Open research questions in Sexuality, Behavior, and Technology

What the literature leaves open

• This study examined chemsex engagement, substance use patterns, and the use of sexual enhancement substances among two understudied occupational subgroups of MSM: digital content creators and sex workers.

  Work, Sex, and Substances: Differences in Self-Reported Chemsex Behaviors Between MSM Sex Workers and Digital Content Creators · 2026 · DOI

• Several limitations of the present study warrant consid- eration. This sampling approach may overrepresent digitally engaged individuals and may not be representative of the broader populations of MSM sex workers and digital content cre- ators, including those living with HIV.

  Work, Sex, and Substances: Differences in Self-Reported Chemsex Behaviors Between MSM Sex Workers and Digital Content Creators · 2026 · DOI

• The present study was pre-registered but differed in some respects from pre-registration. Notably, the recruitment of pathological pornography users was lower than anticipated (n 5 24 vs. planned n 5 31). Consequently, group sizes were slightly unequal, which may have influenced statistical po- wer. We did not include the group of risky users in the manuscript because of the small sample size (n 5 14) but provide results in the supplementary material. In agreement with the large multi-center research project the number of criteria to be included as non-problematic was increased from 0 to 1 before data curation. We included additional ROIs derived from meta-analyses on cue reactivity, the caudate nucleus important in habit formation and the dorsal anterior cingulate cortex as part of the salience network (Starcke et al., 2018). Pathological pornography users were not diagnosed with a compulsive sexual behavior disorder according to ICD 11, interview was based on DSM-V criteria (Wölfling & Müller, 2017) which were adopted from the gaming disorder group also included in our study. The selection of an all-male sample could be seen as another limitation. Ultimately, applying addiction models to problematic pornography use is often criticized risk of (e.g. tolerance/withdrawal, potential instead, the clinical subtypes, 454 Journal of Behavioral Addictions 15 (2026) 1, 445–458 overpathologizing), requiring a more nuanced behavioral addiction framework (Ince, Gaudet, & Bőthe, 2025; Snay- chuk, Dermody, & Kim, 2025).

  Persistent appetitive memory in problematic pornography users · 2026 · DOI

• The results of this study are based on cross-sectional data, which limits the ability to draw causal conclusions. For example, the association between testosterone levels and PPU could theoretically be bidirectional. While we did find significant novel associations between hormones and PPU, effect sizes were generally small. Accordingly, the practical implications of the present findings should be interpreted with caution. This study could not address potential covariates for hormonal values detected in the hair, such as sun exposure (Wester, van der Wulp, Koper, Rijke, & van Rossum, 2016) or washing frequency (Behnke et al., 2021), for which we lacked information for a large part of the sample. However, we consider it unlikely that this has had a strong influence on the present results given that meta-analytic evidence indicates only small effect sizes for associations between hair cortisol and such covariates (Stalder et al., 2017). Further- more, hair testosterone levels of male participants seem to be unrelated to various sorts of hair treatment, but hair color may have an effect (Johnson-Ferguson et al., 2023). since production of Another limitation of our study is that we only included male participants and therefore the generalizability of the results is limited. The results should be viewed with caution in terms of their applicability for female or gender-diverse populations, testosterone and the sensitivity to it, varies greatly between biological genders, leading to potentially different effects in sexuality and behavior (Bancroft, 2005). This gender disparity may also be considered in the context of addiction-relevant effects of cortisol (Franco, Paris, Wulfert, & Frye, 2010) and the interaction between testosterone and cortisol (Barel, Shah- rabani, & Tzischinsky, 2017). Future studies should there- fore investigate non-male populations to clarify whether testosterone, and its interaction with cortisol, is a gender- transcending factor, or posits an exclusively male predis- position. Related variables like sexual orientation, gender identity, or other social factors relating to gender may also affect testosterone (van Anders, Steiger, & Goldey, 2015) and were not assessed in this study. Respective assessments will be obtained in the second cohort of the FOR2974, enabling us to address gender-endocrine relationships more precisely in future studies. Lastly, the sample was rather young and close to the age group where testosterone secretion usually peaks (Handels- man, Sikaris, & Ly, 2016). As testosterone levels are known to decline with increasing age (Harman, Metter, Tobin, Pearson, & Blackman, 2001), future research seeking to replicate the present results in older age groups would be useful.

