studies that support their position.

The Psychologies survey is particularly flawed as it is presented as being representative of children across the UK, whereas it was actually only conducted in one London school.

I was concerned over the way this research was conducted on young people and when raising questions about it was sent various emails and was called by the editor about it. This included a copy of the survey questions and response rates.

From this correspondence it was difficult to identify whether parents did or didn’t know their children were completing an online survey about pornography. Questions asked were in placed muddled or confusing, and while some answers suggested young people had seen online porn, the majority of respondents had not (and nor were they in a sexual relationship). Indeed most respondents who had seen porn weren’t particularly troubled by it – seeing it as arousing or a joke. The limited sample, problematic questions, ambiguity over parental consent and young people’s ability to opt out of the research means this survey is not reliable. And yet it remains popular among both journalists and politicians as ‘proof’ of our ‘problem’ with online porn and young people in the UK.

It would be unfair to single out Psychologies magazine as they are not the only media outlet who has completed research in this area that could have been a lot more robust. Channel 4’s Sex Education Show also conducted a survey on porn as part of its second series (The Sex Education Show vs Pornography) which, despite being told that pornography was not the major issue affecting young people still made a show with this focus because the series was commissioned to have a campaigning focus similar to ‘Jamie’s School Dinners’ (as one producer informed me). Because many of the cases presented in the programme suggested accessing extreme porn was both easy and commonplace it persuaded many people this was a major campaign issue. Even people who might usually question evidence or ask to see research accepted the depiction of online porn within the programme as ‘the norm’.

Completing research on young people and sexual imagery is something that is important but has to be managed ethically, responsibly and carefully. At present while claims are made about the number of young people accessing sexual imagery and the impact this is having on them, in truth there is a lack of robust research in this area. This is mainly linked to a lack of funding to study the topic, and limits to what can be asked of young people by ethics committees.

We do have evidence around the impact of porn but not all of this is based on online porn and even when it is, is flawed by a lack of definitions about what ‘online porn’ is. Many studies are overly simplistic, lab based and feature undergraduate students. The experiences of sexualised media (not just online porn) on young people remains an under researched area and at this time it is difficult to make any firm conclusions about its impact.

Claims about how it is changing young people’s brains, behaviour and bodies sound frightening but often do not have much reliable data to back them up.

Unfortunately at present politicians continue to avoid engaging with evidence on a critical level and various lobby groups of different pro and anti porn (but largely anti porn) positions are making their views count more than independent research. As a result many claims are being made about online porn and its impact on young people but, if you try and source any evidence for said claims, it is difficult to find anything particularly reliable.

The media and politicians, rather than accepting a few flimsy studies that back up their beliefs, need to look more closely at what is happening to young people and hear from those conducting careful, respectful and ethical research in this area.

What happens now?
This is only a proposal. So at present no meeting has been set up and it may be no meeting may happen. Critics of the proposal are arguing it’s a play on the part of the conservative to faith based voters, in a similar move to actions taken in Australia (see here and here). And that it won’t go any further than a chat with ISPs (if that far). Others argue the proposal is based on well meaning, but ill informed, intentions that will continue to be focused upon as part of wider debates on sexualisation.

We have seen little critical discussion of the issue within the media outside of talking over whether the proposal is workable. Debates about the evidence in this area, the acceptance of limited studies to make policy, parallels with Australia, and the needs and rights of young people are largely absent in media coverage and in debates on blogs or twitter (which have tended to focus more on the censorship or tech angles).

Because this is a proposal there are things you can do about this issue. You can lobby your MP and ask them what their views are, and provide them with more balanced information about young people, their rights and ways in which we can empower them to negotiate a commercialised/sexualised culture. (Here’s a nice set of free resources to help them!)

We can all ask to see what evidence the government has that this specific proposal would make a demonstrable difference to the lives of young people, what that difference might be, and how it might be measured.

Critics who fear this is another form of censorship and regulation need their concerns addressing.

We need to be careful to continue discussions about young people’s rights and responsibilities without questioning of this current proposal (or ones like it) degenerating into accusations of promoting abuse or denying young people need support. (As previously experienced in debates on extreme porn).

Parents can lobby for greater responsibility and control and reject the idea of an opt in system. They can argue the existing system where parents can already block access and talk to their children about sex/relationships issues is adequate. This requires parents to step up to the plate and be more engaged in the parenting process and certainly educators, practitioners, healthcare providers, therapists and youth organisations can do more to support parents in this role.

