Effects of pornography

Research on the effects of pornography is concerned with multiple outcomes,[1] including potential influences on sexual function and sexual dysfunction, difficulties with sexual relationships, domestic violence, rape and child sexual abuse. Some viewers of novel and extreme pornography may become tolerant to such images, which may impact sexual response.[1] There is too little evidence to conclude that visual images and films can be addictive.[2][3] Several studies conclude the liberalization of porn in society may be associated with decreased rape and sexual violence rates, suggest no effect, or are inconclusive.[4][5][6][7][8][9][10]

Sexual function and addiction

In males, the most immediate effect of pornography is "large increase in total sexual outlets the same day [...] attributed to masturbation" with most "of them found the experience moderately sexually arousing, enjoyable, and generally pleasant, but some reported being disgusted, ashamed, and shocked."[11]

Pornography addiction is a purported[12] behavioral addiction characterized by compulsive, repeated use of pornographic material until it causes serious negative consequences to one's physical, mental, social, and/or financial well-being.[13][14] There is no diagnosis of pornography addiction in the current Diagnostic and Statistical Manual of Mental Disorders (the DSM-5).[12] The DSM-5 considers such diagnosis and rejects it because "there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders."[12][15]

A 2014 review, found that high-frequency use of visual sexual stimuli "fails to meet standards of addiction", e.g. because it can reduce unhealthy behaviors.[16] Scientists do, however, state that excessive pornography viewing can be unhealthy if it becomes problematic for an individual due to personal or social reasons, including excessive time spent viewing pornography instead of interacting with others. Individuals may report depression, social isolation, career loss, decreased productivity, or financial consequences as a result of their excessive Internet pornography viewing impeding on their social life.[17] Frequent consumers of pornography tend to experience more loneliness, and sexually inexperienced consumers of porn tend to have lower self-esteem with regard to their bodies and sexual potential as compare themselves to the actors in the pornographic material.[18] In a 2014 American Psychological Association (APA) article, Kirsten Weir stated, "It's not clear, however, whether pornography is the proverbial chicken or the egg. Does a person turn to pornography because he's already in an unsatisfying relationship? Or do women pull away and lose interest in sex when they discover their partner is spending quality time with adult film stars?"[15]

Despite little evidence in the research literature for the existence of pornography addiction,[16] an academic review notes that a large, lucrative industry promises treatments for "pornography addiction", which is alleged to have an attendant risk of erectile dysfunction. On the other hand, there are reports of clinical experience that men who watch large amounts of porn come to need more stimulation and aggressive porn in order to become sexually aroused.[19] This desensitization of sexual arousal could lead to porn addiction because of less satisfaction from porn consumption and a higher need to reach the initial satisfaction level. A study done by the University of Cambridge in 2014 correlates porn addiction to drug addiction. Compulsive porn users craved porn and had a greater wanting, but did not have higher sexual desires. Drug addicts are driven to do drugs because they want it rather than enjoy it. [20]

Beliefs

Figure 5 in Effects of Prolonged Consumption of Pornography.[21]
Figure 10 in Effects of Prolonged Consumption of Pornography.[21]

In Effects of Prolonged Consumption of Pornography, a review of pornography research conducted for the Surgeon General in 1986, Zillmann noted that inconsistencies in the literature on pornography exist, but overall concluded that extensive viewing of pornographic material may produce some sociological effects he argued were negative, including a decreased respect for long-term, monogamous relationships, and an attenuated desire for procreation.[21] He describes the hypothetical basis for these conclusions stating:

The values expressed in pornography clash so obviously with the family concept, and they potentially undermine the traditional values that favor marriage, family, and children ... Pornographic scripts dwell on sexual engagements of parties who have just met, who are in no way attached or committed to each other, and who will part shortly, never to meet again ... Sexual gratification in pornography is not a function of emotional attachment, of kindness, of caring, and especially not of continuance of the relationship, as such continuance would translate into responsibilities, curtailments, and costs ...[22]

Other contemporary researchers disagreed, McKay & Dolf Noting "neglected in work on pornography is that adults capable of functioning in contemporary society are also quite able to distinguish the difference between reality and fantasy. That such a point requires stating is indicative of the overly simplistic model of human behaviour which is reflected in this type of work."[23]

