To Call Pornography a Public Health Issue Is Not Enough When it is a Public Health Crisis: A Multi-Survivor Analysis

There is prolific research documenting how the consumption of pornography is a public health issue. According to Fight the New Drug—a non-religious and non-legislative organization that raises awareness on the harmful effects of pornography using science, facts, and personal accounts—pornography can negatively impact the consumer’s mental health and self esteem, fuel loneliness, and lead to an unhealthy cycle of stress1,2,3. Additionally, despite its marketed promise to increase the consumer’s sexual experiences and sexual encounters, pornography carries detrimental impacts on sexual health, ranging from increased rates of erectile dysfunction (ED) to decreased sexual satisfaction4,5. These individual impacts may seem apparent, but without a proper response in attempting to understand (1) what are the different motivating factors in compelling people to consume pornography, (2) what viable solutions can mitigate the many negative health impacts pornography creates, and (3) the historical context pornography arose from, then a culture of complicity around gender based violence becomes the new norm. This is the first problem of how pornography is a public health crisis: it is not seen as one. 

This denial of how pornography is a public health crisis is not surprising. Other public health crises have struggled with being seen as one when those responsible for these crises actively deny the negative health impacts of their products. For example, “the tobacco industry [has] argued for decades that there was no proof of a connection between smoking and lung cancer.”30 Perhaps, what may be different with pornography, is the pornography industry itself has touted their statistics and research. Pornhub releases yearly “insights” about their top searches and pornstars; traffic and time on site; gender demographics; age demographics; devices and technology; celebrity searches; movie and TV characters; video game searches; events, holidays, sports; and the top 20 countries in depth.31 According to the 2021 year in review, here are the searches “that defined 2021”31:

According to Gail Dines, Founder and President of Culture Reframed and Professor Emerita of Sociology and Women’s Studies, “​​As the evidence on the harms of pornography piles up, it has become clear that we can no longer sit back and allow the porn industry to hijack the sexual and emotional well-being of our culture. Extensive scientific research reveals that exposure to porn threatens the social, emotional and physical health of individuals, families and communities. These impacts highlight the degree to which porn is a public health crisis that undermines women and children’s human rights, rather than being a private matter.”30

Similar to how the U.S. military encourages soldiers to play violent games in preparation for the battlefield, rape culture encourages young boys and men to normalize male violence against women through pornography6,7. John D. Foubert, an expert in sexual assault prevention for the U.S. Army, states, “I have studied how to end sexual violence for 25 years. It wasn’t until 10 years ago when I came to the realization that the secret ingredient in the recipe for rape was not secret at all, though at the time it was rarely identified. That ingredient, responsible for giving young men the permission-giving beliefs that make rape so much more likely and telling young women they should like it, is today’s high speed internet pornography. Pornography itself is a recipe for rape that has rewritten the sexual script for the sexual behavior of the millennial generation and is currently rewiring the brains of the generation to follow.”4

The fact that pornography has become our country’s main, if not only, form of sex education is extremely concerning. While anti-racism trainings and critical race theory have gained traction since the rise of Black Lives Matter, Stop Asian Hate, and the push for Ethnic Studies at Oakland Unified School District, pornography reflects a setback in these movements by showcasing themes of racism, sexism, fetishism, homophobia, classicism. For example, pornography perpetuates racist stereotypes of Asian women, displaying them as “Dragon Ladies” or “Lotus Blossums.” The former term arose “in the late 19th and [20th] century [where] Asian women in the US were often depicted as… sexually submissive but also devious. They were sexy, erotic, attractive, and would actively seduce white men, and therefore, would corrupt the Christian white men’s morality”.8 The latter term materialized “after the Second World War, [in which the] US government… allowed the American soldiers to bring their Asian or European wives back to [the] US. When the Asian war brides came to America, a new stereotype of Asian women was also brought back. These women were depicted as “Lotus Blossom’’ who are excellent wives, cute, docile, knowing how to please their husband and great homemaker.”8 While the terms appear as opposites, with the “Dragon Lady” a calculating temptress and the “Lotus Blossom” sexually complicit and subservient, the fact that Asian women can only exist as either of these two opposite extremes contributes to their status as “forever foreigners” in the United States.9 Additionally, both these terms are rooted in Orientalism, which describes how European male identity was constructed as rational, civilized, gentle, and Developed—while other forms of identity were perceived as backwards, barbaric, and violent.10 This binary between the East and West, or inferior and superior, respectively, not only establishes white power and supremacy, but also creates a gendered aspect in which women from the East are deemed unruly and exotic—and are therefore fetishized. For example, the “Dragon Lady” stereotype reinforces Orientalism that the East is “backwards” and “dangerous”, justifying “civilizing” attempts, or colonization by the West. Consequently, fetishization manifests racialized and gendered violence.

