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12 November 2009 • Volume 16(4)  The Prevention Researcher www.TPRonline.org

Sex, Sexuality, Sexting, and SexEd: Adolescents and the Media By Jane D. Brown, Ph.D., Sarah Keller, Ph.D., and Susannah Stern, Ph.D.

Adolescents in the United States spend six to seven hours a day with some form of media, including television, music, movies, magazines, the Internet, and smart cell phones (Roberts, Foehr, & Rideout, 2005). These media have become important sex educators as they include frequent discussion and portrayals of sexual behavior that affect adolescents’ conceptions of sexual attractiveness, romantic relationships, and sexual behavior. Here we summarize brief ly what is known about the use, content and effects of sexual media among adolescents, consider how new media forms such as the Internet and cell phones are being used, and finally, discuss how the media can also be used to promote healthy sexual behavior.

TRADITIONAL MEDIA USE, CONTENT, AND EFFECTS As can be seen in Table 3.1, adolescents still spend a great deal of time each day using what we might call the “traditional” media —television, radio, movies, magazines. Much of the content in each of these media contains discussion and depictions of some aspect of sexuality and/or sexual behavior, although little of the content includes any mention or depiction of the possible risks or responsibilities of early, unprotected sexual behavior (Hust et al., 2008). Exposure to such content is related to sexual outcomes, ranging from body dissatisfaction, to earlier sexual intercourse, less contraceptive use, and even pregnancy (for a comprehensive review see Brown & Strasburger, 2007). Media use and effects on sexuality vary dramatically by a number of factors, including sexual maturity, gender, and race. Studies have shown, for example, that earlier maturing girls are more likely to be interested in sexual content in the media than their less physically mature agemates (Brown, Halpern, & L’Engle, 2005). One study found that of 150 television programs frequently

viewed by early adolescents, only four were watched by more than one-third of both black and white adolescents. Girls and boys also differed dramatically in their most frequently watched television programs, with girls preferring more relationship- oriented shows and boys preferring sports and action-adventure (Brown & Pardun, 2004).

The wide array of media available to teens provides the opportunity for choosing different kinds of content. Some apparently seek sexual content while others would rather not see it. L’Engle and colleagues (2007) identified four patterns of sexual media use among early adolescents (12 to 14 years old) which suggested that some teens also will be more susceptible to what they see about sex in the media than others, given their motivations and prior sexual experience. The teens they called “Virgin Valedictorians,” for example, were the least interested in sexual media content and were focusing on doing well in school, while the “Sexual Sophisticates” preferred sexual content, including pornography, and were the most likely to have had sexual relationships.

Today most traditional media content is accessible on the Internet, and soon will be widely available 24/7 on handheld devices. Research on how teens are using such new media forms for learning about sex is just getting started, but some recent studies provide insight about trends.

NEW MEDIA USE, CONTENT, AND EFFECTS

The new media, also sometimes called digital media, include text messaging on cell phones, MP3 players (e.g., iPods), blogs or chat rooms on Web sites, and Internet social networking sites (SNS) such as Facebook or MySpace, where many users can simultaneously create and communicate on the same Web pages.

Medium/Channels Use by Adolescents (12–17 years old) Sexual Content Sexual Attitudes/Behavior Implications

Television • Average 12 hours per week • Males average about 1.5 hours more per

week than females (Ypulse.com, 2009)

• 70% top teen programs include sex • 10% mention risk/responsibility of

sexual behavior (Kunkel et al., 2005)

Frequent exposure to sexual TV content hastens sexual initiation and early pregnancy (Chandra et al., 2008; Collins et al., 2004).

Radio/Music • Average 16 hours per week • 86% have CD/MP3 player in bedroom • 52% listen to online radio

(NPD Group, 2009)

• 37% popular songs refer to sexual activity

• 2/3 (most commonly Rap) include degrading sex (Primack et al., 2008)

Frequent exposure to sexually degrading music is associated with earlier sexual intercourse (Primack et al., 2009).

Movies • Average 2 movies per month in theater • Prefer action-adventure, comedies

(Ypulse.com, 2009)

• 25% of teen movie characters engage in sexual intercourse, often as way to achieve specific ends

• Contraception rarely portrayed (Stern, 2005)

Exposure to X-rated movies linked to more sexual partners and less contraceptive use among black adolescent urban females (Wingood et al., 2001).