The effects as Gail Dines summarizes Zillman's 1989 study, include "alters perceptions of sexuality; specifically, it fosters presumptions of popularity for less common sexual practices; breeds discontent with the physical appearance and the sexual performance of intimate partners; trivializes rape as a criminal offense and also trivializes sexual child abuse as a criminal offense; and promotes insensitivity toward victims of sexual violence and promotes men's beliefs that they would be capable of committing rape. In addition, habitual male consumers of common pornography appear to be at greater risk of becoming sexually callous and sexually violent toward women than occasional users."[24][25]

Avedon Carol has explained of Zillmann's term "sexually callous" that he meant "a greater tolerance for homosexuality; a belief that women should be able to choose other priorities beside motherhood; less belief in marriage; a belief that women may enjoy sex and choose to participate in it for reasons other than pleasing their husbands or conceiving children - in short, the goals of most feminist groups of the time. Zillmann was unable to demonstrate any increase in misogynist or violent attitudes and desires, although he did try." and stated of the sponsor of the report "Having noted the varied interpretability of Zillmann and Bryant's findings, the [USA] Surgeon-General's report said that the only reliable findings of the research that supposedly proved men were more callous towards women after looking at pornography was this: the group that saw pornography estimated more accurately the prevalence of sexual practices in society. The control group, which did not see the material, tended to underestimate grossly how common certain sexual acts were" and commented "But even this result may be less reliable than it appears, due to methodological problems. Zillmann and Bryant had tried to include non-students in their research, but many of them left the study group when they discovered they would be asked to look at pornography. This meant that the control group contained a different population - older, perhaps more settled married men, for example - and thus any differences in the answers the groups gave to the questions might only reflect different attitudes among the different groups, and not pornography effects at all. The study was no longer controlled. In the end, the research may only mean that older, married men are less critical of their partners than young, single psychology students, and that such young, educated men have more liberal attitudes about women's roles and homosexuality, and more realistic knowledge of sexual practices in society." [26]

In a 2012 review, it was concluded that further studies are needed on this topic.[27] In 2013, large-scale research in the Netherlands in 2013 showed that porn viewing during formative years explained between 0.3% and 4% of the variance of sexual behaviours, even in audiences which are not the target of adult material and from whom such material is nominally withheld.[28]

Sexual violence

Figure 12 in Effects of Prolonged Consumption of Pornography.[21]

Controlled studies

A controlled study describes the relationship between given behaviors or environmental conditions and health effects in a laboratory setting in which conditions other than those under study are effectively held constant across groups of participants receiving various levels of the experimental condition(s). Since it is considered that the only functional difference between groups is the level of experimental condition(s) received, researchers can strongly infer cause-and-effect relationships from statistically significant associations between experimental condition(s) and health consequences. Thus, if executed properly, controlled studies have high levels of internal validity. However, such studies often suffer from questionable external validity due to the considerable differences between real-world environments and the experimental context, and the consequent belief that results cannot be generalized beyond that context.[29]

Some researchers claim that pornography causes unequivocal harm to society by increasing rates of sexual assault,[21][30] a line of research which has been critiqued in The effects of Pornography: An International Perspective.[31] In a paper written in 1965,[32] called Sexual Deviation as Conditioned Behavior: A Hypothesis, R.J. McGuire found that the viewing of pornography can serve as a source of a paraphilic "vivid sexual fantasy" which, when contemplated during masturbation, may condition men into perversion.[33] In an interview conducted by Gail Dines of men in prison who had committed rape against prepubescent children, the rapes came after a "habitual" consumption of child porn "within six months," although the men were previously "horrified at the idea".[34]

Effects of Prolonged Consumption of Pornography reported a review of controlled studies which found that extensive viewing of the type of pornographic material commonly sold at adult bookstores was positively correlated with leniency in the sentencing of a person convicted of rape in a mock trial setting (figure 5), decreased satisfaction of participants with their sex lives and partners (figure 10), and an increased self-reported willingness to commit rape or other forced sexual acts (figure 12).[21] The effects of Pornography: An International Perspective countered this, arguing that the effects of exposure may be different when an individual controls their own exposure than when they are subjected to exposure experimentally:

The laboratory-school experiments or brief exposure experiments (less than a week to a semester or so) are hardly comparable to situations in the real world and may not be relevant at all. ... In real life, individuals can elect to experience some pornography for minutes or hours, at a single session, or over years. In real life, individuals are free to satisfy different sexual urges in ways unavailable to students in classroom or subjects in laboratory situations.[31]

The link between pornography and sexual aggression has been the subject of multiple metaanalyses.[35] Metaanalyses conducted in the 1990s suggested to researchers that there might not be an association of any kind between pornography and rape supportive attitudes in non-experimental studies.[36] However, a metaanalysis by Hald, Malamuth and Yuen (2010) suggests that there is a link between consumption of violent pornography and rape-supportive attitudes in certain populations of men, particularly when moderating variables are taken into consideration.[35]

A meta-analysis conducted in 2015 found that pornography "consumption was associated with sexual aggression in the United States and internationally, among males and females, and in cross-sectional and longitudinal studies. Associations were stronger for verbal than physical sexual aggression, although both were significant. The general pattern of results suggested that violent content may be an exacerbating factor."[37]

In an earlier review of this literature Ferguson and Hartley (2009) argued that "it is time to discard the hypothesis that pornography contributes to increased sexual assault behavior".[38] They stated that the authors of some studies tended to highlight positive findings while deemphasizing null findings, demonstrating confirmation bias in the published literature. Ferguson and Hartley concluded that controlled studies, on balance, were not able to support links between pornography and sexual violence.

Epidemiological studies

An epidemiological study describes the association between given behaviors or environmental conditions, and physical or psychological health by means of observation of real-world phenomena through statistical data. Epidemiological studies generally have high levels of external validity, insofar as they accurately describe events as they occur outside of a laboratory setting, but low levels of internal validity, since they do not strongly establish cause-and-effect relationships between the behaviors or conditions under study, and the health consequences observed.[29]

Danish criminologist Berl Kutchinsky's Studies on Pornography and sex crimes in Denmark (1970), a scientific report ordered by the Presidential Commission on Obscenity and Pornography, found that the legalizing of pornography in Denmark had not resulted in an increase of sex crimes.[39] Since then, many other experiments have been conducted, either supporting or opposing the findings of Berl Kutchinsky, who would continue his study into the social effects of pornography until his death in 1995. His life's work was summed up in the publication Law, Pornography, and Crime: The Danish Experience (1999). Milton Diamond from the University of Hawaii found that the number of reported cases of child sex abuse dropped markedly immediately after the ban on sexually explicit materials was lifted in 1989.[40]

Some researchers claim there is a correlation between pornography and a decrease of sex crimes,[4][5][7][8][9][10] including Diamond (author of review from 2009).[6] The effects of Pornography: An International Perspective was an epidemiological study which found that the massive growth of the pornography industry in the United States between 1975 and 1995 was accompanied by a substantial decrease in the number of sexual assaults per capita, and reported similar results for Japan.[31] Findings of this nature have been critiqued by Robert Peters, president of Morality in Media, on the grounds that the results are better explained by factors other than the increased prevalence of pornography: "a more plausible explanation is that if there is a decline in "forcible rape," it is the result of a tremendous effort to curb rape through community and school-based programs, media coverage, aggressive law enforcement, DNA evidence, longer prison sentences, and more."[41]

In 1986, a review of epidemiological studies by Neil M. Malamuth found that the quantity of pornographic material viewed by men was positively correlated with degree to which they endorsed sexual assault.[42] Malamuth's work describes Check (1984), who found among a diverse sample of Canadian men that more exposure to pornography led to higher acceptance of rape myths, violence against women, and general sexual callousness. In another study, Briere, Corne, Runtz and Neil M. Malamuth, (1984) reported similar correlations in a sample involving college males. On the other hand, the failure to find a statistically significant correlation in another previous study led Malamuth to examine other interesting correlations, which took into account the information about sexuality the samples obtained in their childhood, and pornography emerged as the second most important source of information.[42] Malamuth's work has been criticized by other authors, however, such as Ferguson and Hartley (2009) who argue Malamuth has exaggerated positive findings and has not always properly discussed null findings.[38]

Effects among specific groups

Heterosexual adult relationships

Two psychotherapists operating EastWind Health Associates in Halifax reported their clinical experience that chronic viewing of pornography by adult men can lead to emotional estrangement from their partners, even though the men may desire emotional intimacy.[19] Because of the increasing numbers of men presenting such problems, one therapist remarked, "I think we're at a tipping point with this phenomenon."[19]

