Raunch or romance? Framing and interpreting the relationship between sexualized culture and young people’s sexual health

Clare Bale*

* School of Health and Related Research, University of Sheffield, Sheffield, UK

Sex Educationm Vol. 11, No. 3, August 2011

The increase in exposure to sexually explicit material has been cited as a significant factor influencing adolescent sexuality and health. Concern about the negative impact of this material is increasingly prominent within policy, professional groups, and the media. Little research, however, has been conducted within this area. 

This article presents findings from my research, which is located at the intersection of public health, sociology, media and cultural studies. It explores young people’s perspectives of sexuality, sexual identity and health within the context of sexualized culture and examines how young people discuss these issues, providing a critical account of young people’s engagement with, and experiences of, sexualized culture as ‘agents’ in their own right. My findings are set against historical debates about the nature and impact of sexualized culture and the development of sexual health policy in the United Kingdom.

Introduction

In 2005 Ariel Levy argued that we were now living in a ‘raunch’ culture in which a tawdry, cartoon-like portrayal of sex had become ubiquitous, and that this, once regarded as one kind of sexual expression, had now become viewed as sexuality. Levy’s (2005) viewpoint is not unique. 

Indeed, there has been an explosion of texts that lament the negative consequences of an increasingly pornified society (Paul 2005; Jeffries 2005; Dines 2010; Levin and Kilbourne 2008). The perceived consequences of this include risky sex (unprotected, anal, oral), multiple partners, experimentation with sexuality, unrealistic expectations of sex, sexual coercion, sexual violence, sexual fashion trends (shag bands/daisy chaining, porno-chic), [*1] eating disorders, and a desire for plastic surgery. 

• [*1] Shag Bands are gel bracelets that, when worn by girls, are assumed to imply they are willing to engage in or have engaged in various acts ranging from hugging and kissing to sexual intercourse, as determined by the bracelet’s colour. The wearing of bracelets has raised much controversy in recent times although this is argued to be part of a wider moral panic about adolescent sexuality. 
  Daisy chaining is the practice of engaging in oral (or other) group sex in alternating face up/face down positions, forming a circular group of people. 
  I use the term ‘porno-chic’ to refer to dress codes/fashion that are argued to originate in and draw upon pornographic genres; for example, bondage and S&M.

Anxiety around the media and shifting sexual behaviour has also been registered within public health and related policy, where the impact of mainstream sexualized culture is increasingly cited as a cause for concern, particularly in relation to sexual health. Nowhere is this more audible than in discussions about the impact of sexualization on children and young people who, because of their developmental immaturity and vulnerability, are argued to be particularly at risk (Papadopoulos 2010).

The evidence to support this argument, however, is far from established. Many of the claims that have been made in the area of health on the topic are one-dimensional (Attwood 2002) and speculative at best (Ingham 2007). In contrast, a less frequently reported range of literature from fields outside of health offers a more nuanced interpretation of sexualized culture, sexualization and sexual consumption (Hillier, Kurdas, and Horsley 2001; Smith 2007; Innala 2007). The debate turns, then, not on the existence of sexualized culture, but rather the nature of its meaning and significance for individuals and society.

This article explores the relationship between the media and young people’s sexual health as articulated within public health policy in the United Kingdom. It argues that this relationship is largely framed by covert moralism and by a focus on media effect and exposure and sexual risk and harm. 

Through the presentation of preliminary findings from my own research, which is situated at the intersection between public health, and media and cultural studies, I argue that this framing may in fact constrict and even contain the sexual agency, health and sexual expression of young people. 

I suggest that this is incongruent with the World Health Organization working definition of sexual health and has implications for sex education, sex educators and practitioners and policy-makers. 

I conclude by suggesting that the relationship between sexualized culture and the sexual health of young people may be best understood in terms of competency and considered within a pleasure and rights based definition of sexual health.