Despite this debate being largely about them the opinions of young people are largely absent. It would be good to hear more from young people about what they think about online porn and related issues. We do not do enough to include young people’s voices, nor offer support or empowerment to them on this or other child protection issues and that is something we should rectify as these debates look set to continue.

We can focus on increasing access to relationships education both at home and school, support online services already offering independent and ethical advice to young people on sex/relationships, and ensure any education offered covers topics around delay, respect, communication, confidence and pleasure. Not just about biology, STIs, just saying no, and contraception.

We should question the government on this issue. Why are they considering this proposal? Why is it important to them? What do they think it will achieve? Who are they aiming to protect? And if they are interested in child protection what other areas such as child poverty (in particular) might they also be focusing on?

This proposal raises wider issues around health, education, access, and rights to information. So it is worth looking beyond what may be fairly empty government proposals or broader discussions on censorship and think about what this government’s understanding of young people’s rights may be – along with their awareness of ‘sexualisation’ and how to deal with it.

Certainly young people are living within a different culture where there is easier access to sexualised (and often commercialised) messages. These are not just within the domains of ‘internet porn’ but often in the pages of our daily papers, celebrity sex scandal stories, music, advertising and so on. It is important to talk about the information both young people and parents need, but deciding to begin this debate recommending a top down, censoring approach does not allow us to really explore what would help young people and where actual risks may be from.

Want to know more?
If you are interested in this issue a discussion is ongoing about it on twitter using the hashtag #ukpornban Meanwhile people like @quietriot_girl @auntysarah and @bishtraining have been actively engaged in debating this proposal on twitter. Bish has also written an excellent summary about the issues raised by the proposal here. If you see any other blogs or articles discussing this issue you think are helpful please email me (info@drpetra.co.uk) and I’ll add them to this post.

Other interesting writing on this topic from:

Pandora Blake who talks about some of the flaws in both the proposed scheme and the ‘research’ behind it. This is picked up by both @violetblue in ZDNet and @TomRoyal in ComputerActive who focus on the groups behind the proposal. Particularly the pressure group Media March. Tom’s post was written a year ago, but it seems Media March are still keen to persuade politicians to their cause. More on this organisation can be found at Liberal Conspiracy

Both Mashable and
Guardian Technology discuss whether the proposals even make any sense. (The piece by @tomscott says pretty much what I say above, just a lot more succinctly!)

@foxsoup writes at ThoughtSoup on the major limitations of The Psychologies survey (which journalists are continuing to treat as though it is a robust and leading piece of research in this area). While The Register takes a more pragmatic approach and discusses whether this proposal is really an issue and if it will ever lead to any action (they also talk about the reasons why this issue is being raised now).

In a more personal account Unaverage Girl focuses on how blocking porn could have killed her, reminding us of the wider issues about access to information for young people.

While on a lighter note @zoeimogen suggests we remember Cleanternet (a similar suggestion to this current proposal)

Meanwhile Claire Perry announced on twitter 100% of negative or abusive commentary about opt in system for internet porn is from the chaps. Women 100% positive (so far) Since then many women have taken the opportunity to tell her they disagree.

* Image used here comes from the amazing TV series ‘Father Ted’ where Fathers Ted and Dougal are required to protest against a ‘blasphemous film’ (the clip for which is here, wonderful).

Without further ado, let’s find out the answers to the questions I posed as part of the Science Late evening of sex event on Wednesday. How did you score?

1. What are the most common methods sex researchers use to study sex?
a. By looking – watching people have sex in a laboratory or on film
b. By measuring – assessing sexual behaviour via brain scanning, blood tests or heat sensors
c. By listening – recording answers from surveys or interviews
d. By participating – having sex with the people they are studying
e. Not sure

Correct answer = C

The most commonly used methods in contemporary sex research globally are surveys or interviews/focus groups. Brain scans, heat sensors or blood tests can be used, as can observational studies (where people have sex within laboratory settings). However, these latter two methods are used less as they’re often more difficult to recruit representative participants for studies. With the internet the opportunity for people to film their sexual activities and share those with researchers, and methods where participants film or document their own lives may become increasingly popular in the future. One thing we don’t do, but which people often assume happens, is have sex with the people we’re studying and then write about it. This would be considered unprofessional and unethical in research nowadays, and would focus the study on the researcher rather than a wide range of participants.

Want to find out more?
Check out the Kinsey Institute and the Magnus Hirschfeld Archive for Sexology who provide information about sex research being undertaken and provide answers to your frequently asked questions about sexual behaviour.

You might also find these guides helpful too:
Want to be in a sex study? Tells you about how sex research is conducted and how you can get involved

Sex research since Kinsey’s day – explains the different methodological approaches that can be used to study human sexual behaviour.

