Effects of Pornography on Children: Convergent Public Health Movements
By Tomi Grover, Ph.D.
Cancer InCytes Magazine - Volume 4, Issue 2, Winter 2015
Published December 7th, 2015
Managing Editor: Juliana Zhu, Esq.
Childhood trauma and its implication for disease outcomes is a relatively new concept in the public health sector. A convergence exists with other public health movements concerning pandemic issues effecting children. Three example movements address trafficking (labor trafficking and sex trafficking), the sexual exploitation of children through pornography and childhood trauma (domestic violence, sexual abuse, etc.). The intersections of each movement's efforts could create dynamic synergy in addressing outcomes.
This article focuses on potential convergences of two movements. The Adverse Childhood Experiences movement aims to integrate appropriate screening in clinical practice with information focused on child of abuse, neglect, and family dysfunction. The goal is inclusion of proper assessment for improved treatment of medical issues and future outcomes.
The second movement involves several key organizations (National Center on Sexual Exploitation and Prevent Connect consortium) and aims to address the sexual exploitation of children and childhood exposure to pornography. Specifically, they demonstrate the traumatic outcomes manifested in and on children by the effects of toxic Internet-based graphic productions. Highly violent scenes effect brain development and create medical concerns including the interruption of normal development with potential long-term consequences. Physical, psychological, behavioral, and addiction mental health consequences are associated with pornography consumption. Pediatricians are calling for standardized screening for pornography use by patients. Criminal behavior is a considerable concern in the production of pornography by and the victimization of children.
The efforts to address childhood adversities, sexual abuse, and pornography exposures must collaborate to mitigate the immediate harms that produce long-term health outcomes.
Childhood trauma and its implication for disease outcomes is a relatively new concept in the public health sector. The Adverse Childhood Experiences (ACE) Study assessed the associations between childhood maltreatment and health outcomes. The study included 17,000 Health Maintenance Organization (HMO) members who were given the opportunity to give information focused on experiences such as a child of abuse, neglect, and family dysfunction. 
"It is critical to understand how some of the worst health and social problems in our nation can arise as a consequence of adverse childhood experiences." The full study by Robert F. Anda, MD and Vincent J. Felitti, MD is at: http://www.acestudy.org/. Additionally, there is an excellent Ted talk by Nadine Burke Harris, MD: "How childhood trauma affects health across a lifetime" http://youtu.be/95ovIJ3dsNk. 
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Sex Trafficking and Cancer Risk
While the ACE study touches on sexual abuse as one of the key areas, the questionnaire does not assess a very prevalent co-related issue of childhood exposure to pornography. According to Michael Seto, Ph.D., C.Psych., Director of Forensic Rehab Research, Royal Ottawa Health Care Group, "The early and pervasive exposure to Internet pornography (among children and youth) is the largest unregulated social experiment I'm aware of. We don't know what the effects will be." 
The toxic exposure to currently available pornography on the Internet is creating trauma to children.
"The brains of young children are being bombarded with graphic, extreme Internet pornography, causing significant harm. Today, the content is increasingly extreme, graphic, often violent and degrades and humiliates girls in particular. A recent study found that 88% of top- rated porn scenes contain physical aggression and 49% verbal aggression, with 94% of the targets of that aggression being female." 
Furthermore, even if children are not direct consumers there is an effect on them. "Second Hand Pornography" a study by World Vision demonstrates "Pornography has a strong impact on the behaviors of children who view it AND on other children as well."  Pornography changes the attitudes, behaviors, and expectations of their peers.
Medical science indicates "pornography as a supranormal stimulus and on its potential to invoke a neuroplastic response."  This exposure according to several studies alters the brain of children considerably, especially their frontal cortex.
The damaging effects of pornography exposures go beyond the brain. There are immediate medical concerns for people who consume pornography, which include erectile dysfunction and potential self-injury plus, a whole range of presenting issues such as Arousal addiction, which mimics ADHD, social anxiety, depression, performance anxiety, and OCD. For a more complete discussion, see "The great porn experiment," by Gary Wilson, TEDxGlasgow (https://www.youtube.com/watch?v=wSF82AwSDiU) 
Additionally, there are medical concerns that bring risks for those engaged in making pornography as well. The top 5 medical concerns in the Porn Industry:
5 – sexually transmitted disease and cancer
4 – drug addiction
3 – psychological and emotional damage
2 – blatant physical abuse
1 – tears, rips, rectal and uterine prolapse 
Each of these issues could additionally have long-term medical consequences.
Tomi Grover, Ph.D.
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Children are now producing pornography of themselves and of others. They are found to be involved production of pornography as the "performer" and/or "producer." Additionally, the child is usually engaged in online activities with third parties giving direction or blackmailing them. People online may use elements of force, fraud, extortion, or coercion upon the child. Innocent naivety works against many children; others are manipulated and coerced.
An article by the "National Center on Sexual Exploitation" discusses the findings of a study released March 10, 2015 by the Internet Watch Foundation (IWF) in partnership with Microsoft. "Alarming New Study: Rise in Youth-Produced Child Pornography."  A synopsis from the research is available in the note 10.
The IWF study identified emerging trends as they combed through thousands of interactions of children as they defined below.
What emerged from the data in this Study is an increasing trend for the distribution of sexually explicit content produced by younger children using laptop webcams which, due to the nature of the technology used, they are aware is being shared with at least one other party. To reflect this finding, we instead propose a new definition of “youth-produced sexual content” as: “Nude or semi-nude images or videos produced by a young person of themselves engaging in erotic or sexual activity and intentionally shared by any electronic means.” 