Magazines • 63% of teens read a magazine for fun in last month (Chartier, 2008)

• Boys prefer sports, activity magazines; girls prefer fashion, celebrity magazines

• Teen girl magazines portray girls as obsessed with guys, and their own appearance (Wray & Steele, 2002)

• Teen boys’ magazines are more visually suggestive, all males hetero- sexual (Batchelor, Kitzinger, et al., 2004)

Reading fashion, sports, and health/fitness magazines related to body image and eating disturbances for both adolescent boys and girls (Botta, 2003).

Table 3.1

Traditional Media: Illustrative Findings of Adolescents’ Use and the Effects of Sexual Content

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As can be seen in Table 3.2, adolescents are already using the new media to engage in activities relevant to sex and sexuality. However, those who speak sweepingly of the “dangers” or “promise” of the new media, oversimplify a dynamic and complex set of practices and potential effects.

Initial research suggests that adolescents, especially boys, are using pornography on the Internet. According to surveys of Dutch adolescents (12 to 17 years old) and young U.S. teens (12 to 14 years old), about 30% of females and 50 to 70% of males have viewed sexually explicit images online. Longitudinal studies have found that such exposure predicts less progressive gender role attitudes and perpetration of sexual harassment for males, and sexual uncertainty, uncommitted sexual exploration (i.e., one-night stands, hooking up), earlier oral sex and sexual intercourse for both males and females (Brown & L’Engle, 2009; Peter & Valkenburg, 2006, 2008a, b).

Adolescents also now have greater opportunity than ever before to present themselves publicly to a geographically disparate audience. Many young people choose to display information about their sexuality and sexual lives, such as by indicating their sexual orientations on their SNS profiles, posting stories and poems about sexual desire and experience on blogs, sharing naked or semi-naked pictures and videos of themselves on SNS profiles and via mobile phones (“sexting”), and discussing sexual practices on SNS and blogs. Recent studies (notably, none of which employed a true probability sample) indicate that between one-tenth to one-fifth of teens share “inappropriate” images, references to sexual activity, and/or naked or semi-naked pictures of themselves with others electronically (Moreno et al., 2009a; National Campaign to Prevent Teen & Unplanned Pregnancy, 2009).

Can the act of sharing such sexual content be beneficial for teens in any way? Many would say yes. In fact, it has been repeatedly argued that sexual self-expression on the Internet can be functional for adolescents. The Internet provides a relatively safe space for teens to explore and define themselves as sexual beings (Stern, 2002). Different forums offer distinct opportunities; for example, SNS allow users to craft themselves as sexual (or not-yet-sexual) people to their friends, compelling ref lection on who they are and would like to be, and to initiate and maintain “dating”

relationships that can seem more intimidating in the real world (Subrahmanyam, Greenfield, & Tynes, 2004). Research on gay and lesbian youth, in particular, has demonstrated the value of the Internet as a space for experimentation and self-definition that is often difficult or dangerous in off line spaces. On the Internet, GLBT youth discuss a variety of sexual identities and queer politics, as well as seek partners, navigate the coming out process, and frankly discuss sexual practices, including safer sex (Bond, Hefner, & Drogos, 2008). The Internet also allows those who have historically been discouraged from exploring or asserting sexual desire (especially adolescent girls) an opportunity to recognize their own agency by expressing such feelings openly. The type of validation they sometimes receive can empower young people to accept and assert agency in their own off line relationships. Communicating with unknown yet similar others can also be invaluable for adolescents in another way: via the Internet, young people with sexual health concerns or problems can find peers in similar circumstances whose empathy and companionship can provide life-saving emotional connection. For example, a teen experiencing emotional trauma who locates others in similar straits may feel less alone and

Medium/Channels Use by Adolescents (12–17 years old) Sexual Content Sexual Attitudes/Behavior Implications

Internet • Average 12.5 hours online per week • Are primarily online for email, IM/ SNS,

and gaming (Chartier, 2008) • 30% of females, 70% of males view

Internet porn (Peter & Valkenburg, 2006)

• Sexual health information available • Sexually explicit images/

pornography more accessible than ever before (Brown & L’Engle, 2009)

• 44% report using the Internet to find sexual health information (KFF, 2003)

• Exposure to pornography predicts sexual uncertainty, uncommitted sexual exploration, earlier oral sex, and earlier intercourse (Brown & L’Engle, 2009; Peter & Valkenburg, 2008 a, b)

Social Networking Sites

• 38% of tweens (12–14) and 77% of teens (15–17) have a SNS profile

• SNS are especially popular among older females: 89% of 15- to 17-year-old girls have SNS (Lenhart, 2009)

• Platform for sexual self-expression and finding like-minded teens (i.e., gay, abstinent)

• About 1 in 10 teens are posting sexually suggestive images online (Moreno et al., 2009a)

Little research has yet been reported about the sexual effects of SNS.