Policy and public health: a morality and risk-based discourse

Post 1997, adolescent sexual health policy in the United Kingdom demonstrates a way of talking about the media that problematizes its relationship to young people’s sexual health. The media (including communication technologies) are frequently cited as a significant factor influencing sexuality and the sexual behaviours of young people. 

For example, the Teenage Pregnancy Strategy (Social Exclusion Unit 1999, 45) draws on this idea of effect, citing ‘media influences that glamorise sex’, while The Independent Advisory Group on Sexual Health and HIV (2007) seminar report Sex, Drugs, Alcohol and Young People calls for the censorship, surveillance and regulation of young people, stating: ‘the positive media coverage of celebrity behaviour involving sex, drugs and alcohol acts as an encouragement to young people’ (2007, 8) and ‘(we) need to reconsider the messages young people receive – often subliminally – that it is acceptable to engage in both inappropriate and sexual behaviour’ (2007, 4).

The role and impact of the media in shaping young people’s sexuality and sexual behaviours have become the focus of debates, consultations, think tanks, educational programmes and publications in the United Kingdom. Politicians including David Cameron have bemoaned the influence of lads mags, whilst Claire Curtis-Thomas MP, who commissioned a report looking at sexually explicit publications such as Nuts, Loaded and The Daily Sport in 2008, concluded that their content ‘encourages young men to regard women merely as sex objects’ and described its goal as being, ‘to eliminate any loopholes that exist in the current guidelines for displaying this material’ (Jakubowicz and McClelland 2008). 

In 2008, the Sheffield Centre for Sexual Health and HIV, in partnership with other agencies including Brook and The National Youth Agency, coordinated a National Think Tank to explore the relationship between pornography and young people. 

In 2009, Channel 4 broadcast an episode of The Sex Education Show, part of which was dedicated to exposing the extent and harmful impact of pornography in young people’s lives. 
In the same year, the British Family Planning Association ran a training course entitled ‘Fantasy vs. Reality: The Impact of Pornography on Young People’, and the Sheffield Centre will run a similar course ‘Young People and Pornography’ in 2010. 
More recently, the debate has developed a strong focus on the sexualization of young people, notably young women, as is evident in the recently published Home Office Report by Linda Papadopoulos (2010).

Yet the research to support a view that the impact of the media on sexual health is negative is inconclusive; often derived from quantitative approaches that have been argued to be inappropriate and inadequate, and that have largely been discredited within  the disciplines of media and cultural studies (Gauntlett 2002; Buckingham and Bragg 2004; Bragg and Buckingham 2002). 
These approaches rely upon a behaviourist model of ‘effects’ where audience members are perceived as ‘passive consumers’, influenced by representations in a literal way. 

Research in this tradition is further flawed by a lack of precision in defining what constitutes sexualized and sexual representations and a tendency to ignore context, meaning, representation, register and mode of address (Bragg and Buckingham 2002). In many cases, although not explicit within the literature, the underlying stance is that anything other than monogamous intercourse and vaginal penetration after the age of consent is socially unacceptable, constitutes risk-taking and is therefore unhealthy. 

Normal physiological behaviours and consequences are pathologized. For example, Hong et al. (2007, 161) use questions about attitudes toward pre-marital sex to identify ‘permissive attitudes towards sex’, while Peter and Valkenburg characterize healthy attitudes towards sex and sexuality as those that situate sex in relation to romantic relationships rather than pleasure, and align risky behaviour as having more than one sexual partner in one’s lifetime (Peter and Valkenburg 2007).

Despite the fact that the research we have to hand does not adequately explain the impact of sexualized culture, it tends to assume an authoritative voice and to influence health and social policy. Results are presented in the form of broad and sweeping (often contradictory) comments, conclusions and recommendations. 
Admissions that we know very little about the impact of media on sexuality are no deterrent to drawing firm conclusions about them, and evidence of the positive role the media may play is often downplayed and emphasis is on the negative influence of the media, referring to evidence that the media can serve as a ‘super’ peer for young people, glamorizing and normalizing often unhealthy behaviour (Brown et al. 2006).