A more contemporary and relevant example of binaries affecting the Asian American experience is through the stereotypes “of Asians [swinging] between yellow peril and model minority”.9 For example, “in the face of a crisis such as a public health threat, people tend to resort to ‘othering’ —disassociating themselves from the threat and blaming others—other countries, foreigners, stigmatized groups or other minorities, which helps reduce the powerlessness experienced during the crisis.”9 During COVID-19, Asian Americans are perceived as the yellow peril, or responsible for outbreaks. This can be exemplified by the proliferation of the term “Chinavirus” or “Wuhan virus” used by politicians and media alike, which is directly linked to the spike in violence and hate crimes against Asian Americans. Otherwise, Asian Americans are generally perceived as the “model minority”, which “portrays Asian Americans as having overcome the barriers of minority status and successfully integrating into mainstream society…[While] this stereotype appears positive… It is criticized for masking the socioeconomic difficulties faced by many Asian Americans [a polylithic group]. Further, an underlying assumption of the model minority stereotype is that Asian Americans have overcome racial bias.”27 The model minority myth pits Asian Americans against other groups (or racially divides minority groups) to compete for funding, resources, and attention.9 This leads to discounting the structural and cumulative disadvantages that minority communities face. It also redirects focus away from the white supremacist systems, such that those that benefit from this status quo retain their power. Consequently, the dialectical relationship of how Asian Americans are perceived as either the “yellow peril” or a “model minority” characterize their marginalized status in the United States as perpetual “outsiders” or unassimilable “others.” This deep-seated culturally based racism renders them vulnerable to racial discrimination, aggression, and even violence, especially during times of crises”.9

When Asian Americans are Othered, they are more vulnerable to being dehumanized and objectified. It is unsurprising, then, that the stereotypes of “Dragon Lady” or “Lotus Blossom” are “represented in Asian women pornography. Nowadays, “Asian Women” (sometimes Asian) is still one special category through many popular online pornography websites in the US (e.g.,, xvideos. com, On the most popular pornography website in the US, Xvideos. com (according to Alexa Rank and Similarweb), ‘‘Asian Women’’ ranks 9 on the category with most sexually explicit videos.”8 Experiments have concluded that exposure to pornography leads to both the objectification of women and acceptance of violence towards women.11 Therefore, pornography is not merely a fantasy separate from reality, it has very real consequences, including the fetishization of Asian women—which also conversely means the solidification of white supremacy.26 

According to Hamida Yusufzai, program and case manager at Banteay Srei, an anti-sexual assault and anti-trafficking organization that provides culturally competent resources for Southeast Asian young women at risk for commercial sexual exploitation, “It’s because you’ve got videos and categories in major pornography websites specifically targeting these women saying they’re Asian baby dolls, they’re submissive in nature, and that they’ve got bodies that are childlike with prepubescent, small breasts.” Despite the belief that pornography is a fantasy and has no material effects in reality, Yusufzai reveals that sellers of sex dolls have stated that their products are not just based on children but on Asian women and the stereotypes of their bodies. When consumers buy these sex dolls, they participate in the culture of objectifying and dehumanizing Asian women, which is rooted in racism and extreme violence. Yusufzai states, “I have photographs from presentations I integrate into [antisexual assault] trainings that show people how a sex doll is disassembled. You’ve got her head. You’ve got her arms and legs and they’re pulled apart to fit into a suitcase. Now that’s horrific, because when you think about victims and survivors that were killed, some of them were dismembered, and some of them mutilated.”