Cell Phones • Have cell phone: 52% of 12–13 year olds 72% of 14–16 year olds 84% of 17 year olds • 58% send text messages to friends

(38% daily) (Lenhart, 2009)

• Sexual health information available • About 1 in 5 teens are “sexting”

(National Campaign, 2009)

Little research has yet been reported about the sexual effects of cell phones.

Table 3.2

New Media: Illustrative Findings of Adolescents’ Use and Effects of Sexual Content

Media use and effects on sexuality vary dramatically by a number of factors, including sexual maturity, gender, and race.

14 November 2009 • Volume 16(4)  The Prevention Researcher www.TPRonline.org

Sex, Sexuality, Sexting, and SexEd: Adolescents and the Media, continued

overwhelmed, and thus be more inclined to engage in thoughtful ref lection about his or her next steps (Keller & Balter-Reitz, 2007).

There are, however, several legitimate concerns regarding teens’ sharing of sexual content in the new media. One concern is that sexual content posted by teens may prompt the perception among teen viewers that sex is normal, even glamorous, and risk-free (Moreno et al., 2009a). Teens who see risky sexual practices that do not indicate negative consequences may be more likely to adopt the behaviors that are referenced. In consequence, Moreno et al. (2009b) suggest, user-generated sexual content may also increase the pressure virginal teens feel to become sexually active.

Another concern is that young people, especially girls, who share provocative or sexual imagery of themselves engage in a form of self-objectification in which young people “learn to think of and treat their own bodies as objects of others’ desires.” In so doing, young people may “internalize an observer’s perspective on their physical selves and learn to treat themselves as objects to be looked at and evaluated for their appearance” (American Psychological Association, 2007, p. 18). The self-objectification involved in “sexting” has received scrutiny recently. Reputations are harmed, relationships broken, and friendships shattered when receivers of naked images violate senders’ trust by sending the images on to others. Despite the growing moral panic surrounding sexting, Goodman (2009) suggested that “there is nothing particularly new about young people taking pictures of themselves. It’s as old as the Polaroid. What’s different now is that teenagers can be their own paparazzi and be vulnerable to the humiliation once reserved for celebrities” (p. 15). The ease of wide distribution also may increase the intensity and risks of such behavior.

Teens who have poor health literacy are more likely to search for sexual health information using slang terms, which

may lead to less credible Web sites.

The kinds of sexual content teens post on SNS may also affect how their friends and potential sexual partners treat them, likely in ways that reinforce the behaviors/identities presented. So, for example, a teen girl who presents herself as very sexual through a provocative picture and content indicating interest in sex may find herself labeled a “slut” by some and be more likely to encounter sexual solicitations. A recent study of teen girls who had been abused earlier in life found that those who created provocative avatars (an icon representing a person in cyberspace) were more likely to receive sexual solicitations from strangers (Noll et al., 2009).

Perhaps most worrisome is the possibility that the display of sexual content online increases teens’ chances of online victimization. Wolak and colleagues (2008) have conducted a series of national studies that find that teens who send personal information or talk online to strangers about sex are at greatest risk for sexual victimization, since they are most likely to receive sexual solicitations. Other categories of teens who are known to be at greater risk include those with histories of sexual abuse, sexual orientation concerns, and patterns of off- and online risk taking. Teens who respond to sexual solicitations are at risk not only for predation, but also for potential illness. Studies show that sex partners who meet online engage in higher-risk sexual behaviors, and are therefore at higher risk of acquiring sexually transmitted illnesses, than do partners who meet through conventional means (McFarlane, Ross, & Elford, 2004).