The recent Home Office report on the sexualization of young people (Papadopoulos 2010) also adopts a moralistic tone, and, despite claims that its findings are not based on conjecture, situates empirical data from peer-reviewed journals alongside anecdotal evidence from pressure groups, professionals and clinicians, and television survey data with little to indicate their relative quality and value. The report also makes a series of arguably unrealistic recommendations; for example, suggesting that music videos with sexually explicit lyrics should be screened after the watershed when there is no agreed definition of what constitutes ‘sexually explicit’, and calling for restrictions on the sale of lads mags to over 15s when the age of consent is 16.

On investigation then, while current policy documents and debates suggest there is a high volume of compelling, persuasive and comprehensive literature demonstrating the negative impact of sexually explicit material on adolescent physiology and cognitive– social and emotional functioning/socialization, the body of knowledge they draw on is open to serious criticism, arguably revealing more about the attitudes and values of its producers than the relationship between young people and the media (Attwood 2002).

My research is located at the intersection of public health, sociology, media and cultural studies has emerged from my work as a former NHS Public Health Principal for sexual health and my concern with the potentially harmful influence of the media on the sexual identity and behaviours of young people. It aims to explore the relationship between sexualized culture and young people’s sexual health via qualitative methodology, which, rather than stripping context, explicitly draws upon young people’s experiences and accounts to develop themes for analysis.

The preliminary findings presented in this paper are informed by in-depth interviews undertaken with 21 young people aged 16–19 at a further education college in Nottinghamshire, UK. This institution is attended by students from different communities and cultural, socio-economic backgrounds and with a range of different levels of academic ability. 

It is situated in an area of high deprivation that has high levels of teenage pregnancy, and could therefore be seen as situated in an area of ‘high risk’. Although it would be unrealistic to argue that my participants are representative of all young people in the United Kingdom, the college cohort may be vulnerable to some of the risk factors reported as significant in poor sexual health and teenage pregnancy – for example, low GCSE attainment and deprivation – and as such they offer some generalizable insights into the research area.

Every young person taking part in my study initially replicated the public rhetoric of risk and harm identified earlier in this paper. They described the media as influencing young people’s behaviour, especially young children – ‘making them have sex too early’. Subsequently, however, as their own stories and experiences unfolded, they began to situate themselves as ’other’ to this process and unaffected by the media – ‘but it didn’t/doesn’t affect me’. Participants recounted examples countering their initial claims that all young people are ‘doing it’ earlier and earlier:

Like out of my lot, I think there are three of us who had sex before we were sixteen and the rest were like sixteen, one was seventeen. (Male, age 17)
Participant 1: I don’t know what it is, but it is, you just . . . things you hear . . . that people are having sex at like 12 and stuff. I can remember when I was 12 and everyone wasn’t doing it.
Participant 2: Mmm [serious look on face]
Participant 1: Everyone were at a park they weren’t having sex
Participant 2: Holding hands they were 
Participant 1: Holding hands and kissing
Participant 2: Yeah [laughs], It is weird when you think about it, like when we were at school we used to walk around holding hands and it were like my god, so and so and so’s holding hands, and now its like who’s shagged who [both laugh]. (Females, age 17)
Interviewer: So when you say you hear about it, do you actually know of anybody who is 12 who is having sex?
Participant 1: Erm I think I know somebody 
Participant 2: Yeah 
Participant 1: Can’t think like their names, but I do. (Females, age 16)

In the light of this, I have used an investigative approach that intentionally draws out these more public accounts of sexualization, but which prioritizes young people’s private stories and actual experiences.

The fallacy of exposure

The notion of media exposure is central to a discourse of sexual risk and harm, and, when applied to the relationship between sexualized culture and young people, is commonly understood to signify the bombardment of young people with sexualized material. More often than not, the young person is situated as passive, a victim in this relationship. 

