Public health

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Author: Kath Albury, Natalie Hendry Title: Information, influence, ritual, participation:

Defining digital sexual health Article number: 144078332211365 Year: 2023 Journal: Journal of Sociology Volume: 59 Issue: 3 Pages: 628-645 URL: http://hdl.handle.net/1959.3/469439

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Informa�on, influence, ritual, par�cipa�on: Defining digital sexual health Kath Albury and Natalie Hendry

Abstract

This article draws on Epstein’s theorisations of the ‘ideal’ of sexual health and wellbeing to argue that young people’s access to digital sexual health content should not be understood primarily as a process of ‘information seeking’. Where digital practices are too narrowly viewed through a lens of information seeking and transmission, there may be an excessive focus on whether sexual health content is ‘factual’ – overlooking the question of whether it is meaningful in specific cultural contexts. We link contemporary digital sexual health cultures to the complex – and politicised – histories of popular mediated sexual health communication that underpin them. Exploring alternative theoretical frames – including pornographic vernaculars, influencer pedagogies, media as ritual, and situated peripheral learning in digital communities – we conclude that redefining and refocusing dominant understandings of ‘good’ sexual health content may generate new and productive strategies for engaging with marginal and disaffected digital sexual cultures.

Keywords

digital media, health communication, sexual cultures, sexual health, young people

Corresponding author:

Kath Albury, Swinburne University of Technology, Hawthorn, Victoria, Australia.

Email: [email protected]

Introduction

Digital media has increasingly blurred the boundaries between ‘celebrity’ and ‘influencer’ in recent years, with high-profile YouTubers cast in films and television series, and Hollywood A-listers (the exemplar being Gwyneth Paltrow) transitioning into the role of online entrepreneur/influencer. In this context, both popular and scholarly commentators have debated the relationship between sexual cultures, sex education, and social media content (McKee et al., 2018; Saner, 2018). Celebrities/influencers are often framed as recent (and fundamentally misleading) interlopers in the sphere of sexual health and sex education (see e.g. Wiseman, 2019). Additionally, as Albury (2013) has previously argued, communication strategies and campaigns informed by a public health approach often approach digital media platforms and technologies as spaces where ‘myths’ (or bad information) can and should be countered by ‘facts’ (or good information).

But what are the facts of sexual health? Since the early 2000s, a growing body of literature has sought to evaluate the qualifications of digital sexual health content producers, and the scientific quality of the information they provide (e.g. Buhi et al., 2010; Khurana and Bleakley, 2015; Stanley et al., 2019). But this work leaves a number of questions unanswered. What is the ‘right’ way to learn about sex, and what counts as ‘sexual health information’? Should sexual health experts share scientific expertise, personal experience – or both? And is ‘information seeking’ the right way to describe media users’ activities, or are other terms (such as learning, participation or ritual) more appropriate?

While the disciplinary domains of sexual health education, health promotion and clinical sexual health services are engaging with these questions, their work is primarily grounded in positivist modes of analysis (Epstein, 2022). Unsurprisingly, much of the research into digital technology and popular media within public health (or health adjacent) disciplines favours quantitative methods and information- focused models of communication in which epidemiological metaphors such as ‘virality’, ‘exposure’, ‘contagion’ and ‘prevalence’ are used to describe media practices or cultures of use (e.g. Lewis et al., 2018).

Indeed, as media historian Ghislain Thibault notes, the ‘hypodermic model’ of mass communication (also known as the ‘sender>message >receiver’ model) has theoretical origins in early 20th-century US military rationales for production of ‘venereal disease’ prevention propaganda films (Thibault, 2016). While this model has been contested in the broad fields of media and communication studies, many public health practitioners still seem to assume that a ‘good’ sexual health message or campaign is one that provides an authoritative signal that is a prophylactic (or antidote) to the ‘noise’ of vernacular digital sexual cultures (Albury, 2019). Such an approach has implications for the field of contemporary sexual health practice, particularly where sexual health promotion and sexuality education practitioners seek to engage with young people’s digital sexual cultures – for example, in discussions of celebrities and influencers as sexual ‘role models’(Albury, 2013).

This article offers an overview of the messiness that emerges when media content relating to sexuality is defined in terms of ‘sexual health information’, and practices of media use are defined as ‘information seeking’. Rather than seeking to delineate the differences between legitimate/expert and illegitimate/influencer sources of sexual health content, we first trace the links between contemporary ‘authentic’ or relatable influencer cultures, and the long-standing historical genres of mediated sexual expertise that underpin them. We challenge the assumption that mediated sexual content sits in opposition to ‘good’ sexual health – on the contrary, we suggest that popular media accounts of sexuality and have informed contemporary definitions of sexual health and wellbeing. These earlier pre-digital ‘sexperts’ and mediated cultures may offer nuanced precedents for understanding digital sexual cultures beyond good or bad sexual health messaging.