What’s it like to be a sex researcher? answers the frequently asked questions I’ve received about studying sex.

How to run a sex study outlines the steps you’d undertake to carry out a scientific study.

2. How often does the average UK couple have sex per week?
a. 7-10 times
b. 4-7 times
c. Once a week or less
d. Not sure

Correct answer = C

Robust and reliable research indicates that younger people do have more sexual encounters annually than older people. You can see links to research where frequency has been addressed here. The UK Natsal study found the average for heterosexual sexual activity per month was around 6 times. If you account for sexual behaviour over a wide range of ages the average is once a week or less. However, reputable sex research focuses more on quality rather than quantity. We would usually ask people for a range of sexual behaviours they engage in (masturbation, oral sex, intercourse) and whether they enjoyed them. That way you might find someone doesn’t report much ‘sex’ (as in intercourse) but they enjoy masturbation on a regular basis and are happy with this.

This contrasts with the media’s description of sex where ‘sex’ is usually only considered in terms of intercourse and quantity is taken as a measure of ‘great sex’.

Want to find out more?
Set yourself an experiment. Look at magazine or newspaper coverage of sex/relationships over the next month and see how ‘great sex’ is described. Is it written about in terms of exploration, variety and pleasure, or described in terms of quantity and penetration.

3. The average penis size is 5 inches long
a. True
b. False
c. Not sure

Correct answer = B

Many studies do give the average erect penis length as 5 inches. However, there are numerous problems with studies on penis size as they vary in the methods used to collect data. Some studies relied on self report, others on a researcher either measuring an erect or flaccid penis. Critical reflection on penis size studies suggest there are problems with the inconsistency of measuring penis size (summarized here). Interestingly research in this area suggests men (gay and straight) are more worried about length than girth, although women seem to be more interested in girth. And partners of men (male or female) are usually most bothered about their partner’s technique and the way they treat them. With anecdotal evidence suggesting men with larger penises don’t try so hard to please their lovers.

4. Women and men are equally stimulated by visual images of sex
a. True
b. False
c. Not sure

Correct answer = A

Women and men are just as likely to be turned on by visual images of sex. This may run counter to common knowledge of this issue, particularly since the media often repeats the idea that men are visual creatures and provide various evolutionary and biological explanations for this. What science is now discovering is that women, like men, do get aroused by sexual imagery. There is a diverse range of what turns women on – as with men. There is often the myth that women prefer erotica and men like porn, or women need their sexual imagery served up with a warm slice of romance. Yet studies where women have been asked about or shown sexual imagery suggest they do respond to a variety of arousing stimuli.

Interestingly many of the studies assessing response to visual images of sex (usually done through showing a series of images or sexual film clips and measuring genital response) did not include women. These were conducted on male participants (often undergraduate students) who were tested in response to viewing sexual images to see if exposure to said imagery had led to them feeling more hostile towards women.

More recent studies of women show they report enjoying a range of sexual imagery but do often worry more than men about the content of materials and how they’re made. Debates around the impact of porn, and whether the content is sexist, can often make women feel guilty for looking at/enjoying sexual imagery. Interestingly we’ve focused more on asking women critical questions about how they respond to porn than we have inviting men to reflect on their porn use.

Want to learn more?
Violet Blue’s written a fascinating book called The Ultimate Guide to Adult Videos which discusses how to pick porn to view, and answers some of the common concerns people have about content.

Alternatively there is a vigorous debate about porn/sexual imagery that’s ongoing. Some view porn as innately sexist and degrading to women, others feel it’s a symptom of a sexist culture but not a direct contributor to sexism/abuse. While some believe porn could help improve relationships, or at least has no harmful effects. You can find debates ongoing across different websites (particularly those with a feminist/political focus). Read up on the issues and see where you fit in.

5. Men can fake orgasm
a. True
b. False
c. Not sure

Correct answer = A

Men can, and do, fake orgasm. We don’t know exactly how many do this, but therapists and educators are increasingly hearing from men who are worried about faking orgasm. Reasons for doing so include being tired, sore, wanting to bring sex to an end, and not wanting to let a partner down. Men report feeling the need to fake because of pressure to perform sexually. It is unclear whether this pressure is experienced more or less acutely by straight or gay men. Interestingly, we tend to respond to women faking orgasm as being an inevitable (partly linked to the stereotype of women being less sexual). We tend to respond to the idea of men faking with disbelief or humour. This does little to help either gender if they feel the need to fake.

Want to find out more?
Comedian Richard Herring has written a great book called Talking Cock which although based on humour is a useful survey on male sexual behaviour and includes some discussion about faking orgasm.