School-age juveniles

In the UK Association of Teachers and Lecturers feels schoolchildren need to be educated about pornography and warned what is reasonable and what is not acceptable.[43] Some experts say teaching about sex and relationships in school will reduce the appetite for pornography among schoolchildren. Authors of a 2014 report which examined 276 studies concluded that "causal relationships" between pornography and unprotected sex or sex at a young age "could not be established." Another smaller review from 2012 was also inconclusive.[1][44]

Criminals

Silbert, M. and Pines, A., in "Pornography and Sexual Abuse of Women," published their study involving prostitutes in the international journal Sex Roles, "The comments followed the same pattern: the assailant referred to pornographic materials he had seen or read and then insisted that the victims not only enjoyed rape but also extreme violence."[45]

The study Use of Pornography in the Criminal and Developmental Histories of Sexual Offenders examined the exposure to and the usage of pornography in the histories of 38 rapists and 26 child molesters. The study found that both groups reported exposure to pornography and were "significantly more likely" to use pornographic materials before and during their offenses. According to the study pornography was employed to relieve an impulse to act out. According to the study, child molesters indicated "significantly more" exposure to pornography than rapists in adulthood.[46]

According to the study "Pornography Use as a Risk Marker for an Aggressive Pattern of Behavior Among Sexually Reactive Children and Adolescents", sexually reactive children and adolescents (SRCAs), also referred to as juvenile sexual offenders, "may be more vulnerable and likely to experience damaging effects from pornography use." According to the study, the SRCAs who used pornography were "more likely" to display aggressive behaviors than their nonusing counterparts.[47]

However, some evidence suggests that pornography consumption helps some sex offenders to keep from acting out on their urges.[48]

Pornographic film actors

Because pornographic film making involves unsimulated sex, usually without condoms (barebacking), pornographic actors are particularly vulnerable to sexually transmitted diseases. In a paper written by the LA Board of Public Health, officials claimed that among 825 performers screened in 2000–01, 7.7% of females and 5.5% of males had chlamydia, and 2% overall had gonorrhea. These rates are much higher than in patients visiting family planning clinics, where chlamydia and gonorrhea rates were 4.0% and 0.7%, respectively. Between January 2003 and March 2005, approximately 976 performers were reported with 1,153 positive STD test results. Of the 1,153 positive test results, 722 (62.6%) were chlamydia, 355 (30.8%) were gonorrhea, and 126 (10.9%) were coinfections with chlamydia and gonorrhea. Less is known about the prevalence and risk of transmission of other STDs such as syphilis, herpes simplex virus, human papillomavirus, hepatitis B or C, trichomonal infection, or diseases transmitted through the fecal–oral route.[49] The data collection of LA public health was criticized by pornographic industry sources on the grounds that most of those testing positive had never made a pornographic film, and were in fact being excluded from pornographic film acting until they had treated their STDs. Non-treatable STDs like HSV represent a difficult case: according to actress Chloe, "After you've been in this business for a while, you have herpes. Everyone has herpes."[50]