We then push back against the notion that media use should primarily be understood as a process of ‘information seeking’ and ‘information transmission’ (Carey, 2008); suggesting that ‘sexual health information’ may not be the most useful framework for understanding contemporary digital sexual learning practices and cultures. To be clear, we do not dismiss the utility of factual ‘sexual health information’ entirely. Not do we seek to argue that celebrities, influencers or other content creators are ‘better’ guides for sexual learning than professional educators or health specialists. Drawing on recent

studies of health influencer pedagogies (Hendry et al., 2021) and cultures of situated peripheral learning in digital communities (Marwick and Lewis, 2017), we suggest that a focus on ‘sexual health information’ (and by extension, sexual health dis- or mis-information) is too narrow for understanding digital sexual learning practices and cultures. Instead, we build an argument to propose more expansive frameworks for understanding how sexuality and sexual health-related content circulates in digital cultures, where these frameworks may better account for the ritual and communicative aspects of both sexual cultures and media practices.

Background: defining sexual health

As Steven Epstein (2022) observes, ‘sexual health’ is not so much an ontological state of being as it is an ‘elusive [and recently minted] ideal’. The World Health Organization (WHO) website defines sexual health as:

a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. (WHO, 2022 [2006])

But as Epstein notes, while the WHO definition is broad-ranging and ‘capacious’, the defining characteristics of sexual health are still intensely contested in both popular and scholarly discourse. While more traditionally biomedically bounded notions of sexual health primarily focus on the prevention and treatment of sexually transmitted infections, blood-borne viruses such as HIV, and diseases and disorders impacting conception and childbirth, often subsumed into the category of ‘reproductive health’ (Epstein, 2022, pp. 6–7). In the WHO’s 2017 operational guidelines for reproductive and sexual health policy and program implementation, aspects of sexual and reproductive health are represented graphically as rosette of ‘distinct but intertwined’ elements (WHO, 2017, p. 10), including ‘fertility care’, ‘sexual function and psychosocial counselling’, ‘prevention and control of HIV and other sexually transmissible infection’, and ‘comprehensive

education and information’ (WHO, 2017, p. 5). These constitutive elements are surrounded by what the guidelines describe as ‘a climate of social-structural factors’ (such as ‘laws, policies, regulations and strategies’); and underpinned by a ‘foundation of guiding principles’ (such as ‘respect, protection and fulfilment of human rights’) (WHO, 2017, p. 5).

As these guidelines demonstrate, biomedical understandings of sexual health are increasingly eclipsed or elided by the broader notions of sexual rights and sexual wellbeing – a term that is, in itself, simultaneously precise and vague (Epstein, 2022, p. 8). There are a number of academic studies – and validated scales – that aim to both define and measure sexual wellbeing in precise terms with reference to reported psychological, socio-political and physiological factors (e.g. Rosen & Bachmann, 2008, Schick et al., 2008, Stephenson & Meston 2010). Within popular discourse, however, sexual wellbeing is a more amorphous term, that relies less on quantitative measurement, and more on more individualised self-reporting. Similarly, the notion of sexual rights can be precisely defined (and contested) with reference to human rights frameworks (Petchesky, 2000), or can be interpreted more loosely in vernacular discussions about sexual behaviour and identity – example in relation to the question of whether anyone has a ‘right to sex’ (Srinivasan, 2021).

This article does not seek to interrogate any of these terms in depth – indeed all of them are already subject to many thousands of words of dissent and deconstruction. We offer these introductory (and incomplete) definitions as a preamble to a more considered reflection on the challenges inherent in discussions of ‘sexual health information seeking’ in digital environments – particularly where it is assumed that media users are primarily seeking the transmission of facts.

Mediating sexual health

As Barker and colleagues (2018) observe, there is a long, pre-digital history of mediated sexual advice-giving. Drawing on Foucault’s (1978) theorisations of ‘the proliferation of discourse’, they suggest that mediated sexual communication – ranging from medical problem- pages in magazines, to newspaper ‘agony aunt’ columns, to VHS ‘edu- porn’ – played a central role in shaping 20th-century understandings of sexuality and gender. Like Epstein (2022), Barker and colleagues (2018)

paint a comprehensive picture of the increasingly broad range of topics that have come to be in-scope for mediated discussions of sexuality and sexual health – including normative frameworks for genital appearance, sexual functioning and dysfunction; ‘how-to’ instructions for specific sexual practices; and broader instruction around ‘healthy’ sex (and sexual etiquette) in the context of dating and relationships.

