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As children spend more time watching, reading and engaging with media, their exposure to sexualized media content is nearly inevitable. Subsequently, it is important to be aware of what types of sexualized messages children are consuming and how these messages affect children.

What the Evidence Says
Exposure to sexual content in media at a young age can be detrimental. Young children’s exposure to developmentally inappropriate and overtly sexual material in media can scare and confuse them about their own sexuality (Flood, 2009).

Children learn from media. Children and adolescents can learn through media about what is considered to be acceptable sexual behavior. While educational media can provide useful guidance and help teach older children and adolescents about sexual health, risks and behaviors, unrealistic portrayals of sexual behavior in the media combined with less alternative sources of factual information about sexuality and appropriate behaviors can lead children to use media as a “sexual super peer” that may encourage them to be sexually active, take risks, and/or adopt these beliefs as their own (Brown et al., 2006).

Exposure to pornography can alter how a child perceives sex and body image. Studies have shown that children who are exposed to pornography often have difficulties distinguishing between the fictional pornographic characters and behaviors they see and real life sexual situations. This can lead children and adolescents to have unrealistic views of how their bodies should look, insecurities about their appearance (particularly in males), and anxieties about sexual performance and intimacy (Peter & Valkenburg, 2010).

During the Visit
If your patient screens “positive” on the Media Use Survey and is expressing issues with sex and/or sexuality, it is important to discuss these issues with the patient and his/her family.
  • Help parents understand that sexual references are common in all types of media (advertisements, music, movies, magazines, etc.). Subsequently, recommend that parents monitor and limit their child’s exposure to sexual content.
  • Encourage parents to keep an ear/eye out for sexual comments or behaviors their children say or exhibit, and to address them right away in hopes of starting conversations about often difficult subjects.
  • Explain to parents that avoiding the topic of sexual messages depicted in media could reinforce negative stereotypes and encourage the child to believe any misinformation presented. If they view a sexual message with their child, encourage parents to discuss the message and to put it in the context of real life and consequences.
  • Encourage parents to look into internet and cable filters and employ the safeguards that technology allows to help block access to inappropriate channels and websites. If they have questions on how to do this, they can call their internet/cable providers.
  • When it comes to starting to address pubertal changes during well child visits, consider offering the parents an opportunity to discuss any questions they may have as well as the patient.
  • Describe and provide resources to parents about how they can teach media literacy skills to children at different developmental stages. Provide parents with accurate consumer health resources related to sexual behavior, and encourage parents to prepare answers to commonly asked questions about sex, especially if they are having difficulties broaching the subject of sexuality. Even for those of us in healthcare, this topic can be tricky to discuss. Browse the CMCH blog “Ask the Mediatrician” section on sexuality for commonly asked questions and answers.
Future Directions
As the body of research grows, there is more evidence to suggest that young children will continue to be exposed to sexual content in the media. We need to focus on providing youth with accurate sexual health information.