Furthermore, racism has been declared a public health crisis with “racial minorities [bearing] a disproportionate burden of morbidity and mortality.”28,29 In a webinar with Gail Dines, Carolyn West, a Professor of psychology at the University of Washington, Tacoma and a domestic violence expert, states, “What we’re seeing today in contemporary pornography is so troublesome. One of the most difficult work I’ve done, as a domestic violence and sexual assault researcher, a sex educator, and teacher for human sexuality classes for thirty plus years—nothing has disturbed me as much as the work I’ve been doing around pornography and race. I do this work because no one wanted to [acknowledge] the intersection to race and I was appalled by the level of racism that exists in pornography. I always say I didn’t choose this work, the work chose me. I do this work because I think there’s a silence and secrecy around Black women’s sexuality. For 400 years we have had to fight to have any ownership of our sexuality.” Black women’s sexuality remain commodified in pornography, and in West’s documentary, Let Me Tell Ya’ll Bout Black Chicks: Images of Black Women in Pornography, she demonstrates how racism and sexism is interwoven throughout the porn industry, which hypersexualizes and dehumanizes Black women in degrading ways. 

In a guest piece titled Why Does the Porn Industry Get Away with Racist Portrayals of Black People, Dr. West writes, “We should care about racism in porn because as we continue to unearth the stories of sexual brutality that were experienced by countless Black women, such as what happened to Recy Taylor, pornography titles such as “join to see White boys conquering Angry Black women”] have eroticized, sanitized, and erased this long history of sexual terrorism against Black women in this country.”32

Pornography does not just reflect the cultural norms of the time but also doubles down on current geopolitical events. With the escalation of violence in Ukraine, on February 25th, 2022, the number two searches on Pornhub were “Ukrainian” and “Ukrainian girl.” Horrifying genres such as “refugee porn” and “war porn” demonstrate the reality in which “trafficked women and children… end up… on the pages of ‘tube sites’ which, like Pornhub, allow users to upload videos without any authentication for age and consent. Today, a top porn site features the video, “Hot Ukrainian Girl F***ing her man on live stream against war.”12 Sex buyers celebrate war in Ukraine and other forms of mass instability that causes increased vulnerability since these conditions coerce women and girls into the sex trade—including pornography, or filmed prostitution (Picture 1.1). The pipeline of vulnerable women entering the sex trade caused by push factors—such as colonization, imperialism, and militarism—can be highlighted throughout history where previous U.S. military bases have become red light districts. Within Eastern Europe, the Ukrainian sex trade intersects with demand through sex tourism from the West and “mail-order bride” trafficking. Military, war, and sexual violence are all intricately connected to dehumanize women and girls (Pictures 1.2,1.3). The pornography industry’s ability to generate more profit in times of war and imperialism further shows how pornography is a public health crisis. Ultimately, if we center the most marginalized and vulnerable in our solutions and analysis, then pornography would be considered a public health crisis. 

Picture 1.1

German sex buyer celebrating war in Ukraine (Twitter picture by Elly Arrow)

Pornography fuels sex trafficking by serving as a platform for the purchase of people for sex; advertising trafficked victims and survivors; collecting videos as blackmail against women to coerce them to comply with traffickers, boyfriends, pimps; and participating in child pornography. 

Pictures 1.2 and 1.3

Examples of refugees preyed upon to enter prostitution (Instagram pictures by Quds news Network on Instagram)

Knowing how pornography is complicit in not only enforcing harmful attitudes towards each other—especially harming, targeting, and profiting off of marginalized peoples—but also giving more power to traffickers and abusers, is calling pornography a public health issue enough? 

Yusufzai comments, “At Banteay Srei, we talk about how pornography fuels sex trafficking, and people have accepted that. So it’s really interesting to now, to kind of complete that circle and say, pornography fuels sex trafficking, and if sex trafficking is a public health issue and crisis, then pornography is a public health issue and crisis.”