  Hair testosterone and cortisol interactively predict problematic pornography use in a male sample · 2026 · DOI

• While our study provides an important first quantitative description of intentional pornography access among Span- ish adolescents, several limitations must be acknowledged. First, certain at-risk youth populations may not be fully rep- resented in our sample (e.g., homeless, detained, runaway, or sheltered youth), which might lead to an underestimation of prevalence in groups with potentially higher vulnerabil- ity. Second, given the sensitive nature of questions about pornography, participants might underreport their usage due to social desirability or discomfort. Although self-adminis- tered electronic surveys tend to reduce this bias among ado- lescents (Romer et al., 1997), this risk cannot be entirely eliminated (Tourangeau & Yan, 2007). Third, our design did not capture detailed consumption characteristics, such as frequency of use in hours or users’ attitudes toward pornography — dimensions that are critical to fully understanding the phenomenon. Additionally, we did not assess other variables that the literature identifies as Sexuality Research and Social Policy1 3 relevant to pornography consumption, such as previous sex- ual experiences (Ševčíková & Konečný, 2011), despite evi- dence that sexually active adolescents are more likely to be exposed to sexual material (Bleakley et al., 2008; Ševčíková et al., 2014). As a result, potentially important moderating or mediating factors remain unmeasured. Fourth, we did not gather data on the age of first exposure to pornography. Evidence from Spain indicates that many children encoun- ter pornography for the first time before age 12, often unin- tentionally, and that early exposure may be associated with more problematic patterns of consumption during adoles- cence (Alonso Ruido et al., 2022). This limitation restricts our ability to examine developmental pathways related to pornography use. Fifth, the study did not distinguish between different types of pornography (e.g., violent vs. non-violent, mainstream vs. user-generated). This lack of differentiation may obscure the potential varying effects of exposure to dif- ferent content types on attitudes, behaviors, and well-being. Mixed-methods approaches would be particularly valuable in future research to better capture adolescents’ experiences with diverse forms of pornographic material. Sixth, we lacked information on technology-related sociodemographic variables known to influence pornog- raphy access, such as device ownership, age at obtaining a personal device, unrestricted internet access, and paren- tal control. Recent studies show that early smartphone ownership, limited parental supervision, and unrestricted connectivity significantly increase opportunities for access- ing online sexual content (Rivas-Koehl et al., 2023). The omission of these variables limits our ability to contextu- alize intentional access within adolescents’ broader digital environments. Finally, although our study offers a broad snapshot of intentional access in a large adolescent sample, its cross- sectional design prevents causal inferences. Longitudinal studies would allow a deeper understanding of how device access, early exposure, parental control, and content type collectively shape pornography consumption trajectories over time.

  Prevalence and Factors Associated with Intentional Pornography Access among Spanish Adolescents · 2026 · DOI

• We acknowledge the following limitations of our study, which may serve as potential areas for future research. First, this study used CGSS2018 to examine the relation- ship between social media use and people’s attitudes toward premarital sex, along with the mediating roles of expo- sure to Japanese and Korean cultures and gender equality consciousness. While more recent data, particularly those collected during the pandemic, would better capture these dynamics, most post-2018 surveys lack measures of expo- sure to Japanese and Korean cultures. Although we revali- dated the main effect using CGSS2021 data, the mediation analysis could not be replicated. Moreover, this study relied on cross-sectional data, which cannot fully capture how attitudes toward sexuality are changing in China. Given the rapid evolution of digital society, cross-sectional data may not reflect the latest reality. To address these limitations, future research should collect original data and, where pos- sible, employ longitudinal designs to further test and enrich existing findings. Second, social media use was measured by internet usage frequency, with WeChat use and online reading time employed as alternative measures for robustness checks. While these proxies capture general patterns, the absence of direct measures of social media use, as well as distinctions between platforms and content, may limit the reliability of the findings. Given that different platforms (e.g., Douyin and Kuaishou) vary in user demographics and content expo- sure, future research should build upon existing findings to develop more refined scales for measuring social media usage. Such instruments would facilitate the analyses of the relationship between usage behaviors and attitudes toward premarital sex among young users, as well as enable cross- platform comparisons. Third, this study used travel experience to Europe and North America as a proxy variable to control for exposure to European and American cultures, which to some extent reduced its potential confounding effect on the relationship between social media use and attitudes toward premarital sex. However, exposure to European and American cultures is multifaceted, and overseas travel represents only one dimension of it. Future research should adopt more com- prehensive measures to better capture exposure to European and American cultures and thereby more effectively account for its potential influence on the association between social media use and attitudes toward premarital sex.

  Social Media Use and Attitudes Toward Premarital Sex in China: A Chain-Mediating Analysis · 2026 · DOI

• We did not measure reflective need satisfaction (as did Fairbairn et al., 2022; Hales et al., 2015) but rather focused on attributions to the source. Focusing on attributions is a strength of this research, as it shifts the emphasis from immediate well-being to understanding attributions that can influence safety and reasoning. Participants reported an average medium level of subjective intoxication (M = 3.1, Md = 3), so our results cannot be generalized to high subjective intoxication levels, which may impair reflexive processes. For ethical reasons, we only recruited par- ticipants who could provide appropriate consent. Owing to the research’s naturalistic approach, we could not account for beverage type or amount consumed and had to keep measurements brief. Future studies should examine alcohol’s effect on ostra- cism, sexual objectification, and threat perception in controlled settings. Finally, we did not measure actual alcohol levels but relied on subjective intoxi- cation. As noted above, we propose that subjective and physiological measures of intoxication may be differentially suited to capturing reflexive versus reflective responses, and future research should directly test this by measuring both simultane- Just say no? Alcohol affects threat perception and reactions to…1 3 ously. Indeed, similar BrAC levels can produce different behavioral effects depending on factors such as beverage administration (Nagar et al., 2021), further supporting the value of examining subjective intoxication when studying reflective processes. Future research should directly test this distinction by measuring both physiological and sub- jective intoxication simultaneously and examining their differential associations with reflexive versus reflective responses to ostracism and sexual objectification.