Yet research conducted by Bragg and Buckingham in 2004 concluded that young people draw upon their own experiences and emerging identities to interpret the media and employ broader values such as trust and mutual respect to formulate their attitudes, beliefs and values in their readings of media texts. I would also argue that rather than being ‘exposed’ to sexualized culture, many young people claim that they actively seek out sexual texts, including pornography, in different ways and for different reasons.

Reasons for seeking out sexual material reported by my participants included satisfying curiosity, facilitating masturbation and relieving boredom:

You hear so many people talking about it, you look to satisfy your curiosity. (Female, age 16) When I got bored I’d go, right let’s have a wank, let’s watch porn, that would be it sorted, it just kills boredom, like for you to kill boredom. (Male, age 17)

Young people also report accessing such material to increase their knowledge, skills and confidence in relation to sexual practices and their sexual experiences. The following comments are from a young man who talked about how he gained confidence in ensuring his girlfriend experienced orgasm and pleasure, and from a young bisexual woman who accessed chatrooms to gain support in relation to her own emerging sexuality, which she did not feel able to explore in ‘real life’:

I’ve gone onto a site called ask men.com it is fantastic. Everything I’ve learned during sex, how to please the women, how to make her feel comfortable, how to be a gentleman about having sex. (Male, age 17)
I think sometimes it’s quite helpful to see other people going through what you’re going through. (Female, age 16)

At other times, young people reported engaging with sexually explicit material to transgress or oppose censorship:

Yeah, it’s banned from like every music channel, YouTube, all of them. You have to go on a certain website to watch it. That’s pretty in your face [laughs] and over the top, but that’s their sort of theme. They go over the top with everything. I went on YouTube and it was all censored. What they had was just like a blur for a video. So, ok, let’s find the real one. I googled it and found a full version of that. (Male, age 18)

Or, for the sick/yuck/ humour factor:

It’s like the ‘2 girls 1 cup’ video. [*2] People’d video people’s reactions and put them on YouTube so people could laugh at their reactions to the disgusting thing . . . and it goes around spreading around like that . . . is very funny seeing people’s reactions about it though, and someone shows their grandma on YouTube, it’s quite funny [laughs]. (Female, age 16)
Someone got it on their iPhone and showed it me, but they didn’t even tell me what it was, was like ere have a look at this, and turned round it was just like, huhuhuhu . . . that’s bad [makes face and laughs]. (Male, age 17)

• [*2] ‘2 Girls 1 Cup’ is the unofficial nickname of the trailer of a 2007 Brazilian scat-fetish pornographic film produced by MFX Media, entitled Hungry Bitches. The trailer features two women defecating into a cup, taking turns in ostensibly consuming the excrement, and vomiting it into each other’s mouths.

While a number of surveys suggest that a high proportion of young people have seen or been ‘exposed’ to pornography at an early age (Livingstone and Bober 2005), the young people I have worked with suggest that they know how to access sexual material (if they should want to) and, feel they have a right to do it:

For me quite honestly pornography is you go on a computer and you look on a website and that’s where porn is and porn stays there. (Female, age 17)
If I was with somebody and they told me to get rid of my you know erotica I would tell them to fuck off you know like what we’re going to break up in a year or so and what am I going to do then, you know and I think it’s unhealthy to try and restrict that. (Female, age 17)

The use of the term ‘exposure’ within health and evidence-based medicine does not capture this kind of complexity and it can easily be misinterpreted. For example, at a recent conference I attended, quantitative survey data were presented showing a high proportion of teenagers having seen representations of sex involving poo or wee and/or animals. [*3]

• [*3] The words ‘poo’ and ‘wee’ were used in the activity as they were terms more likely to be used by young people themselves.

This was presented to the audience as an indication of the exposure of young people to shocking and inappropriate material, with no consideration of how young people might be engaging with it. The audience response was one of distaste and surprise, and culminated in a discussion about how to stop or mitigate the phenomenon. I knew frommy own research that the survey had taken place at the time of viral circulation of ‘2 Girls 1 Cup’ via YouTube, and that rather than this being an indication of ‘exposure’, young people of both sexes were actively accessing and circulating it for its shock, horror, yuck and gross factor. What was striking was the way in which the audience, despite consisting largely of critical academics, were so easily drawn into reactive emotions informed by this reductive fallacy of exposure.