From the 1980s onward, popular mediated sex advice targeting both LGBTQ+ communities and cis heterosexual audiences increasingly included instructions for negotiating the use of latex barriers (primarily as a form of HIV prevention) for both vaginal and anal contact (Albury, 2002; Patton, 1996). In the late 1990s, popular sex columnists such as Dan Savage mainstreamed discussions of sexual practices and subcultures that were previously seen as primarily queer or ‘alternative’ (Holden, 2020). By the early 2000s, a proliferation of digital technologies and platforms both amplified and refocused these mediated practices of advice-seeking and advice-giving. As Savage put it in a 2021 interview:

Search engines made my job harder. Because I used to get a lot of how-to questions or what is. People would hear about something or overhear something, and they wouldn’t have a place to go where they could look that up very easily and they’d ask me. And those columns were easy to write.… What is this particular sex toy? Well, now that particular sex toy has its own wiki page, as does almost any sex act that you can think of, which means all of my questions are situational ethics. (Savage in Shapiro et al., 2021)

It may seem from the above account that mediated sexual health advice was only recently ‘complicated’ by the intermingling of biomedical and socio-political understandings of sexual health and wellbeing. But as Comella (2017) observes, reflecting on her extended ethnography of the US feminist sex toy industry, many contemporary understandings of sexual health, reproductive health and sexual wellbeing as political have their origins in the Women’s Liberation movements of the 1960s and 1970s.

The ideology and ethos of feminist politics were expressed through multiple iterations of the foundational women’s sexual and reproductive health primer Our Bodies Ourselves, which both

countered biomedical understandings of sexual health expertise with first-person accounts of embodied sexual experience and promoted narratives of ‘normal’ sexual function drawn from medical and sexological research (Wells, 2008). Across multiple editions, Our Bodies Ourselves was not credited to a single author (or group of authors) but was instead attributed to the Boston Women’s Health Collective. But while this formative example of (Anglophone) sexual health information-sharing reflects a collective and communitarian approach, other high-profile 20th-century sexual health communication pioneers had much in common with contemporary digital micro-celebrities and influencers.

Influence before influencers

Beyond the feminist self-help movement, the so-called sexual revolution of the 1960s and 1970s was itself expressed through and shaped via popular media – from the unencumbered masculine Playboy ethos (documented by Ehrenreich, 1983, among others), to the ‘liberated’ sexuality personified by high-profile feminists including Gloria Steinem and Germaine Greer. As both a prolific media producer and popular subject of reportage, Greer promoted cuntpower (or active female heterosexual pleasure) across alternative/ countercultural press such as Suck in 1970 and 1971. She amplified her reach via mainstream broadcast and print media coverage of her bestseller The Female Eunuch in 1972. As Le Masurier (2016, p. 37) observes, ‘part of Greer’s appeal was her insistence on personal rebellion’ – or what now might be viewed as a personal brand. Within both her media appearances and her own writing she personified what we now might term an aspirational yet ‘relatable’ form of revolutionary sexuality.

Similarly, Betty Dodson, a visual artist, author, sexual adventurer and pioneering ‘hands on’ masturbation educator/workshop facilitator built a national and international profile following the publication of her article ‘Liberating masturbation’ in Ms. Magazine (Dodson, 2016; Epstein, 2022). Her book of the same name (later revised and re-issued as Sex for One) blended accounts of her personal sexual experiences, explicit illustrated sex tips, and ‘how to’s for healing sexual shame to form what can be seen as a template for contemporary media discussions of sex and sexuality. And while Dodson, Greer (and their

fellow early feminist celebrities) can be seen as the antecedents of contemporary digital sexual health and wellness influencers, bloggers and vloggers, they were just a small part of a much broader movement (Barker et al., 2018; Comella, 2017).

The legacy of early popular feminist ‘sexperts’ into the 1980s and 1990s similarly endorsed and amplified first-person sexual narrative as a legitimate form sexual health expertise (Barker et al., 2018). Deploying a range of media genres ranging from confessional sex diaries, or accounts of participation in sexual adventurism that evoked ‘gonzo’ journalism, alt-sexual influencers such as Annie Sprinkle and Susie Bright offered advice across in a range of media environments, ranging from sex magazines targeting men, to lesbian-focused alternative porn (Juno and Vale, 1991). These iterations in turn informed the ‘elusive’ definitions and redefinitions of sexual health, as documented by Epstein (2022). While these (micro)celebrity genres outlined above primarily targeted women, a parallel movement of what UK commentators termed ‘lad mags’ offered sex and relationship content to men, drawing on similarly playful and experiential narrative tropes (Gauntlett, 2008; Gill, 2007). As hard copy magazine and newspaper circulation declined, digital-first newsletter and magazines (such as Vice, Buzzfeed and Mel Magazine) reshaped sexual health- focused ‘lifestyle journalism’ according to digital conventions (Albury, 2019).

By the mid 2000s, social websites and platforms such as Facebook, MySpace, YouTube and Tumblr eclipsed both print media and legacy news as the most significant sites for circulating sexual content. A 2019 survey of 3895 young people (commissioned by UNESCO) reports that the top three sources of ‘information/education about the body, sex and relationships’ for 15–24-year-olds across 112 countries were ‘friends and peers’ (31%), ‘digital spaces’ (29%) and ‘school based education’ (25%) (UNESCO, 2020, p. 5). Young women, and non-binary or gender-fluid survey respondents were most likely to have used digital sources to seek information on all topics, including personal relationships, cultural attitudes to sexuality, sexual orientation, gender roles and discrimination, sexually transmitted infections and HIV, sexual harassment and abuse (UNESCO, 2020, p. 8). Respondents had accessed a range of digital resources – including apps, videos and websites – as sources of information, however their preferred sources

were ‘articles/blogs’ (33%) and ‘erotic content’ (32%) (UNESCO, 2020, p. 9). While the study specifically focuses on digital practices, many of the sources listed build on pre-digital histories of sexual media content production – particularly those that blur the boundaries between factual and entertainment content.