  • Baumgartner, S. E., Sumter, S. R., Peter, J., & Valkenburg, P. M. (2012). Identifying Teens at Risk: Developmental Pathways of Online and Offline Sexual Risk Behavior. Pediatrics, 130(6), e1489-e1496. doi:10.1542/peds.2012-0842
  • Bogt, T. M., Engels, R. M. E., Bogers, S., & Kloosterman, M. (2010). “Shake It Baby, Shake It”: Media Preferences, Sexual Attitudes and Gender Stereotypes Among Adolescents. Sex Roles, 63(11-12), 844-859. doi:10.1007/s11199-010-9815-1
  • Brown, J. D., L’Engle, K. L., Pardun, C. J., Guo, G., Kenneavy, K., & Jackson, C. (2006). Sexy Media Matter: Exposure to Sexual Content in Music, Movies, Television, and Magazines Predicts Black and White Adolescents’ Sexual Behavior. Pediatrics, 117(4), 1018-1027. doi:10.1542/peds.2005-1406
  • Chandra, A., Martino, S. C., Collins, R. L., Elliott, M. N., Berry, S. H., Kanouse, D. E., & Miu, A. (2008). Does watching sex on television predict teen pregnancy? Findings from a national longitudinal survey of youth. Pediatrics, 122(5), 1047-1054. doi:10.1542/peds.2007-3066
  • Collins, R. L., Martino, S. C., Elliott, M. N., & Miu, A. (2011). Relationships between adolescent sexual outcomes and exposure to sex in media: Robustness to propensity-based analysis. Developmental Psychology, 47(2), 585-591. doi:10.1037/a0022563
  • Cougar Hall, P., West, J., & Hill, S. (2012). Sexualization in Lyrics of Popular Music from 1959 to 2009: Implications for Sexuality Educators. Sexuality & Culture, 16(2), 103-117. doi:10.1007/s12119-011-9103-4
  • Dalton, M. A., Adachi-Mejia, A. M., Longacre, M. R., Titus-Ernstoff, L. T., Gibson, J. J., Martin, S. K., . . . Beach, M. L. (2006). Parental Rules and Monitoring of Children’s Movie Viewing Associated With Children’s Risk for Smoking and Drinking. Pediatrics, 118(5), 1932-1942. doi:10.1542/peds.2005-3082
  • Davis, M., & Rasmussen, M. L. (2015). Sex, Health and the Technological Imagination. Culture, Health & Sexuality, 17(4), 393-397. doi:10.1080/13691058.2014.994332
    Escobar-Chaves, S. L., Tortolero, S. R., Markham, C. M., Low, B. J., Eitel, P., & Thickstun, P. (2005). Impact of the media on adolescent sexual attitudes and behaviors. Pediatrics, 116(1), 303-326.
  • Fischer, P. M., Schwartz, M. P., Richards, J. W., Jr, Goldstein, A. O., & Rojas, T. H. (1991). Brand logo recognition by children aged 3 to 6 years: Mickey mouse and old joe the camel. JAMA, 266(22), 3145-3148. doi:10.1001/jama.1991.03470220061027
  • Fisher, D. A., Hill, D. L., Grube, J. W., Bersamin, M. M., Walker, S., & Gruber, E. L. (2009). Televised sexual content and parental mediation: Influences on adolescent sexuality. Media Psychol, 12(2), 121-147. doi:10.1080/15213260902849901
  • Flood, M. (2009). The harms of pornography exposure among children and young people. Child Abuse Review, 18(6), 384-400. doi:10.1002/car.1092
    Fox, J., & Tang, W. Y. (2013). Sexism in online video games: The role of conformity to masculine norms and social dominance orientation. Computers in Human Behavior(0). doi:http://dx.doi.org/10.1016/j.chb.2013.07.014
  • Freeman, D., Brucks, M., & Wallendorf, M. (2005). Young children’s understandings of cigarette smoking. Addiction, 100(10), 1537-1545. doi:10.1111/j.1360-0443.2005.01195.x
    Gottfried, J. A., Vaala, S. E., Bleakley, A., Hennessy, M., & Jordan, A. (2013). Does the Effect of Exposure to TV Sex on Adolescent Sexual Behavior Vary by Genre? Communication Research, 40(1), 73-95. doi:10.1177/0093650211415399
  • Kim, J. L., Sorsoli, C. L., Collins, K., Zylbergold, B. A., Schooler, D., & Tolman, D. L. (2007). From sex to sexuality: exposing the heterosexual script on primetime network television. J Sex Res, 44(2), 145-157. doi:10.1080/00224490701263660
  • Martino, S. C., Collins, R. L., Elliott, M. N., Strachman, A., Kanouse, D. E., & Berry, S. H. (2006). Exposure to Degrading Versus Nondegrading Music Lyrics and Sexual Behavior Among Youth. Pediatrics, 118(2), e430-e441. doi:10.1542/peds.2006-0131
  • Peter, J., & Valkenburg, P. M. (2010). Processes Underlying the Effects of Adolescents’ Use of Sexually Explicit Internet Material: The Role of Perceived Realism. Communication Research, 37(3), 375-399. doi:10.1177/0093650210362464
  • Primack, B. A., Kraemer, K. L., Fine, M. J., & Dalton, M. A. (2009). Media exposure and marijuana and alcohol use among adolescents. Subst Use Misuse, 44(5), 722-739. doi:10.1080/10826080802490097
  • Stermer, S. P., & Burkley, M. (2012). SeX-Box: Exposure to Sexist Video Games Predicts Benevolent Sexism. Psychology of Popular Media Culture, No Pagination Specified. doi:10.1037/a0028397
    van Oosten, J. M. F., Peter, J., & Valkenburg, P. M. (2015). The Influence of Sexual Music Videos on Adolescents’ Misogynistic Beliefs: The Role of Video Content, Gender, and Affective Engagement. Communication Research. doi:10.1177/0093650214565893
  • Ward, L. M. (2003). Understanding the role of entertainment media in the sexual socialization of American youth: A review of empirical research. Developmental Review, 23(3), 347-388. doi:http://dx.doi.org/10.1016/S0273-2297(03)00013-3
  • Whiteley, L. B., Brown, L. K., Swenson, R. R., Romer, D., DiClemente, R. J., Salazar, L. E., . . . Valois, R. F. (2011). African American adolescents and new media: associations with HIV/STI risk behavior and psychosocial variables. Ethn Dis, 21(2), 216-222. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484683/pdf/nihms407526.pdf

This toolkit was created with funding from Harvard Pilgrim Health Care