Freedom to explore and learn

One of the key responses from young people that emerged repeatedly during the course of my research was how they had learnt and developed opinions and capabilities, by drawing both on their experiences with media and with sexual practices, even when those experiences deviated from what they described as their ideal. For example, talking about watching ‘2 Girls 1 Cup’, one young woman said:

I think it’s just a bit of fun. I think it embraces people to be honest, so they are more mentally stable, more than if they see something like that for the first time? At least they’ve seen it before. If they see it again anywhere else, they’re not going to be as shocked about it, it like embraces ’em. (Female, age 16)

Another young woman told me about her first sexual encounter, which took place in the park. Although it had not lived up to her ideal, in that it was not ‘dead romantic’, she was quite pragmatic about the experience. While describing herself as regretting this act, she saw it as an inevitable rite of passage that had contributed to her own sense of sexual self, meaning she was clearer and more confident about future relationships. She was quite clear that her notion of perfect sex was somewhat idealistic:

I was going out with this boy and I thought it were like the love of my life, and we were going to get married and have babies. But obviously right that didn’t happen [laughs], . . . erm . . . but we are still friends now. And, erm, . . . I don’t know it was the most horriblist experience ever, it weren’t ‘nice’ [pulls face], it weren’t like romantic, it was like in the middle of the day in some trees [laughs]. But, in one way I’m glad that I did it otherwise, I’m not a very gutsy person so I don’t think I would of being able to do it. So I’m glad that I did it. (Female, age 17)

In terms of the way we interpret findings, these responses contrast with the notion that young people commonly regret their first sexual encounter (Johnson et al. 1994; Dickson, Herbison, and Silva 1998; Wight et al. 2000), challenging the view that adolescent sexuality is inherently dangerous and that any risk-taking in this area is unacceptable. 

We might question, as Furstenburg (2003) does, why we find a risky activity such as learning to drive acceptable for young people but not learning to be sexual, or consider an approach in which sexual activity itself is not viewed as risk-taking behaviour (Michaud 2006). This would entail a paradigm shift away from a view of risk-taking young people to one of young people who are exploring the world.

In contrast to depictions in the press of knowing and promiscuous young people, the participants in my study demonstrated a high degree of anxiety and naivety about sex that did not appear to differ greatly from my own experiences of being a 16-year-old, which was 26 years ago:

You are not in the films now. It’s actually reality and you are thinking shit, you know. (Male, age 17)
Comes as a bit of a shock I guess when you see it all on like your films and like everything. They are having sex and you come to it and it’s your first time and you think, wow it’s completely different. (Male, age 16)

This anxiety is not helped by what young people described as the inadequacy of a sex education system, which never included discussions about media representations and which did not equip them with the confidence to be able to make decisions when encountering their first sexual activity:

Young people haven’t got a clue. Especially like sex education and all that, that’s like they go, he puts that in there and they have a baby nine months later. It’s not real, it’s no use that is it? V (Male, age 16)

One young woman reported that she did not have the skills to say no to her first sexual encounter. She described feeling horny, wanting sex, but was not expecting it there and then. She did not know how to negotiate this and felt she would have been better equipped if she had not been so unprepared and embarrassed at seeing an erect penis with a condom on it:

I was just like I didn’t know what to say. ’Cos obviously, I’m not being funny, but before then I don’t think I’d ever seen a willy with a condom on so I didn’t. That’s why I went have you got one on and he was like yeah, and I was a bit like oh right ’cos I didn’t know, I’d never seen one with one on [laughs] do you know what I mean. I know that sounds dead stupid but it’s true, I just didn’t. (Female, age 18)

Raunch or romance?