Vernacular pedagogies and sexual health

From the 1990s, North American producers of commercial pornography have produced ‘couples’ videos that specifically offer sexually explicit instruction in particular sexual practices within the genre of ‘educational porn’ (Albury, 2014). Similarly, in the United Kingdom, health promotion organisation The Pleasure Project has collaborated with professional sexual entertainment producers to create explicit heterosexual content featuring condoms (Knerr and Philpott, 2009). Others have also sought to incorporate safer-sex strategies, including the use of gloves, condoms, and ‘dirty talk as sexual negotiation’ into their digital content, although this is more common in explicitly queer/ lesbian porn production (Stardust, 2014).

While pornography that features condoms is seen to model safer-sex within the gay men’s community, bareback (or condomless) gay porn content can be viewed as pedagogical in a negative sense – that is, it is suspected of eroticising and thus promoting practices of unprotected anal intercourse. Indeed, prior to the advent of pre-exposure prophylaxis for HIV, sexual health organisations in Australia and the United Kingdom sought to intervene in public conversations about barebacking in pornography, with the AIDS Council of NSW (now known as ACON Health) requesting that sex-on-premises venues seek to conform with safer-sex ‘best-practice’ codes not broadcast bareback porn in their screening rooms (AIDS Council of NSW, 2008, p. 5). However, as Sharif Mowlabocus and colleagues (2013) observe, while both younger and older gay men may value pornography as a site for fantasy, pleasure and connection with gay sexual cultures, when questioned directly (in an interview context) about whether pornography ‘taught’ them to desire unprotected anal intercourse, men describe the appeal primarily in relation to ‘fantasy’ alone. They draw on media studies approaches to the ways audiences’ sense-making practices to explain this contradiction:

the direct media effects argument is, at best, problematic, because it seeks to identify a single cause upon which to attribute a particular social problem. In doing so, it marginalises the respondents’ ability to manufacture, frame and negotiate complex textual meanings.… Meanwhile the advent of the ‘circuit of culture’ response to the media effects debate … has decentred the primacy (and power) of the text over the consumer. (Mowlabocus et al., 2013, p. 531)

In their reflections on the contradictions emerging in gay men’s conversations about the pleasure they gain from watching bareback porn, Mowlabocus and colleagues draw attention to a central dilemma that can be seen to trouble pedagogical sexual health content more generally. On one level, many interviewees associated condomless sex with ‘taboo’, since the use of condoms was so deeply embedded in gay men’s cultures for nearly 40 years. At the same time, as Mowlabocus and colleagues note, ‘in gay male subculture today, using condoms during sex continues to be regarded as important, but watching bareback pornography is what is interesting’ (2013, p. 540, original emphasis).

Since the mid 2000s, a range of government and non-government organisations have created digital sexual health and wellbeing content for adults that engages with this tension between interesting and important. For example, Sex School, a Berlin-based digital sex education platform created by feminist porn producers, offers both sexually explicit and non-explicit educational videos on topics ranging from kissing to BDSM on either a ‘day-pass’ or longer-term subscription basis (https://sexschoolhub.com/how-itworks/). In Australia, the New South Wales Health Department has funded Take Blaktion, a sexual health promotion video series scripted and performed by Aboriginal comedians, and produced by a First Nations- led media company (McCormack, 2022). While some of these projects freely draw on what Cindy Patton (1991) has termed ‘the pornographic vernacular’, others invoke cultural entertainment genres. In contrast, the majority of government- and non-government-produced digital sexual health content targeting young people seems to offer less variety – and interest – in both content and tone.

Important vs interesting: online sexual health content and young people

Mowlabocus and colleagues’ (2013) distinction between the kind of sexual knowledge that is important, versus the kind of knowledge that might be interesting evokes Alan McKee and colleagues’ (2014) research into the differences between adult perceptions of appropriate sexuality education, and the kind of content that school- aged young people say they want to see. When asked about the value of the sexual health information they received at school, the young participants in McKee and colleagues’ study responded that classroom content was too ‘scientific’ – that is, abstract or clinical – and not sufficiently applicable to everyday relationships and sexual cultures (McKee et al., 2014, p. 656). Participants in the study suggested that while it was acceptable to discuss sexually transmitted infections in the context of sexuality education, there was no space in sex education for discussing sex in a way that acknowledged that they might be sexually active.