These are disturbing trends and should motivate every parent and professional to be proactive in educating and monitoring their children's online activities as well as screening for exposures. Clinical screening should be included in routine care. 
There are parents who are abusing their own and other children in the production of videos or live streaming of the acts. In a related area of study, Kenneth Ferraro of Purdue states in: Children abused by parents face increased cancer risk, "It's shocking just how much the damage sticks, and it is a reminder that childhood, which is defined by rapidly changing biological systems, is a sensitive period of development." 
The physical aspects of childhood sexual abuse are already proven by the ACE study to have an effect on long-term health outcomes. The next step is to make the screening for pornography exposures a relevant addition to clinical screening process. Addiction in children to pornography has ramification for presenting issues that are psychological, behavioral, and medical. Dr. Nadine Burke Harris indicated in her talk (in note 3) that we must invest in a thorough assessment to get the right diagnosis and an interdisciplinary approach in responding to the whole child with wrap around services.
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We know how to address public health issues as evidenced by many changes to our society based on finding appropriate solutions. One example is seat belts and car seats for children. We have come a long way in protecting the precious cargo carried in automobiles. We must take those same approaches to diminishing the effects of pornography on our children. One of the best practices being implemented in the United Kingdom is the opt-in verses the opt-out requirement for access to pornography on the Internet as discussed by Anderson. (See note 4.) This is a great start to minimizing the exposures of children to the harmful effects of pornography.
We must recognize the immensity of the issue of childhood exposure to pornography. We can implement the most promising public health practices, which include four key areas Prevention, Intervention, Education, and Real-solutions (PIER). We can prevention exposure. We can intervene through monitoring, reducing the demand, advocacy for change, demanding enforcement of laws, and creating a climate of unacceptability. We can educate on the harmful effects of pornography for which many resources already exist. We can demand and create real-solutions including restorative practices for children and recovery programs for those that area addicted. For a list of potential resources, see notes. 
The efforts to address childhood adversities, sexual abuse, and pornography exposures must collaborate to mitigate the immediate harms that produce long-term health outcomes. The movements are compatible and converge at many points, which will have significant impact for the health of children now and in the future.
About the Author
Tomi Grover is an educational entrepreneur. She teaches, speaks, and writes on topics, which intersect her passions and experience including human trafficking, exploitation of children, pornography, and justice. She holds a PhD in Social Work and Ministry-Based Evangelism, a Master of Arts in Christian Education from Southwestern Baptist Theological Seminary, and a Bachelor of Liberal Arts and Science in Criminal Justice from the University of Florida. You can find more information about her work at www.TomiGrover.com and www.TraffickStop.org.
[1.] Felitti, V., & Anda, R. (n.d.). The Adverse Childhood Experiences Study. Retrieved November 1, 2015, from http://www.acestudy.org/
[2.] Injury Prevention & Control : Division of Violence Prevention. Center for Disease Control. (n.d.). Retrieved November 1, 2015.
[3.] Nadine Burke Harris: How childhood trauma affects health across a lifetime. (n.d.). Retrieved November 1, 2015, from http://youtu.be/95ovIJ3dsNk
[4.] Anderson, C. (n.d.). The Impact of Pornography on Children, Youth, and Culture. Retrieved November 1, 2015, from https://www.youtube.com/watch?v=AObWYaQHGAo&index=5&list=PLQ7O5HO4mHqddSmqpTlL-CYCcMm5RVZva
[5.] Why is Finding a Solution to the Public Health Crisis from Pornography so Difficult? | Ernie Allen | US Capitol Symposium. (2015, September 2). Retrieved November 2, 2015.
 "Second Hand Pornography" (n.d.). Retrieved November 2, 2015, from http://www.worldvision.org.kh.reportdet.aspx?id=3
 Hilton, D. (2015, July 14). Pornography and the Brain Public Health Considerations. Retrieved November 2, 2015, from http://pornharmsresearch.com/wp-content/uploads/Hilton-Symposium-Speech.pdf Referencing: Hilton, D.L. Pornography Addiction: A Supranormal Stimulus Considered in the Context of Neuroplasticity. Socioaffective Neuroscience and Psychology, Vol 3 (2013)
 The great porn experiment | Gary Wilson | TEDxGlasgow. (n.d.). Retrieved November 2, 2015.
 Getting Screwed: The Top 5 Medical Dangers of the Porn Industry. (n.d.). Retrieved November 2, 2015, from http://dailysyndrome.com/extreme/getting-screwed-the-top-5-medical-dangers-of-the-porn-industry/
 Alarming New Study: Rise in Youth-Produced Child Pornography. (2015, March 10). Retrieved November 2, 2015, from http://endsexualexploitation.org/articles/alarming-new-study-rise-in-youth-produced-child-pornography/
 Emerging Patters and Trends Report. (n.d.). Retrieved November 2, 2015, from http://pornharmsresearch.com/wp-content/uploads/Emerging-Patterns-and-Trends-Report-1-Youth-Produced-Sexual-Content-1.pdf
 The Impact of Pornography on Children. (2015, October 19). Retrieved November 2, 2015, from http://www.acpeds.org/the-college-speaks/position-statements/the-impact-of-pornography-on-children
 Study: Children abused by parents face increased cancer risk. University News Service. (n.d.). Retrieved November 2, 2015, from http://www.purdue.edu/newsroom/research/2012/120717FerraroChildren.html
 Various resources for public health approach: (http://www.preventconnect.org), (http://ncose.com), (www.socialcostsofpornography.com), (www.fightthenewdrug.com), (http://www.cordeliaanderson.com/Resources/Documents/Porn%20Resource%20List%204%202015.pdf) Each accessed November 1, 2015.