In their accounts of sexualized culture, young people, particularly young women, also describe experiences that illustrate the strength of heteronormative frameworks, making it necessary for them to avoid potential consequences such as loss of reputation and labelling as a slag:

I wouldn’t want to be like the women that you see, that are right slagged off in the newspapers for what they do. (Female, age 16)

One young woman described to me how she had for a long time wanted to do some nude modelling, but was afraid of the consequences:

It was something I wanted to do but had been held back from because of you know the way that people view it. (Female, age 18)

Another articulated her frustration at the restraints she felt on her sexual expression:

What’s really frustrating is because, you know when you, you have an image of yourself, not necessarily the image that everyone else has, but if you have an image of yourself as liberated women, as like a sexual adventurer . . . like you can do what you want, and you want to really experience your life . . . and you think that’s a really good positive attitude towards experimenting. But at the same time, the second someone calls you easy, you immediately want to scrub it out. (Female, age 18)

And this young woman described how she felt her worth was associated with her sexual experience:

Like every time you sleep with another person that goes on your clock like you’re a car with a speedometer. It doesn’t really happen to guys but it does happen to young women like you have a speedometer and it goes like a milometer and every guy it goes up and the more miles it goes up the less desirable you are in a way. (Female, age 17)

Interestingly, none of the young women raised the issue of feeling pressured to be sexy, which is a major focus in much of the discussion about sexualization. Instead, many expressed ambivalence; 

• on the one hand saying they wished they were more confident about their bodies and appearance, whilst 
• on the other continuing to define themselves as different to the kind of girl who is confident with her body, sexuality – the ‘up for it’ girl. 

These young women’s behaviours appear to be strongly self-regulated by a limited choice of ‘romance or raunch’ and the perceived negative consequences of choosing the latter, and this indicates the dominance of a morality and risk discourse as opposed to a pleasure and rights-based approach to sexual health and sexuality. Whilst the young men I interviewed also talked of the way in which they felt an expectation to be groomed and presentable, they did not express the same limited choice and self-regulation demonstrated by the young women. Indeed, many of the ways they talked of young women reinforced these binaries.

Given that public health embraces the notion of ‘stewardship’ – that is, a state’s duty to look after the important needs of people, both individually and collectively – we need to take seriously the normative and moralizing framework of sexuality and sexual health evident within health research and policy. This framework directly contradicts the World Health Organization working definition of sexual health commonly used by public health practitioners and commissioners. Unlike earlier definitions of sexual health that focused on reproductive functions and pathologies, the emphasis here is on an individual’s right to act and participate in society:

Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. (World Health Organization 2002, 5; emphasis added)

This definition provides a model for a rights-based definition of adolescent sexual health that could encompass the notion of willing participation in sexual activity of choice, including those practices that are argued to be instigated by the media, are deemed to be risky and challenge the innocence of childhood.

The approach I have presented within this article challenges the positioning of young people’s sexuality in a covertly moralistic, risk-based discourse, and calls for a multidimensional pleasure-based sexual health economy – one in which young people might function and participate. 

It does not, however, presume that obscenity – that is, the process by which a culture brings into its public arena phenomena that have previously been designated obscene – is in itself wholly unproblematic or totally benign. 
For example, much of the anxiety concerning sexualized society relates to the impact on young women, and possible links to inequality, exploitation and sexual violence. It has been argued that sexual lifestyles are commodified, with images and discourses of young women’s desire sold back to them though porno-chic, cosmetic surgery, beauty and lifestyle products, music and accessories. 

In this way sexualized culture is used to ‘sell’ sexual health through its presentation of sexuality as the key to fulfilment and sexual empowerment. As Gill (2009) identifies, however, the aesthetic portfolio of women presented is limited and excludes those of us who do not fit a narrow sexualized aesthetic, exemplified in the figure of the ‘midriff’. [*4] The narcissistic fashioning of the female body in contemporary cultural practices may then work to pressure and constrain women (and, we might also suggest, men) in new ways.

• [*4] The ‘midriff’ is an advertising term signifying a young, attractive, heterosexual woman who knowingly and deliberately plays with her sexual power and is always ‘up for it’ (i.e. sex), named after the fashion for exposing this part of the body (Gill 2006).