This meant that the application of safe-sex knowledge (i.e. where to buy a condom, or how to use one in the context of a sexual encounter) was disconnected from the content provided in the classroom where they might (for example) be taught to roll an unpackaged condom onto a banana (McKee et al., 2014, p. 659). In later projects drawing on this research, McKee sought to build new models for entertaining (and by extension, interesting) forms of youth-focused sexuality education in collaboration with the Australian teen girls’ magazine Girlfriend (McKee, 2017), and with a non-government sexual and reproductive health organisation (McKee et al., 2018). The latter project involved the production of a series of ‘vulgar’ comedy videos for young men, which were initially intended to be shared on social media by young people. The videos featured male comedians acting as ‘influencers’ performing a comedy monologue on a sexual topic (such as masturbation), followed by short, reflective interviews.

Although the content of the app was humorous and sexually suggestive, it was not sexually explicit and did not ‘punch down’ at cis- gendered women or trans people. Despite this, adult stakeholders in the project expressed concern that sharing the content on YouTube or similar channels would make it difficult to ‘control’ the messaging and interpretation of the content, making it too ‘risky’ (organisationally) to distribute directly to the intended audience via social media (McKee et al., 2018, p. 4581). As McKee and colleagues note, there are certainly

risks associated with the distribution of sexual health media on YouTube itself, in that sexual health organisations are unable to control the content of the advertising – and other videos – that YouTube’s algorithms associate with uploaded material (McKee et al., 2018, p. 4582). In the context of a video targeting heterosexual young men (for example), there is a real possibility that a video that aims to promote respectful relationships might be associated (via YouTube’s recommender systems) with a playlist of misogynist ‘neo- traditionalists’ asserting men’s innate dominance over women; or ‘pick-up artist’ vloggers promoting manipulative or abusive sexual behaviour (Mozilla Foundation, 2021).

However, the adult stakeholders in McKee’s study were not concerned by YouTube’s algorithmic affordances – rather, they were worried that social media content could not afford an assurance that audience members would interpret digital content ‘correctly’. It was implied that young people could not interpret the presentation of lived experience (even in the more ‘serious’ interview content) unless an ‘expert’ educator guided their reflections. This framing of social media content as risky information leads us back to our central question of whether and how sexual health content can best be understood in terms of ‘education’ or ‘information’.

Influencers and sexual health: authenticity as pedagogy

Implicit in our discussion is a claim that these earlier mediated sexual cultures offer precedents for how we might understand contemporary sexual health content creators or influencers who actively circulate sexual health content within attention economies. While mapping the concept and history of influencer culture is beyond the scope of this article (see Abidin, 2018a), what is critical here is how influencers, as microcelebrities (Senft, 2008) or cultural intermediaries (Hutchinson, 2017), rely on the digital infrastructures and platforms that enable them to share content through relatable and authentic performances. These performances may be commercial (e.g. sharing a review of a new sex toy they co-branded), mundane (e.g. sitting in a waiting room at a health service for an STI testing appointment), involve cultural or social advice (e.g. asking their followers what they think about a personal problem or discussing the pros and cons of a new dating app) or something in between all three. Of course, these practices draw on

broader social media vernacular cultures and are not exclusive to influencers. But what is central to influencer culture is its capacity to publicly direct attention towards commercial aspirations and interests, often alongside personal goals, that may also provide sex education.

Writing about health communication more generally, Joseph Petraglia (2009) offers a useful framework for the pedagogical role of influencer cultures. He argues that public health promotion often overlooks the role of authenticity. As the attention economy becomes more and more complex, the problem Petraglia identified in 2009 has become more intensified: public health communication and ‘health education circulates so widely but so impersonally, that it blends into the scenery’ (2009, p. 176). What is missing, in Petraglia’s (2009, p. 176) analysis, is authenticity, understood as ‘not just perceived relevance but a felt relevance that pulls information out of the background and to the fore. Authenticity enables individuals to understand, emotionally as well as cognitively, how information can relate to their everyday existence.’ What is important here is not whether or not health information is objectively true – a point we return to below – but how someone engaging with that information, educator, influencer or platform perceives it as authentic.

In Petraglia’s account, authenticity affords health communication or education through two elements that are distinct from the simplistic media effects or behaviour change ‘hypodermic models’ of communication. First, authenticity emerges through stories and narrative that convey ‘rich contextualisation’ (Petraglia, 2009, p. 176) that help persuade people towards health information, but also particular values, norms, ideas and practices. We can see this operating through ‘the pornographic vernacular’, where porn potentially offers entertaining mediated narratives of shared identities, fantasy, playfulness, and, in Mowlabocus and colleagues’ (2013) distinction, between what is important and what is interesting.