Pornography is a public health crisis. 

Knowing that the consumption of pornography has an insidious relationship with sexual violence, what does this mean for providers who are often the first point of contact for survivors and victims? There is growing recognition that doctors can be first responders, intervening before long years of exploitation and abuse can take a greater toll.13 When providers notice young women and girls with genital injuries, bruising, malnutrition, numerous STIs, abandonment and neglect, mental health issues, and trauma, they will heavily medicate these patients and diagnose them with severe mental health issues based on the biomedical model. According to Professor Jason Corburn, founder of Global Learning Exchange for Healthy & Equitable Communities, the biomedical model focuses on pathogens, brought upon by individual behavior, hereditary biology, or genetics, at the molecular level. Therefore, this model’s interventions include changing personal risk factors, risk education, and case management for the sick.* However, the consumption of pornography reflects social values (such as racism, Orientalism, and white supremacy, as previously discussed). Therefore, an individual level approach will not get to the core in addressing pornography since doing so would mean addressing the racist, sexist, and classist values rooted in society. 

An alternative and juxtaposition to the biomedical model is the ecological model, whose primary drivers of health include living and working conditions, distribution of wealth, and social status in society—which can all combine to produce trauma. Therefore, interventions may include changes in policy or law, institutions working to improve living and working conditions and opportunities, the elimination of discrimination, etc.1* The ecological model understands that what pushes vulnerable women into the porn industry (and other parts of the sex trade) is poverty and childhood exposure to child sexual abuse, domestic violence, and lack of support systems.14 Therefore, interventions must work to eradicate these vulnerabilities, requiring changes and responses in other sectors. Studies find that survivors have identified short term needs including “victim identification, housing, and emergency medical care. Long-term needs included life-skills, community building, legal assistance, and medical care.”15 Without this collaborative response across sectors, pornography will continue to remain a hidden public health crisis. 

The biomedical model is not an approach that will fundamentally make these young women and girls feel safe and will not change their material conditions caused by systems and inequities—especially when their partners continue to consume pornography, family members have laptops open with tabs linked to pornsites, and friends suggest consuming pornography to bond. For instance, when so many young girls are showing up to the clinics with their windpipes crushed, Yusufzai realizes that after being asked several times, the young women will confess that their boyfriends have strangled and choked them during sex to act out what they have seen in pornography. This is why a lack of screening and needs assessment, or intake forms that include exposure or consumption of porngraphy as one of the categories, providers will fail to truly understand the cause of these young women’s serious injuries. 

Therefore, Banteay Srei, a department of Asian Health Services, trains the rest of the staff on how to notice signs of commercial sexual exploitation. They also have a referral system for young women who are suspected of being victims of sexual abuse and exploitation. “Unless you’re lucky enough to walk into a clinic where everybody’s been trained been by Banteay Srei, unless that’s on your intake sheet, unless you have a CSEC [commercial sexual exploitation of children] protocol, unless you have regular trainings, unless you have providers and members of staff that are very aware of exploitation and abuse—you have a public health crisis in itself for letting gender based violence continue.” Yusufzai observes, “When doctors see patients one after the other very quickly, it can be difficult to say, ‘Hey, I know you might not want to talk about this now, but has anything happened in your past that we should know about?’ And asking once is not enough because we know that a lot of victims and survivors will not disclose and might not disclose unless you ask them eight or nine times. But no one’s got time for that.”

However, asking patients who display a range of signs of sexual violence about their situation more than once may not necessarily elicit the truth, especially when there are many factors preventing survivors from disclosing their situation. Those factors include, but are not limited to:

  1. Shame in disclosing consumption of pornography, even if coerced into watching with a boyfriend or friend,
  2. Increased vulnerability in other sectors of their life that are complicated and intertwine to compound their situations, such as having an unstable family (ie. having an alcoholic father that has pornography open on his computer, having a mother that may have a drug addiction as a coping mechanism, etc.),
  3. Providers and therapists who may be aware of how sexual trauma and sexual abuse affects a patient’s well-being, but may not want to address and unpack these heavy topics,
  4. Providers and therapists who do not have a trauma informed lens may not build rapport with the patient and engage with them in an empathetic manner,
  5. Not wanting to put their partner, pimp, boyfriend who caused harm in trouble due to grooming, a sense of loyalty, and the desire to protect their image.