This tension is one that, as a feminist, I am still grappling with in terms of my data and personal beliefs, values and conclusions. Certainly, through the process of conducting research, my opinion has significantly shifted from a view that sexualized culture has a negative impact on young people towards a far more nuanced understanding. 

My concern is that whilst we continue to demonstrate a degree of moral panic about the media, young women’s sexuality will continue to be regulated, and they will lack the space in which to safely, confidently and legitimately develop sexual competencies and experience. 

At a personal level, however, I still feel uncomfortable with the public sexualized display of bodies and I am concerned that if we consider this issue purely in terms of rights to ‘sexualities’ and sexual practices of all kinds, this should not signify an abandonment of questions about power, violence, coercion, diversity and accountability.

Broadening the debate around sexualized culture to include the potential for pleasure and the sexual autonomy of young people raises some very serious and highly contentious issues, such as 

• the age of consent (Cowling and Reynolds 2004; Waites 2009), 
• the inclusion of topics such as pleasure, pornography and 
• sexualized culture within sex and relationship education programmes, and 
• the possibility of developing a definition of adolescent sexual health that reflects a democratization of desire (McNair 2002). 

For healthcare providers there remain genuine anxieties associated with the legal requirements and professional accountabilities related to safeguarding and child protection. These are key areas where we, in our roles as academics, policy-makers, providers, or indeed as carers, parents or grandparents, may have concerns. Policy, if it is to make inroads into promoting positive sexual health, cannot ignore these issues.

Neither is my scepticism about the myopic and moralistic focus on adolescent sexual health evident in recent social and public health policy meant to be unreservedly damning. 
There have been a number of key benefits arising as a consequence of the new visibility of sexual health policy, including that directed at young people, and even from the moral panic associated with the impact of the media on young people. 

For example, the past 10 years have seen an unprecedented rise in the profile of the sexual health agenda in the United Kingdom, which was previously described as a Cinderella service. Recent figures released from the Health Protection Agency indicate that numbers of new diagnoses of sexually transmitted infections rose by 3% between 2008 and 2009 in the United Kingdom. Some of the increase will be as a result of higher levels of access to services and screening, indicating that we are identifying and treating people with sexually transmitted infections more effectively than in the past. 

Young people are now more likely than ever to be able to access sexual health services, including free contraception and condoms, emergency hormonal contraception and sexually transmitted infection screening. 

Conclusion 

Although sexual health policy has made it legitimate for us to discuss the sexual health of young people, recent health literature and policy, as illustrated, fails to consider the complex ways in which young people engage with the media and the potential for an increasingly visible sexual culture that might help young people to develop a broad range of sexual competencies and to navigate and function in an increasingly complex and diverse media and social world.

The United Kingdom has not been able to commit to a comprehensive sex and relationships education programme for our young people, and the coalition government’s public health policy is likely to retain a focus on young people’s sexual health – albeit with a focus on individualized lifestyle choices and behaviour change. 

As an academic and practitioner working in this field, I argue for a commitment to breaking down the taboo associated with young people’s sexual knowledge and behaviour, and to re-orientating policy and public health practice with a greater appreciation and understanding of sexualized culture and young people as sexual consumers – something that, to date, we know very little about. 

In particular, having undertaken a personal journey of exploration within my own research and observed how my own views have changed, I urge caution in accepting a public discourse of exposure and effect, risk and harm. We need not only to research young people’s experiences and the nature of sexualized culture, using a broad range of disciplinary approaches, but also to increase our ability to appraise evidence in this area, and to explore and challenge the values by which we, as policy-makers and advisors, formulate our beliefs about sex, the media and young people.

Acknowledgements

The author would like to formally acknowledge and thank PhD supervisors Paul Bissell and Barry Gibson for their contribution and direction to the development of this research. The author also thanks Sara Bragg for her invaluable and thought-provoking comments on an earlier draft of this article.

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