See also

References

  1. 1 2 3 Segal, David (28 March 2014). "Does Porn Hurt Children?". New York Times. Retrieved 30 March 2014.
  2. ↑ http://www.hngn.com/articles/24567/20140217/porn-addiction-lie-researchers-scientific-evidence-proves.htm
  3. ↑ Tamsin McMahon Will quitting porn improve your life? A growing ‘NoFap’ movement of young men are saying no to porn and masturbation Maclean's, January 20, 2014. Quote: "Kruger helped revise the sexual disorders section of the latest edition of the psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders, which doesn’t include sex or porn addiction due to lack of academic evidence that they exist."
  4. 1 2 Pornography, Sex Crime, and Public Policy by Berl Kutchinsky.
  5. 1 2 Kutchinsky, Berl (Summer 1973). "The Effect of Easy Availability of Pornography on the Incidence of Sex Crimes: The Danish Experience". Journal of Social Issues 29 (3): 163–181. doi:10.1111/j.1540-4560.1973.tb00094.x. Retrieved 31 March 2014.
  6. 1 2 Diamond, Milton (September–October 2009). "Pornography, public acceptance and sex related crime: A review". International Journal of Law and Psychiatry 32 (5): 304–314. doi:10.1016/j.ijlp.2009.06.004. Retrieved 31 March 2014. External link in |journal= (help)
  7. 1 2 Pornography and Sexual Representation: A Reference Guide, Volume 3 (book) by Joseph W. Slade.
  8. 1 2 Studies on Pornography and Sex Crimes in Denmark (1970) by Berl Kutchinsky.
  9. 1 2 Kendall, Todd D. (July 2007). "Pornography, rape and the internet" (PDF). Retrieved 30 March 2014.
  10. 1 2 D'Amato, Anthony (23 June 2006). "Porn Up, Rape Down". Retrieved 19 December 2006.
  11. ↑ Marvin Browna, Donald M. Amorosoa & Edward E. Warea (2010). "Behavioral Effects of Viewing Pornography". The Journal of Social Psychology 98 (2): 235–245. doi:10.1080/00224545.1976.9923394. reporting at least one ejaculation
  12. 1 2 3 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 481, 797–798. ISBN 978-0-89042-555-8. Thus, groups of repetitive behaviors, which some term behavioral addictions, with such subcategories as "sex addiction," "exercise addiction," or "shopping addiction," are not included because at this time there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders.
  13. ↑ Stein, Dan J.; Hollander, Eric; Rothbaum, Barbara Olasov (31 August 2009). Textbook of Anxiety Disorders. American Psychiatric Pub. pp. 359–. ISBN 978-1-58562-254-2. Retrieved 24 April 2010.
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  18. ↑ Watson, Mary Ann, and Randyl D. Smith. "Positive Porn: Educational, Medical, And Clinical Uses." American Journal Of Sexuality Education 7.2 (2012): 122-145. DOI10.1080/15546128.2012.680861
  19. 1 2 3 Cuthbertson, Richard (2 January 2015). "Internet porn 'rewiring' young brains, Halifax therapists say". CBC News (CBC News). Retrieved 5 January 2015.
  20. ↑ Voon, Valerie, and Thomas B. Mole, Paula Banca, et al. "Neural Correlates Of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviors." PLOS ONE:. N.P., 11 July 2014. Web. 26 Apr. 2016
  21. 1 2 3 4 5 6 Zillmann, Dolf. "Effects of Prolonged Consumption of Pornography". National Institutes of Health.
  22. ↑ Zillmann, pages 16-17
  23. ↑ McKay, H.B.; Dolff, D.J (1984). 'The Impact of Pornography: An Analysis of Research and Summary of Findings'; Working Papers on Pornography and Prostitution Report No. 3. Department of Justice, Canada.
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  25. ↑ Bryant, editors, D. Zillmann, J. (1989). Pornography : research advances and policy considerations. Hillsdale (New Jersey): Lawrence Erlbaum Associates. ISBN 0805806156.
  26. ↑ Carol, Avedon (1994). Nudes, Prudes and Attitudes: Pornography and Censorship. Gloucester: New Clarion Press. p. 69.
  27. ↑ http://rory.net/PUBS/PornAdolescents.pdf
  28. ↑ Hald GM; Kuyper L; Adam PC; de Wit JB (Dec 2013). "Does viewing explain doing? Assessing the association between sexually explicit materials use and sexual behaviors in a large sample of Dutch adolescents and young adults.". The Journal of Sexual Mediciner (International Society for Sexual Medicine) 10 (12): 2986–95. doi:10.1111/jsm.12157. PMID 23621804.