Sage Serrano*, an undocumented Native woman studying Gender and Women’s Studies at the University of California, Berkeley, and a survivor of domestic violence, has courageously opened up about her relapses in consuming pornography despite the fact that she is able to discern that the women on the screens are pretending to enjoy the sessions as actors. “You can tell when someone is aroused or not, because women will get erections too, where blood flows to our sexual organs, and the vagina will get puffy and red. But you don’t see that in porngoraphy. When I consume pornography and try to masturbate, it felt like I wasn’t having a personal orgasm, but a social orgasm: I told myself I should be experiencing pleasure because this is what I should be doing as a woman and how you get real power as a woman. What I thought was pleasure was socially induced.”

This contradiction is where a trauma-informed lens is critical. According to Kristen Jenson, founder of Defend Young Minds, survivors may cope through the following ways: (1) turning to pornography to recreate and normalize the abuse and trauma they went through, and/or (2) turning to pornoraphy to be more like their abuser in order to no longer feel like a survivor or victim as a mechanism to try to feel more in control. Moreover, Dr. Foulbert has explained in presentations that college students who are rape victims gravitated toward porn to normalize the trauma they had suffered. 

Serrano’s story exemplifies point (2). She recalls how, one time, when masturbating to pornography, she could explicitly tell that the woman was in pain, yet that woman had to keep taking the violent penetration. While Serrano explains that as a survivor, she could viscerally feel the woman’s pain, at the same time, she felt herself become the man in the scene through the camera angle in the man’s point of view. “That sense of having the power to dominate was the addicting part,” Serrano says. “That fleeting, false sense of control that is born out of trauma and a replication of oppressive dynamics, but just inverted because I was the one watching. That is dangerous and teaches both survivors and abusers that power is gained from harming others.” 

The dichotomy between survivor and abuser is not a binary. Literature has prolifically documented how the abused becomes the abuser, and how the abuser is more likely to be abused.16 The life course perspective—a focus on experiences that influence health from preconception through pregnancy, infancy, childhood, adolescence, young adulthood, and midlife that affect chronic disease risk and health outcomes in later stages in life1*—is a more specific approach toward understanding how sexual assault affects communities beyond the ecological model. By understanding how the consumption of pornography affects children at a young age, application of the life course perspective can contextualize adults who have been abused and/or are abusers. Because sexual assault lies in a gray area of the spectrum, understanding issues of gender based violence is complicated, creating nuances and tensions in deciding who deserves empathy, and thus care and solutions. In relation to survivors with a complicated history of exposure and consumption of  pornography, continuous relapses in pornography illustrate the self-abuse of their bodies in terms of how they portray, view, and treat their own bodies. In other words, survivors become abusers of their own body, often recreating their trauma to normalize their past abuse. A key hallmark of this self-abuse of the body is the naturalization of the social orgasm, instead of natural orgasm (as discussed later on), induced by self pleasure. 

Rather than having the roles between abuser and survivor switched and re-enacted, a trauma informed and community health lens asserts that (1) the cycle of violence and power and (2) the ability to exert dominance and control over someone else should not exist. However, the power to exert dominance and the perpetuation of violence has become increasingly sexualized by pornography. In order to halt this cycle of trauma and violence, interventions must be holistic. Many survivors and individuals who have consumed pornography may have stumbled across sites from chat rooms or online forums like Tumblr by themselves, but oftentimes, they have been exposed by a friend or family member indirectly or directly. A community-centered approach understands that it is not just the young person, but also their loved ones, who must be informed about the relational impacts of the consumption of pornography, including its long term impacts. Because the research connecting pornography to sexual violence is conclusive4: when a person consumes pornography and sexually assaults another individual, the survivor will live the rest of their life attempting to regain control of their body. As M.D Bessel van der Kolk, one of the world’s foremost experts on trauma, titled his book: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. The long term psychological and physical effects of sexual assault illustrate pornography as a public health crisis and thus must be taken seriously.

