Consent, pornography use, and perceived impact on sexual behavior among women

INTRODUCTION: The aim was to explore how women in Sweden report use of pornography and how they perceive the impact of pornography on their own sexuality and that of others, particularly in relation to sexual consent. MATERIAL AND METHODS: This cross-sectional study included 557 women visiting a gynecological clinic for contraceptive counseling in 2023. A mixed-methods approach was used, combining quantitative and qualitative analyses. RESULTS: Three quarters of women (78%, n = 431) reported having used pornography at least once. Among users, 73% used pornography less than once a month, 20% monthly, and 7% weekly or daily. Participants were more likely to report that others' sexual behavior was influenced by pornography than their own. Thematic analysis of open-ended answers identified several key perceived effects of pornography, including the creation of unrealistic expectations, impacts on relational intimacy, reinforcement of unattainable beauty standards, normalization of non-consensual acts and harmful gender roles, as well as its role in sexual discovery. Regarding sexual consent, 63% reported being asked for consent during their most recent sexual encounter, although 98% affirmed having experienced consent on that occasion. Overall, pornography users were less likely to have been asked for consent as compared to non-users (p = 0.03), and regular pornography users were more likely to report not experiencing consent during the latest sexual encounter (p = 0.03) as compared to non-regular users. CONCLUSIONS: Based on the thematic analysis, use of pornography had the potential to influence perceptions of sexuality and intimacy, with both positive and negative aspects. Additionally, pornography use was associated with a decreased likelihood of sexual consent. Considering Sweden's sexual education programs and the Consent Law (2018), these findings highlight the need to integrate pornography literacy into sexual education.