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  30. ↑ Malamuth, Neil M.: "Do Sexually Violent Media Indirectly Contribute to Antisocial Behavior?", , page 10
  31. 1 2 3 Diamond, Milton. "The effects of Pornography: An International Perspective". University of Hawaii System.
  32. ↑ McGuire, RJ; Carlisle, JM; Young, BG (1965). "Sexual Deviations as Conditioned Behavior: A Hypothesis.". Behaviour research and therapy 3: 185–90. PMID 14253217. External link in |journal= (help)
  33. ↑ McGuire, R.J.; Carlisle, J.M.; Young, B.G. (1964). "Sexual deviations as conditioned behaviour: A hypothesis". Behaviour Research and Therapy 2 (2–4): 185–90. doi:10.1016/0005-7967(64)90014-2.
  34. ↑ Bindel, Julie, The Truth About the Porn Industry: Gail Dines, the Author of an Explosive New Book About the Sex Industry, on Why Pornography Has Never Been a Greater Threat to Our Relationships, in The (U.K.) Guardian, Jul. 2, 2010, section Life & Style, subsection Women, as accessed Jul. 17, 2010.
  35. 1 2 Hald, Gert Martin; Malamuth, Neil; Yuen, Carlin (2000). "Pornography and Attitudes Supporting Violence Against Women: Revisiting the Relationship in Nonexperimental Studies" (PDF). UCLA Division of Social Sciences. Retrieved 13 March 2013.
    • Kingstona, Drew; Malamuthb, Neil; Fedoroffc, Paul; Marshalld, William (24 March 2009). "The Importance of Individual Differences in Pornography Use: Theoretical Perspectives and Implications for Treating Sexual Offenders". The Journal of Sex Research 46 (=2–3): 216. doi:10.1080/00224490902747701.
  36. ↑ Allen, Mike; D'Alessio, Dave; Brezgel, Keri (17 March 2006) [1995]. "A Meta-Analysis Summarizing the Effects of Pornography II Aggression After Exposure". Human Communication Research 22 (2): 258–283. doi:10.1111/j.1468-2958.1995.tb00368.x.
  37. ↑ Wright, Paul J.; Tokunaga, Robert S.; Kraus, Ashley (2015-12-01). "A Meta-Analysis of Pornography Consumption and Actual Acts of Sexual Aggression in General Population Studies". Journal of Communication: n/a–n/a. doi:10.1111/jcom.12201. ISSN 1460-2466.
  38. 1 2 Ferguson, Christopher J., The pleasure is momentary...the expense damnable? The influence of pornography on rape and sexual assault. (PDF)
  39. ↑ Berl Kutchinsky: Studies on Pornography and sex crimes in Denmark
  40. ↑ The Effects of Pornography: An International Perspective University of Hawaii Porn 101: Eroticism, Pornography, and the First Amendment: Milton Diamond Ph.D.
  41. ↑ Peters, Robert (4 August 2006). "‘Could it be that pornography prevents rape?’". ObscenityCrimes.org. Archived from the original on 2006-10-01. External link in |work= (help)
  42. 1 2 Malamuth, Neil M. (August 4, 1986). Do Sexually Violent Media Indirectly Contribute to Antisocial Behavior?. Public Health Service of United States. p. 38.
  43. ↑ Sellgren, Katherine (26 March 2013). "BBC News - Pupils 'should be taught about risks of pornography'". BBC News. Retrieved 13 March 2014.
  44. ↑ "BBC News - Is sex education key to porn battle?". BBC News. 20 September 2013. Retrieved 13 March 2014.
  45. ↑ Silbert, Mimi H.; Pines, Ayala M. (1984). "Pornography and sexual abuse of women". Sex Roles 10 (11–12): 857–68. doi:10.1007/BF00288509.
  46. ↑ Carter, D. L.; Prentky, R. A.; Knight, R. A.; Vanderveer, P. L.; Boucher, R. J. (1987). "Use of Pornography in the Criminal and Developmental Histories of Sexual Offenders". Journal of Interpersonal Violence 2 (2): 196–211. doi:10.1177/088626087002002005.
  47. ↑ Alexy, Eileen M.; Ann W. Burgess; Robert A. Prentky (2009). "Pornography Use as a Risk Marker for an Aggressive Pattern of Behavior Among Sexually Reactive Children and Adolescents". Journal of the American Psychiatric Nurses Association 14 (6): 442–453. doi:10.1177/1078390308327137. PMID 21665787.
  48. ↑ Moyer, Melinda Wenner (23 June 2011). "The Sunny Side of Smut". Scientific American. Retrieved 13 March 2014.
  49. ↑ Grudzen, Corita R.; Kerndt, Peter R. (June 19, 2007). "The Adult Film Industry: Time to Regulate?". PLoS Medicine (Public Library of Science, U.S. National Library of Medicine). PMC 1892037. Archived from the original on August 6, 2007.
  50. ↑ Martin Amis (March 17, 2001). "A rough trade". London: guardian.co.uk. Retrieved April 10, 2009.

Further reading

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