NEW MEDIA AS SEXUAL HEALTH EDUCATORS The newest forms of media also offer a variety of strategies for getting sexual health information to youth. New media can be successful channels for sex education for precisely the same reasons that youth are such avid users. Young people use digital media for exploring and maintaining social, sexual, and romantic relationships because of presumed safety, perceived anonymity, transcendence from adult control, 24/7 availability, and the ability to communicate with peers. Young audiences are frequent users of new media for sexual health information. Hundreds, if not thousands, of sexual health sites are maintained online, and studies show that about a quarter or more of online teens access the Internet to find information about sex, sexually transmitted diseases, and pregnancy (Lenhart, Madden, & Hitlin, 2005). Sites like www.iwannaknow.org provide interactive games that may foster safe sex negotiation. In one study, 41% of young adults said they had changed their behavior because of health information they found online, and almost half had contacted a health care provider as a result (Ybarra & Suman, 2008). Most teens (and youth advocates) agree that the Internet is a valuable place to turn for answers to embarrassing sex-related questions, to learn more about uncomfortable topics, to familiarize themselves with intimate body parts, and to gain perspective on conditions and sexual practices. Sexual health Web sites can also provide ideas about how to handle sexual situations, how to use birth control, and how to seek help when needed (Borzekowski & Rickert, 2001). Online sources may offer a sense of anonymity that may encourage teenagers to ask questions they would feel uncomfortable asking in person. There are two main concerns associated with the use of new media to learn about sex and sexual health. First is the possibility that the information teens access and/or receive is inaccurate or misleading. Since adolescents have shown little proclivity to assess the credibility of Web sites (basing their assessments on how “professional” sites look rather than on who built the site and why) (Fidel, Davies, & Douglass, 1999), it seems reasonable to speculate that teens searching online may receive information that misinforms them, or is misinterpreted by them, potentially to their detriment. This may especially be the case when Web sites created for teens primarily or exclusively use medical terminology to refer to anatomy, sexual practices, and conditions. In particular, teens who have poor health literacy (who are also more likely to be at risk for sexually transmitted diseases), are more likely to search for sexual health information using slang terms, which may lead to less credible Web sites (Cecchino & Morgan, 2009). Furthermore, the several content analyses that have looked at safe sex Web site design have found that sites promote condom use and abstinence, but few discuss other safe sex strategies, such as reducing the number of partners, reducing casual sex, or delaying first intercourse (Keller et al., 2004; Noar et al., 2006). A second concern associated with the use of new media to learn about sex and sexual health is that teens who turn to the Internet for answers may turn away from real people in their lives. Parents, community members, teachers, and doctors from teens’ own communities may better understand the unique needs and situations of individual teens. Moreover, many adults feel a strong desire to communicate certain values about sex to their own teens and dislike the notion that strangers (whether they be Web site creators or senders of sex-ed text messages) might promote or at least not condemn sexual thoughts and activities among teens. MEDIA INTERVENTIONS FOR SEXUAL HEALTH Only a handful of small-scale new media interventions for adolescents’ sexual health have been systematically evaluated so

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Research on gay and lesbian youth, in particular, has demonstrated the value of the Internet as a space and place for experimentation and self-definition that is often difficult or dangerous in offline spaces.

far. Most of these evaluations have focused on interventions of software administered in classroom settings. Results suggest that computer-based programs may be a cost effective and easily replicable means of providing teens with basic information and skills necessary to prevent pregnancy, STDs, and HIV. AIDS Interactive, for example, is a program using stories, role models, and demonstrations to provide information about HIV prevention. It was tested with 152 college students, who showed significantly higher HIV knowledge and intentions to practice safe sex with current partners (Evans et al., 2000). Students who interacted with a computer-based curriculum called Reducing the Risk outperformed other students on knowledge, condom self-efficacy, attitudes toward waiting to have sex, and perceived susceptibility to HIV (Roberto et al., 2007). Lightfoot, Comulada & Stover (2007) found that the online version of Project LIGHT (“Living in Good Health Together”), a sexuality education program targeted at high-risk adults and adolescents, was more effective than the in-person version. Some interventions combine new and old media. A clinic-based approach that used PowerPoint presentations with links to trusted sexual health Web sites on waiting room computers showed that teenagers who viewed the presentation were more likely than others to use two methods of contraception or to use a condom every time they had sex (Howard, 2009). It’s Your Sex Life (a.k.a. “Think MTV”), a campaign co-sponsored by MTV and the Kaiser Family Foundation (2003), used TV programming, TV public service announcements, and a comprehensive Web site (www.think.mtv.com). A 2003 survey of MTV viewers (ages 16 to 24) found that those who had seen campaign ads were more likely to use condoms (73%), wait to have sex (60%), and to talk with a partner about safe sex (49%). Technologies such as cell phones and SNS offer much more interactivity, although evaluations of these approaches are scarce. Some campaigns have been successful in using a SNS component. The National Campaign to Prevent Teen and Unplanned Pregnancy partnered with MySpace to produce the “Stay Teen” PSA contest. In its first month, the contest attracted 100,000 page views and 8,000 friends. All young people may not like having adults use social networking sites to promote family planning and STD clinics because they see it as “Their Space.” A survey of 994 teenagers in San Francisco found that fewer than half (41%) were willing to add a clinic as a friend on their own SNS (Ralph, 2009). In another study, a physician sent an email to 190 teens she had never met who had posted sexual and other risky content on SNS profiles. The email from “Dr. Meg” indicated concern with the teens’ risky posts, provided information about privacy settings, offered a link to a Web site where a free STD kit could be obtained,