Second, authenticity and persuasion are enacted through participatory dialogical practices that emerge through interaction between ‘the rhetor and [their] audience.… It is not controlled or predetermined … but is co-constructed and constantly evolving’ (Petraglia, 2009, p. 179). This dialogue or interaction operates as a ‘self-

actualising process’ or ‘a product of private deliberation’ of teasing out a solution from conflicting thoughts or ideas. This moves us away from sexual health information seeking as a static moment in time or where sexual ‘myths’ can be simply countered by providing the public with the ‘right’ facts. As Petraglia (2009, p. 185) reflects: many health messages are not so much incomprehensible or imprecise as they are inauthentic – they do not jibe with what people know about themselves and the world they live in. Accordingly, the challenge health educators and communicators face has less to do with giving the ‘right’ information than with persuading the learner that information and ideas are relevant to their everyday existence.

In this way, authenticity and persuasion underpin what Hendry and colleagues (2021) frame as ‘influencer pedagogy’, or ‘the indirect, mediated processes of education produced through relatable interactions between influencers and their followers on social media platforms’ (2021, p. 1). This influencer pedagogical potential is distinct from formal health teachers or other educators on social media who seek to integrate content with formal educational practice. An influencer pedagogy is inherently dynamic and co-constructed as people interact with influencers, digital platforms and devices. It capitalises on the parasocial relationships (Horton & Wohl, 1956) between influencers, health communicators and entrepreneurs and their audiences, as well as the everyday practices of people scrolling through platforms and accounts, interacting with content organised by algorithmic processes, and establishing a felt sense of authenticity, relatability or shared values with influencers. Again, what is important is not whether or not someone is or isn’t ‘truthfully’ authentic – what is perceived as authentic for influencers and others on social media changes over time (see Abidin, 2017, 2018b, for examples of changes in influencer authenticity) – nor whether or not authenticity refers to a quality inherent in an individual or is a social performance (Petraglia, 1998).

Influencer pedagogy highlights how influencers and other content creators disavow yet at other times evoke the role of an educator. Australian ‘media personality’ and influencer, Abbie Chatfield, exemplifies this pedagogical capacity as she straddles the tension between sharing interesting and important content on social media. In 2019, Chatfield appeared on the Australian reality television show, The

Bachelor, and other reality shows, later working as a television and radio host. Noted for her ‘outspoken’ views, Chatfield frames her podcast It’s A Lot (2022) as ‘The classic “education but make it fun” mantra’, extending how she used her Instagram ‘in the way that I wanted to, discussing sex, mental health, the patriarchy and everything in between’, and with an ‘IDGAF [I Don’t Give A Fuck] approach to all of these taboo topics’. On social media, radio and her podcast, Chatfield has discussed open relationships; advocated for Covid-19 vaccination; interviewed sex workers; and promoted an ABBIE g-spot vibrator. These practices offer opportunities for learning, both explicitly (e.g. inviting guests to share their expertise on her podcast) and implicitly (e.g. sharing her day-to-day struggles with neurodiversity). At the same time, we can see Chatfield’s practices as extending pre-digital cultures and ‘sexpertise’ as she continues sharing about topics typically discussed by Savage, Dodson, Bright and others.

Whether or not influencers like Abbie Chatfield identify as educators or health communicators is irrelevant; ‘influencer pedagogy implicitly embraces tensions between being and not being an educator’ (Hendry et al., 2021, p. 11, original emphasis). Influencers, and others who adopt the tropes and practices of influencer culture, balance varying degrees of expertise and personal testimony alongside commercial activities or aspirations. Other social media figures and users embrace influencer cultures and practices – and in turn, we argue, influencer pedagogies – to different degrees. For example, Southerton (2021) identifies how, through the Covid-19 pandemic, medical workers on TikTok adopted the vernacular practices and sensibility of TikTok genres to convey professionalism but also their personal experiences. Understanding the potential for influencers’ cultures to offer both intentional and unintentional, and explicit and implicit opportunities for sexual learning may offer useful examples for rethinking ‘good’ sexual health education.

But is digital sexual health content ‘information’?

Throughout this article, we have referred to sexual health media content as health information, echoing the scholarly tendency to frame the ideal or imagined audience for such content as sexual health information seekers. We have used this term partly out of expediency –

it is both common and familiar. Further, as we have noted in relation to health communication and influencer pedagogies, it makes sense to distinguish more informal online sexual health content (whether it is instructional/pedagogical or more clearly entertainment-focused) from more formal educational content that is structured and organised around curricula, assessment tasks and learning outcomes. Whether it is defined as ‘relationships and sexuality education’ or ‘sexual and reproductive health education’, such content is generally subject to extensive policy and funding guidelines, governmental or legislative oversights, standardisation and associated forms of governance relating to delivery and outcomes. In contrast, sexual health ‘information’ is less bounded and rigid (even if it is delivered as part of an organised program or campaign). Drawing on recent media and cultural studies traditions that seek to understand digital media use not simply as an individualised act of consumption, but as an activity that takes place in the context of ‘everyday data cultures’ (Burgess et al., 2022), we now reflect on whether information – and information seeking – is the best way to understand sexual health content.

