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

org
A
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 briefly 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
oftime 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
orresponsibilities 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, & LEngle, 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. LEngle 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 (1217 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
www.TPRonline.org The Prevention Researcher Volume 16(4) November 2009 13
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 & LEngle, 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 reflection 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 offline 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 (1217 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 & LEngle, 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 & LEngle, 2009; Peter & Valkenburg,
2008 a, b)
Social Networking
Sites
38% of tweens (1214) and 77% of teens
(1517) 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 1213 year olds
72% of 1416 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
reflection 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 observers 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. Its as old
as the Polaroid. Whats 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
morelikely to search for sexual health
information using slang terms, which
maylead 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,
likelyin 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
whohad 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
www.TPRonline.org The Prevention Researcher Volume 16(4) November 2009 15
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). Its 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
to24) 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 nd 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 moreboth 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 howthey are
affected by electronic media.
Copyright 2009, Integrated Research Services Inc.
Jane Brown