If you’re a man and find it consistently difficult to orgasm it might be you have delayed (or retarded) ejaculation. More information about this condition and treatment options available here.

6. Men reach their sexual peak at 17 years old, women at around 40 years old
a. True
b. False
c. Not sure

Correct answer = B

Although this is often quoted in the media it doesn’t make sense in social research terms. The data seems to have come from surveys in the first half of the 20th century on sex where young men could record an interest in sex, but young women couldn’t. Culturally young women weren’t supposed to be sexual (particularly before marriage) and so either were unable to report on sexual behaviour, or were too afraid to disclose what they may have done. Older women who were married and had experienced sex were in a stronger position to report on their experiences. So early surveys measured behaviour and found younger men were able to report sex positively, as were older women. This is not the same as hitting a sexual peak during lifespan.

Although studies do still about that reinforce this myth or suggest particular ‘peak’ times for sex, reliable research suggests that rather than their being specific peak times for sex, there will be times when people enjoy, desire, and have sex more or less. This will be influenced by many factors including health, parenthood, financial security, relationship quality, and lifestyle factors (such as work stress).

Sexual activity may reduce as people age, and certainly we do see young people reporting having more sexual encounters. However, this does not mean the same thing as pleasure or desire or exploration. Older people do also report they may not have as much sex as in their youth, but the sex they have remains important and pleasurable.

Part of the misrepresentation of sexual behaviour across lifespan as having one off peaks is linked to the quantity over quality. A more accurate way of looking at this issue would be to see sex intertwined with other factors (listed above) and to expect points in your life when you’ll have no sex (with a partner), lots of sex, and occasional sex – with quality differing also.

Want to find out more?
Keep a diary for the next year and record when you had sex. Note periods when you enjoyed different sexual activities (masturbation alone, oral sex, intercourse), who you were intimate with, and when you were or were not enjoying sex to identify what else was happening. It might be something negative like being made redundant, or something positive like starting a new job where you put your energy into that activity.

7. Animals (other than humans) can be gay
a. True
b. False
c. Not sure

Correct answer = A

Homosexuality has been observed in numerous species from dolphins to monkeys, dogs to sheep. We have only recently begun to learn more about this topic as science has in the past often misrepresented homosexuality in animals, describing it as ‘immature sexual behaviour’ or reporting it as something that only happens because no other sexual partners are available. Or simply not discussing it at all.

Want to find out more?
The question of sexuality is one that fascinates people – and can be a reason for concern or celebration. If you want to find out more about your own sexuality why not try the Kinsey scale which gives you a score from heterosexual through to entirely homosexual. You can even get a t-shirt to proudly display your rating.

Within the scientific community we’re still debating homosexuality and for two differing takes on this issue you might consider Queer Theory which sees sexuality largely as a social construct or contrast this with Qazi Rahman and Glenn Wilson’s excellent book Born Gay.

There’s also widespread discussion about whether homosexuality can be ‘cured’. Evidence shows it cannot (because it’s not a disease or dysfunction). You might find these papers interesting – they feature interviews with psychiatrists and patients who were part of treatment programmes to ‘cure’ them of homosexuality.

8. Where do most people get their sex information from?
a. Friends and family
b. School/college sex education
c. Self help/sex experts
d. The media (magazines, films, television, internet)
f. Pornography

Correct answer = D

Most people do use the media, and particularly the internet (where available to learn more about sex). Friends can be highly influential, although more for young people than older adults. The self help/sexpert market (which often influences media content) is worrying given that many sex experts are not adequately qualified to discuss sex and relationships issues. Porn is not the first place people look for information, however evidence suggests it is somewhere people will turn to if they can’t find answers elsewhere.

Want to learn more?
If you want to find useful places to get quality sex information (aside from the links above), I’d recommend:
Paul Joannides – author of Guide to Getting it On
Cory Silverberg – who writes Sexuality About
Good Vibrations magazine
Dodson and Ross – sex tips, advice and information
DIY sex education from All About My Vagina
Susie Bright gives great sex advice over at Jezebel

9. What’s the most popular area in sex research currently?
a. Desire and pleasure
b. Sexual problems
c. Sexuality
d. Sex addiction
e. Love, romance and courtship

Correct answer = B

The most funded and most prolific research globally focuses currently on sexual problems. That’s things like sexual dysfunctions and sexually transmitted infections (particularly HIV). While these are issues requiring investigation, there are problems about other issues such as love and romance, desire and pleasure receiving far less attention. In particular concerns have been expressed about the ‘medicalisation of sex’ (for women and men) and the way sex research has been influenced by pharmaceutical funding.