In an article for the online magazine Real Life, Mick Hagood (2020) follows a thread of ‘infocentrism’ through 20th-century communication scholarship. In doing so, he draws attention to the limitations that the equating of media technologies with ‘information’ has imposed on a range of disciplines. While acknowledging that producing, circulating and accumulating information is one aspect of everyday media practice, Hagood draws on Spinoza’s Ethics to argue that those who view media content and media practice exclusively through what might be termed a moral contest between ‘legitimate’ information and dis- or misinformation are missing the point. Media networks do not connect our minds so much as they connect ‘our flesh, bones, and guts’ (Hagood, 2020).

To put it another way, our lifeworlds are not simply the products of rational accumulations and tabulations of data, they are constituted by our hopes, fears, injuries, pleasures, disappointments and dreams. Hagood argues that contemporary media economies are governed by what he terms ‘information capitalism’ precisely because the affective dimensions of media – including its ability to soothe, distract and excite – have been minimised or dismissed in both scholarly debates

and popular commentary around media literacies. Hagood supports this proposal with reference to US communication scholar James Carey’s theorisation of ‘media as ritual’ – a model Carey proposed to counter the largely ‘effects’-focused communication scholarship that gained popularity from the 1960s onwards.

In a series of interlinked essays collated in the book Communication as Culture, Carey (2008) juxtaposes two understandings of mediated communication. The first model, which he dubs ‘media as transmission’, frames communication (via metaphor) as a process of moving information through space. This understanding of communication, Carey argues, dates back to the early days of shipping dispatches, telegraphs and the expansion of railways across the United States. In this context, communication is primarily seen as a means of linking geographical locations, and specific sites of expertise and industry. Media content, in this framework, is a form of commodity, that can be (in Carey’s words) ‘transported, measured, reduced, and timed’ (2008, p. 193).

This description might sound very familiar to anyone here who has been part of the development of a health communication resource or health promotion campaign. What is lost in this understanding of communication, Carey argues, is the way that media practices reinscribe other modes of engagement – from theatre to religion. In what Carey terms the ‘ritual’ view of communication, media is not about the transmission of information – it is about building and sustaining culture. Rather than imagining a precise and measurable ‘cause and effect’ relationship between a particular piece of media content and a particular ‘consumer’s’ beliefs or behaviours, the ritual view suggests we attend to repetitive patterns of media use – things like checking for Tinder matches while we’re in the library studying for an exam, scrolling TikTok on the train, or watching the news every night while cooking dinner.

These ritual practices, Carey argues can help us build and maintain our identities and interpersonal connections. As he puts it:

In a ritual definition, communication is linked to terms such as ‘sharing,’ ‘participation,’ ‘association,’ ‘fellowship,’ and ‘the possession of a common faith.’ This definition exploits the ancient identity and common roots of the terms ‘commonness,’ ‘communion,’ ‘community,’

and ‘communication.’ A ritual view of communication is directed not toward the extension of messages in space but toward the maintenance of society in time; not the act of imparting information but the representation of shared beliefs. (Carey, 2008, p. 5)

Engaging with media can be, according to the ritual view, more akin to attending a religious service (or a similar community gathering) than a practice of ‘information transmission’. Information may be shared or acquired, but this occurs in the context of a cultural practice, as part of shared feelings, senses and aesthetic experiences. Here, digital communication takes place in (or aspires to create) community.

Sexual health and learning in community

In their dialogic reflection on young people’s digitally mediated cultures, Henry Jenkins, Mizuko Ito and danah boyd suggest that young people’s engagements with these spaces are best understood not as ‘exposure’ or even ‘consumption’, but as ‘modes of participation’ (2015, p. 37). Building on Jenkins’ foundational work on participatory cultures (1992) – specifically the creative sites of cultural appropriation and ‘remix’ populated by media fans – Jenkins et al. (2015) reflect on the ways that young people come together in digital environments that enable what Lave and Wenger (1991) have termed ‘situated peripheral learning’ in communities of practice. Such spaces serve as sites of informal learning where newcomers are able to learn (and negotiate their identities) via observation of established community conventions. Later, Ito and colleagues (2019) theorise this as learning through ‘affinity networks’ – digital peer networks sharing similar relational and culturally situated interests – where educational aims (e.g. learning about consent and sex in private online group or sharing stories about negotiating relationships and managing medication for chronic illnesses or mental health challenges) are supported relationally through peer brokering and connection rather than ‘transferring’ information.

As Etienne Wenger describes it, the concept of ‘communities of practice’ does not seek to understand psychological or developmental aspects of learning, but instead foregrounds the social and cultural dimensions of learning in relationship to others (Wenger, 1998, p. 5). Wenger explains that learning does not simply take place in classrooms, but takes place in communities of practice, involving

three dimensions: (1) ‘mutual engagement’ (in terms of relationship- building and collaboration); (2) ‘a joint enterprise’ (with shared interpretation of meaning, and shared accountability); and ‘a shared repertoire’ (in-jokes, stories, shared tools or ‘artefacts’) (Wenger, 1998, p. 73). It is not surprising that informal practices of sexual health learning take place in such spaces – for example, Nielsen and colleagues’ (2015) study of young Finnish women’s participation in message boards includes accounts of ‘pervy role-play’ in the form of explicit sexual messaging both between friends, and with strangers.