Consequently, a trauma-informed analysis is necessary when working with survivors who have experienced gender based violence. Comprehensive trainings ingrained with cultural humility must also factor into how race and class, as previously exemplified by the fetishization of Asian women, and poor women coerced into the sex trade in Ukraine, compound to increase survivor’s vulnerabilities. Providers and therapists must not only be able to spot the signs of sexual abuse, but also be able to build rapport with patients who may be groomed to not disclose any information about their abuser. Unless pornography is treated as a public health crisis, survivors seeking resources and a catalyst to their healing process may turn to the re-consumption of pornography, end up in violent and abusive relationships, and/or repeat patterns of being harmed/harming others—dynamics acutely familiar and thus easy to fall back on. 

A possible explanation for the addiction to pornography and relapses in its consumption other than the need to feel in control and experience social orgasms is that, on a molecular level, pornography rewires the brain. When neurologists investigated brain scans, they found that men’s brains reacted to women as if they were objects, not people—demonstrating the process of dehumanization in effect that allows men and boys to degrade, commodify, and rape women and girls.17 Indeed, “the very maps that nerve cells travel through the brain become re-routed as people use more and more pornography.”4 In an experimental study, users of pornography “become less able to wait for gratification than people who use less pornography.”4 Pornography is creating a generation of youth whose social skills and empathetic behaviors are becoming slowly eroded as our sexual script, which “can influence behavior, shape desire, and structure expectations about real-world sexual encounters.”14 Luckily, empathy and behavioral skills can be taught and re-learned. Therefore, what does this mean for our sex education, which has become substituted with pornography? 

With pornography becoming the United States’ sex education, men and boys are taught that violating boundaries is sexy, that a “no” does not need to be respected, and that they will be protected if and/or when they rape someone. Violence, then, fulfills their masculinity. Conversely, young girls and women are taught that they must expect and experience sexual violence in their sexual encounters for it to not be “boring” or “vanilla.” 

Serrano highlights how exposure to pornography at a very young age made her want to be a porn star at 14 years old. “I was and am a short, brown, hairy girl who was seeking love. I thought if I pleased someone enough, was exciting enough, was fun enough, was open and down to try anything, then people would keep coming back to me. Because I had no healthy parental relationship or any role model in my life, I had no boundaries. I was grateful that anybody touched me, even if it was violent, because I was so vulnerable. It’s taken me years to unlearn all these things and heal the relationship with my body.” 

Pornography upholds rape culture and attempts to eradicate consent. News outlets have titles such as “Boy, 14, raped girl aged ten after watching online porn”;  “the University of New Hampshire did a study that showed that the states with the highest readership of pornographic magazines like Playboy and Penthouse also have the highest rape rates.”19 Studies find that exposure to violent pornography is linked to teen dating violence20; 83% of college men reported consumption of pornography and stated they would be more likely to commit rape or sexual assault if they knew they wouldn’t be caught.21 

These saddening headlines and studies demonstrate how the prefrontal cortex, specifically the frontal lobes, have mirror neurons that encode what individuals see and re-enact. This means that the scenes of rape in pornography are becoming part of our society’s sexual script, and part of our country’s rape education—a normalization that must be contested since pornography does not build personality and character.26 Indeed, pornography does not allow children to explore their sexualities based on mutual desire and respect; it also does not encourage relationship building and character development. Rather, pornography strives to have its consumers see people as objects to dominate. Additionally, it does not engender sexual and reproductive health by promoting the non-usage of condoms (which is considered “sexy” or how to show “love” to a partner), the unsanitary practice of immediately penetrating the vagina after penetrating the anus, the normalization of degrading and humiliating acts such as peeing in women’s mouths or in their bodies, and ejaculation on a woman’s face (EOWF)—which pornography is responsible for popularizing.18,26 The specific example of EOWF aligns with Serrano’s usage of the term social orgasm, highlighted by qualitative research study Naked Aggression: The Meaning and Practice of Ejaculation on a Woman’s Face