Campaigners working within sex research are working to try and broaden the range of topics studied in this area, but limitations around funding and academic priorities do still influence what gets studied. This is a problem since many members of the public have many unanswered questions about sex which are currently not being addressed.

Interestingly, the area of sex addiction is hyped up a lot in the press but is not being researched to the same degree within academia/therapy. That’s because the concept is not agreed upon by practitioners. You can find out more in this great discussion between Susie Bright and Leonore Tiefer on the topic, or see just how problematic the diagnosis of sex addiction is in my blog ‘Help! I’m a sex addict and I didn’t even know it’.

10. Why do sex researchers study sex?
There are numerous reasons why we study sex. To find out more about human sexual behaviour, to get people answers to questions they have. To reduce problems – STIs, anxieties, fears. To promote sexual pleasure. Or to encourage abstinence (not all sex researchers are sex positive). Some sex researchers are motivated to research sex because they want to offer help, to share pleasure, or to learn more about themselves. Some may have had a personal experience (positive or negative) that’s motivated them to study a particular area of sex.

As part of the Science Museum event I asked guests to share why they thought we studied sex and I’ll blog all their ideas next week – along with some updates from real life sex researchers about their motivations.

So, are you a sexpert? You may have scored well or badly on this test. It doesn’t really matter. Many of the questions were deliberately tricky. Hopefully what the test has revealed to you is that there’s a lot more to sex research than you may have imagined, it’s an area that spans many academic areas (science, medicine, history, anthropology and zoology to name a few). It’s a growing subject area and one with a real application to human life. By continuing to read up on sex (using some of the links above) and ask questions about all the sex stories you read in the press (and anyone who calls themselves a ‘sexpert’) you’ll be well on the way to sexpertise.

If you work in science communication, sex research or sexual health you are welcome to use this quiz (and answers) in your own activities (with acknolwedgement). Please do research all answers before presenting to ensure you fully understand topics, and perhaps you can bring in questions and resources of your own to add to the quiz.

Last night the Science Museum in London hosted one of its fabulous ‘Lates’ events. The theme of the evening was ‘sex and science’ and there was a great range of things to do. From learning more about yourself in the ‘who am I?’ tour, through to speed dating, finding out about the history of sex toys, salsa dancing, an experiment in ‘dance, hormones and sexual selection’ and some sexy punk science. Condoms were available to all guests, just in case things got extra fruity, and judging by the amount of drink and giggling going on I think people had a good time

I hosted a talk called ‘So you think you’re a sexpert?’ where we took 10 commonly asked questions about sex or commonly quoted sex ‘facts’ and put them to the test with some interactive voting to find out how smart our audience were about sex.

I’d like to give a great big thank you to everyone who came to Science Lates last night. I thought it was a novel way to share science, and the range of talks/events going on ensured we could create a balance between the fun and frisky and the serious and scientific.

For those of you who weren’t able to make it, I’ve reproduced the ‘So you think you’re a sexpert?’ quiz below, and I’ll give you the answers tomorrow, along with incorporating questions from the audience last night.

1. What are the most common methods sex researchers use to study sex?
a. By looking – watching people have sex in a laboratory or on film
b. By measuring – assessing sexual behaviour via brain scanning or heat sensors
c. By listening – recording answers from surveys or interviews
d. By participating – having sex with the people they are studying
e. Not sure

2. How often does the average UK couple have sex per week?
a. 7-10 times
b. 4-7 times
c. Once a week or less
d. Not sure

3. The average (erect) penis size is 5 inches long
a. True
b. False
c. Not sure

4. Women and men are equally stimulated by visual images of sex
a. True
b. False
c. Not sure

5. Men can fake orgasm
a. True
b. False
c. Not sure

6. Men reach their sexual peak at 17 years old, women at around 40 years old
a. True
b. False
c. Not sure

7. Animals (other than humans) can be gay
a. True
b. False
c. Not sure

8. Where do most people get their sex information from?
a. Friends and family
b. School/college sex education
c. Self help/sex experts
d. The media (magazines, films, television, internet)
f. Pornography

9. What’s the most popular area in sex research currently?
a. Desire and pleasure
b. Sexual problems
c. Sexuality
d. Sex addiction
e. Love, romance and courtship

10. Why do sex researchers study sex?
This was an open-ended question we gave to the audience last night. I’ve got all their answers to sort through and I’ll be posting those in a blog next week, along with some answers from real-life sex researchers and educators.

Come back tomorrow and you can find out whether you’re a sexpert, and learn more about each question.