This session aims to summarize the current state of research regarding the extent of contemporary youth engagement with pornography and its effects on their mental health and risk behaviors. An ongoing literature review was conducted on pornography use among youth, as well as its relationship to mental health and risk behaviors. Resulting studies were evaluated for relevancy and level of evidence, and the most important themes are consolidated for this presentation. Pornography use has become increasingly prevalent as easy unsupervised access to the internet has been enabled by easy internet access such as by smartphone ownership. The increase in screen media usage during the global pandemic has only further increased pornography engagement. Exposure to sadomasochistic, violent, and aggressive sex has become commonplace. Older boys, those who spend more time online, those with same-sex interests, and those with poor family relationships spend the most time viewing pornography. Parents reliably underestimate the amount and types of pornography their teens have viewed. With relatively few receiving sex education from schools or parents, pornography is the default sexual education for many, with implications for sexual attitudes and practices. Youth have a poor understanding of what is real and what is theater when viewing pornography. Pornography exposure affects adolescents’ perceptions of and engagement in risky sexual behaviors such as sex with multiple partners, infidelity, unprotected sex, sex after alcohol and drug use, and sharing nude pictures of oneself online. Violent pornography exposure correlates with perpetration of sexual assault among boys and with sexual victimization among girls. Exposure to online pornography is now normative among older children and teens, significantly affecting attitudes toward sex. Adolescents often learn sexual performance scripts or practices from pornography, and imitate these with peers, leading to risky behaviors and habits. Clinicians who work with children and adolescents should understand how to talk with and advise patients and their families about pornography and its effects. Parent-child conversations on the topic can be difficult but easier when parents pick an appropriate time and place, take a curious stance, and avoid emoting shock or judgment.
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