“First, scholars have traced EOWF’s development in pornography from obscurity to today’s prevalence (Moore, 2007; Williams, 1989), but despite oral sex performed on male partners being a common sexual practice among heterosexual adolescents and adults (Herbenick et al., 2010; Leichliter, Chandra, Liddon, Fenton, & Aral, 2007), there is no evidence that EOWF has been a common sexual practice, and no known sexual behavior surveys include the act as a measured sexual practice. We thus argue that EOWF is a sexual act largely constructed and popularized through the pornography industry. Second, the act of EOWF induces no apparent physical pleasure in and of itself (beyond masturbation) and physical stimulation of the penis leading up to ejaculation must often be stopped or interrupted to engage in the act. Thus, the audience’s pleasure derived from watching EOWF, fantasizing about it while masturbating, or acting it out with female partner(s) can be argued to be primarily psychological and ideological. For these reasons, EOWF is a fitting act through which to investigate pornography’s unique role in providing sexual scripts as well as what those scripts may represent in gender and sexual dynamics” [italics mine]18

Because there is no historical practice and physically grounded pleasure derived from EOWF, pornography produces a sexual script that naturalizes male aggression. When it is natural and normal for men and boys to equate sex with violence as a testament to their masculine ideal, it is unsurprising that the media will push forward messages of “boys will be boys” upon instances of male violence against women.26 However, there is no biological basis for boys and men to be violent and abusive, behaviors that are learned through pornography and captured through hypersexualized media. Therefore, pornography is responsible for reproducing the narrative that boys and men are aggressive, and thus girls and women should experience pleasure through the social orgasm—a reflection of how certain groups and peoples are socially conditioned by social norms, social structures, and social systems (i.e. patriarchy). Without understanding how these norms, structures, and systems rewrite and condition women’s and girls’ sexualities, women and girls often feel ashamed for their social orgasms—which contradict their beliefs and desires of mutuality, respect, and relationship building—and highlight the internalization of oppressive systems such as racism, misogyny, and patriarchy. Hence, pornography has consequences beyond public health: it leaks into and reflects our social spheres, informing our decisions, actions, and policies that we may not even be conscious of. 

Equally complicit in this reality is the U.S. public schools sex education being based on mere biology. Like many other students in this system, Serrano recollects, “My sex education in middle school was just labelling the ovaries, fallopian tubes, and clitoris. But it never felt like we were talking about our own bodies and instead all that labeling and categorizing was probably why all those labels and categories in pornography didn’t give off immediate red flags. Especially when you grow up already familiar with those same body parts being sexualized and you have already been taught how you should experience pleasure in ways that dehumanize you and cut off your connection to your body and soul.” 

Yusufzai challenges youth to imagine what sex education looks like based on intimacy. “What if we instead of society promoting young men are cool based on how many girls they run through, but how many hands they hold? Pornography has stripped away our intimacy and relationship building, which is sometimes the hardest thing we will encounter.” Such words are reminiscent of Audre Lorde’s Uses of the Erotic: The Erotic As Power, which warns us about the conflation of the erotic with the pornographic:

“The erotic has often been misnamed by men and used against women. It has been made into the confused, the trivial, the psychotic, the plasticized sensation. For this reason, we have often turned away from the exploration and consideration of the erotic as a source of power and information, confusing it with its opposite, the pornographic. But pornography is a direct denial of the power of the erotic, for it represents the suppresion of feeling. Pornography emphasises sensation without feeling… To refuse to be conscious of what we are feeling at any time, however comfortable that may seem, is to deny a large part of the experience, and allow ourselves to be reduced to the pornography, the abused, and the absurd.”23

Serrano additionally challenges youth to imagine what sex education looks like by reconnecting with the land. “As an indigenous woman, when I say land back, I also mean bodies back. Because they’re both interconnected. There’s 420 million pornsites in the world, and that’s intimately connected to missing and murdered indigenous women.”