This does not mean that participatory cultures are always ideal sites for learning. As Jenkins and his colleagues note, just because participants in digital cultures are members of ‘a community’, this does not mean they aim ‘to make the world a better place’ (2015, p. 11). The dimensions of communities of practice described by Wenger do not exclusively promote ‘positive’ or pro-social learning cultures – such spaces can be sites of bullying, grooming, radicalisation, hostility and outright abuse. Jenkins and colleagues observe that participatory cultures can actively support self-harm practices among their membership and still meet all the criteria of ‘participation’ (2015, p. 11). Additionally, as Adrienne Massanari (2015) has noted, much of the affirmative scholarly research into participatory cultures pre-dates the consolidation of power of major social platforms, such as Facebook, Instagram, Twitter, Snapchat, Reddit and, more recently, TikTok.

Further, as Massanari puts it, ‘it is not that individuals are no longer participating, creating or sharing; it is that we have come to realize that such actions do not necessarily encourage greater engagement with the world at large or are inherently more democratic or ensure a more peaceful and just future’ (2015, p. 168). Massanari’s observation resonates with contemporary expressions of concern regarding the power of platforms such as Facebook to amplify hostile content on topics ranging from vaccinations to sexual violence. Indeed, as Marwick and Lewis (2017, p. 34) observe, participatory cultures on platforms such as 8chan and Reddit have organised to facilitate right- wing, misogynist radicalisation within what has come to be known as the anti-feminist ‘manosphere’ (Ging, 2019). Such cultures actively reinforce community belonging through participation in incel communities, or joining organised campaigns of racial and sexual

vilification and harassment that are grounded in shared resistance to ‘political correctness’ (Jane, 2018). While these actions are clearly antithetical to even the broadest definitions of sexual health and wellbeing outlined by the WHO (and others), it seems clear that seeking to counter them with factual sexual health information will not meet the community’s existing standards for authenticity and ritualised fellowship.

Conclusions

In this article, we have reflected on contemporary digital sites of formal and informal sexual learning. We note the barriers that face sexual health content creators who seek to assess the utility and efficacy of sexual health content primarily via a lens of ‘information transmission’, suggesting alternative modes of understanding digital sexual health content: in the context of ‘authentic’ influencer pedagogies, or as an interesting (and communitarian) aspect of everyday rituals of digital media use. In our final discussion of the role of situated peripheral learning and participatory digital cultures, we have cautioned sexual health communication that fails to engage with the more menacing aspects of online cultures. By viewing digital practices primarily via the metaphor of information seeking and information transmission, sexual health communicators fail to offer meaningful support to those who seek to not only learn but also to build affective community and connection. ‘Information’-led education interventions may ultimately undermine any well-meaning pedagogical intention.

Our aim has been modest in scope – we do not seek to offer a fully fledged alterative model for digital sexual health communicators (or evaluators) who seek to break away from a narrow focus on information. Nor do we suggest that sexual health promotion organisations should simply ‘add influencers and stir’. But we do see promise in campaigns and platforms like Take Blaktion that seek to erode the boundaries between sexual health content that is important, and that which is interesting. Additionally, we see promise in Dan Savage’s distinction between sexual health ‘search engine’ content that primarily transmits facts, and more personal and reflexive social media content that seeks to engage with situational ethics. As Epstein (2022) notes – and we have sought to further illustrate in our history of

mediated sexual health communication – the broad church of ‘sexual health’ is capacious and messy. Sexual health practice as we currently understand it has emerged and evolved in dialogue with popular media content, and has space for many communicative approaches. But it is the more situational, dialogic and intimate mode of communication that has the greatest potential to meaningfully engage with those who seek authenticity and connection in the more marginal and challenging spaces of digital sexual culture.

Acknowledgements

We thank our anonymous reviewers, and the journal editors for their kind feedback and patience. This paper was supported the Australian Research Council Future Fellowship ‘Digital and data literacies for sexual health policy and practice’ (FT210100085).

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/ or publication of this article: This work was supported by the Australian Research Council, (grant number FT210100085).

ORCID iDs

Kath Albury https://orcid.org/0000-0001-9043-8126

Natalie Hendry https://orcid.org/0000-0002-2591-420X

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Author biographies

Kath Albury is an Australian Research Council (ARC) Future Fellow (FT210100085) in the School of Social Sciences, Media, Film and Education; and an Associate Investigator in the ARC Centre of Excellence for Automated Decision-Making + Society, Swinburne University of Technology.

Natalie Hendry is a senior lecturer in the Melbourne Graduate School of Education, The University of Melbourne. Her work considers the relationship between health, media and education, particularly how digital cultures shape everyday health practices.