and encouraged teens with questions to talk to parents, doctors, or to email her back. The results suggested the email accounted for a significant number of the contacted teens removing the risky content from their own pages or changing their privacy settings (Moreno et al., 2009b). Capitalizing on teens’ love affair with cell phones, Internet Sexuality Information Services, Inc. (ISIS), a nonprofit based in Oakland, California, partnered with the San Francisco Department of Public Health to develop a sexual health text messaging service for youth. SexInfo allows teens to use their cell phones in a manner similar to when they vote for their favorite American Idol contestant. The most popular call requests have been: “A1 if ur condom broke,” “C3 to find out about STIs,” and “B1 if u think ur pregnant.” Preliminary data showed that 4,500 callers used the service during the first 25 weeks; 2,500 of the calls led to referrals and requests for more information (Levine et al., 2008). ISIS also launched a Web site (www.inSPOT.org) that offers information about getting tested and treatment. It also enables people with STDs to send anonymous email warnings to their partners. The site sends e-cards to notify people that they may have been exposed to an infection (e.g., “Sometimes there are strings attached. I got diagnosed with STDs since we were together. Get checked out soon.”) (Honan, 2008).

CONCLUSIONS It is clear that both the new and traditional media are being used by adolescents as they learn more about their developing sexuality. Much of existing media content, unfortunately, is not designed to result in healthy sexuality. Both new and older forms of media can be used to promote healthier sexuality among adolescents, however. Certainly we need to know more—both in terms of the types of interventions possible with traditional and new media, and from evaluations to ensure that time and funds are well spent. Most existing interventions have failed to target messages to specific audiences, such as sexual minorities or adolescents with varying levels of sexual experience. Interventions need to be targeted not only by style and content but also by channel, since different categories of teenagers use new technologies differently. Internet, MP3, and cell phone technologies offer not only more

SUGGESTIONS RESOURCES

Acknowledge normality and value of using new media to explore sexuality and romantic relationships. Direct teens to the best Web sites.

www.sexetc.org www.iwannaknow.org www.amplifyyourvoice.org www.thenationalcampaign.org

Educate teens about how to assess the credibility of the Web sites they consult for sexual health information.

American Library Association: www.ala.org/ala/mgrps/divs/lita

Encourage teens to use privacy settings on social networking sites. Discourage teens from communicating sexual behavior and preferences, and sending sexual content online, especially to strangers.

Federal Trade Commission: Social Networking Sites: Safety Tips for Tweens and Teens www.ftc.gov/bcp/edu/pubs/ consumer/tech/tec14.shtm

Educate teens about the pitfalls (e.g., statutory rape laws in most states) of sexual relationships with adults (Wolak et al., 2008).

Statutory Rape Laws by State: www.cga.ct.gov/2003/olrdata/ jud/rpt/2003-R-0376.htm

Table 3.3

Suggestions and Resources for Adults Working With Adolescents

16 November 2009 • Volume 16(4)  The Prevention Researcher www.TPRonline.org

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Sex, Sexuality, Sexting, and SexEd: Adolescents and the Media, continued

cost-effective dissemination, but also the ability to reach a wider diversity of audiences (including young adolescents) in ways never before possible. Poorer youth, for example, may be reached more effectively with text messages since they are less likely to have access to or use computers, except for schoolwork (Pascoe, 2009).

In sum, although adolescents are using digital media to access sexual health information, such media are not yet filling the sexual health gap. Young users need to be taught how to assess the credibility of online information, and parents and others who work with young people need to know about credible sexual health Web sites and content in traditional media that promotes

healthier sexual behavior so they can help steer adolescents in the right direction (See Table 3.3). 

Jane D. Brown, Ph.D., (Jane_Brown@unc.edu) is the James L. Knight Professor in the School of Journalism and Mass Communication at the University of North Carolina in Chapel Hill. She has spent more than 25 years studying how adolescents use and are affected by the media. Sarah N. Keller, Ph.D., Associate Professor of Communication, Montana State University-Billings, is an expert in public health communication and evaluation. Susannah R. Stern, Ph.D., is an Associate Professor in Communication Studies at the University of

San Diego. Her research investigates how children and teens use and make sense of media, how young people are targeted as media consumers, and how they are affected by electronic media.

Jane Brown

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