Such a call to action prompts a historical analysis. Indeed, when Christopher Columbus first came to Turtle Island, or what is now known as the United States, he recounts in his journals how one of the very first things he did was subjugate and rape the Taino women alongside claiming the land. Ecofeminists have also written extensively on the linkages between the domination of both the land and women. For example, Sherry Ortner, a distinguished cultural anthropologist and professor writes in Is Female to Male as Nature is to Culture, “that when women are seen ‘closer’ to nature, it also makes them easier to subordinate, just as nature itself is everywhere devalued and subordinated.”23 Moreover, Carolyn Merchant, a prominent ecofeminist, wrote in The Scientific Revolution and The Death of Nature that following the Scientific Revolution, the environment became something to be exploited, transformed, and used for profit, drawing an eerie similarity to how women’s labor and reproductive abilities have, for thousands of years, been exploited and freely accessed.24 Therefore, when the U.S. public education system, in tandem with a sparse sex education, does not provide a decolonial historical analysis of our country’s foundation, the legacy of colonization proliferates through our understanding of the world and each other. This is problematic when colonization is based upon (1) disconnecting women from the land (2) domination, conquest, rape, and exploitation—which are the very same themes enacted in pornographic scenes racist reenactments of white men raping Native women. 

According to Serrano, “Pornography is a public health crisis because it is our primary source of education when it comes to building intimacy when it actually tears it down, and white-washes our histories of being colonized, while severing our connection to our bodies, our land, our minds, and our spirits. It tells us to be okay with violence against women and children and the land.” Precisely because this violence is normalized is why there is a barrier in perceiving pornography as a public health crisis. Succinctly captured by Gail Dines, “Pornography takes violence against women, and it sexualizes it. And when you sexualize violence against women, you render the violence invisible.”

On the other hand, the violence is visible to providers in Federally Qualified Community Health Centers (FQHCs), colloquially known as community health clinics, which are located in federally designated medically underserved areas or populations. Therefore, these clinics seeing patients who are low income and experience other compounding, intersecting vulnerabilities in their locale should have screening assessment, needs assessment, and/or intake forms that include exposure or consumption of porngraphy as one of their categories. Furthermore, because community health* response is multisector, history teachers and other stakeholders must be accountable for pushing for a curriculum that no longer centers around the legacy of white supremacy; sexual and reproductive health educators should create more comprehensive curricula based on relationship-building, intimacy, and prevention. To create a world where there are no survivors, educators and providers must work in tandem with each other to eliminate gender-based violence. This includes treating pornography as a public health crisis with appopriate responses in all sectors and working to eliminate vulnerabilities that have historically affected the most marginalized. Furthermore, we must build a culture based on intimacy, encourage feminine masculinity as written in bell hook’s The Will to Change: Men, Masculinity, and Love), and explore how exploitative systems have impacted our relationships with others and our own selves. We must fight the commodification of people’s bodies, not commodifying people’s bodies. Moving towards this future is feasible and possible. After all, “empathy, understanding, patience and time can help break the cycle along with raising awareness, intensive services and healthy attachments.” 25 In this, every person is a stakeholder and has a duty in ensuring that pornography is treated as a public health crisis. 

“Women will never have that dignity, security, 

compensation that is the promise of equality

so long as the pornography exists as it does now.” 

— Excerpt from Francis Biddle’s Sister: 

Pornography, Civil Rights, and Speech 

(MacKinnon, Feminism Unmodified)

Acknowledgement(s): I would like to express my gratitude to Hamida Yusufzai for allowing me to interview her. Hamida, you are not just my supervisor, but my mentor and role model. Your organizing, advocacy, and work have had an impact on not just me, but all the other young women you have met. Also, I would like to thank Sage Serrano for allowing me to interview her. Your grace, leadership, and passion reaches everyone, including me. You are a blessing to know. 

Citations Here