  Just say no? Alcohol affects threat perception and reactions to ostracism and sexual objectification · 2026 · DOI

• Despite pornography's global availability and PPU's recent official recognition as a manifestation of compulsive sexual behavior disorder, these problems remain poorly understood, primarily due to a lack of rigorous research beyond small, homogeneous samples.

  A global investigation of the Moral Incongruence Model of Pornography Use across genders, religions, and cultures · 2026 · DOI

• Prevention, treatment, and future research should address within versus between-person processes and continue combining laboratory tasks with EMA to clarify how lab-indexed mechanisms translate into real-world impaired control.

  Predicting moments of impaired control over addictive behaviors: Relevance of craving and inhibitory control measured in laboratory and ambulatory settings · 2026 · DOI

• In reflecting on this topic, we acknowledge that while the association between methamphetamine use and syphilis transmission may stimulate additional research on SDU, there are drawbacks associated with this research focusing on sexually transmitted infections (STIs) alone.

  Sex, Methamphetamine, and a Surge in Syphilis Among Women and Men Who Have Sex With Women: A Call to Diversify Research Addressing Sexualized Drug Use · 2026 · DOI

• Because the study was cross-sectional, it cannot determine causality between sexual risk events and mental health out- comes. Symptoms of depression, suicidality, and substance abuse might have preceded, followed, or coincided with sexu- ally risky behaviors. Data relies on self-reports, which may be influenced by recall bias or social desirability, and vary- ing timeframes could affect reliability. The social-relational context of sexual risk behavior is complex and may influence responses to items gauging mental health symptom status. Reports regarding suicidal ideation, planning, and attempts by substantial numbers of sexually active male adolescents raise concerns about well-being but also about response reli- ability and validity. While the YRBS offers broad estimates of adolescent risk status, more robust screening measures would improve assessment and facilitate appropriate safe- guards and care.

  Depression, Suicidality, and Substance Abuse Among Sexual Risk Behavior Subgroups of Male High School Students · 2026 · DOI

• Background and aims: Despite a previously reported connection between compulsive sexual behaviors (CSB), such as problematic pornography use, and heightened cue-reactivity, empirical evidence of the alteration of processes responsible for increased salience attribution to erotic cues remains sparse.

  Enhanced conditioning and disrupted extinction processes in men struggling with compulsive sexual behaviors · 2025 · DOI

• Introduction: Problematic pornography use (PPU) affects some individuals, causing distress and impaired functioning, and while psychotherapy is considered a first-line intervention, its efficacy remains understudied and unknown to many therapists.

  Psychotherapy for problematic pornography use: A comprehensive meta-analysis · 2025 · DOI

• Abstract Introduction Despite unrealistic body portrayals commonly seen in pornographic materials, only a few studies have examined the association between pornography use frequency (PUF) and body dissatisfaction (BD) over time and most of these studies have been limited in scope (e.

  Curves and Pixels: Longitudinal Associations Between Frequency of Pornography Use and Body Dissatisfaction in a Sample of Young Hungarian Adults · 2025 · DOI

• This study adds to the limited literature on pornography’s role in initial and on-going learning about kink-related practices and cultures, through findings from an online international survey of 615 self-identified BDSM practitioners.

  Holes in kinky education: the role of pornography in learning about BDSM sexualities · 2025 · DOI

• , bondage, discipline, dominance, submission, sadism, and masochism) has become increasingly present in popular media in recent years, much remains unknown about the etiology and correlates of BDSM.

  What’s God got to do with it? The relationship between religion, sadism, and masochism · 2024 · DOI

• To address this gap in the literature, seven focus groups ( n = 35) were conducted to explore the factors that facilitate and inhibit bystander action in the context of three different IBSA scenarios (taking, sharing, and making threats to share nude or sexual images without consent).

  Facilitators and Barriers of Bystander Intervention Intent in Image-Based Sexual Abuse Contexts: A Focus Group Study with a University Sample · 2024 · DOI

• Despite the prominence of 12-step recovery as an approach to addressing compulsive sexual behavior (CSB) worldwide, little is known about the phenomenological experiences of recovery from CSB among individuals who participate in 12-step groups for CSB (known as ‘S’ groups).

  Lived Experiences of Recovery from Compulsive Sexual Behavior among Members of Sex and Love Addicts Anonymous: A Qualitative Thematic Analysis · 2021 · DOI

• OBJECTIVE: Despite the high prevalence of adolescents' pornography use and increasing societal concerns about it, the examination of problematic pornography use (PPU) among this population is still scarce, potentially due to the lack of well-validated, reliable measures.

  Validity and reliability of the short version of the Problematic Pornography Consumption Scale (PPCS-6-A) in adolescents. · 2021 · DOI

• Despite Malamuth's confluence model (CM) of sexual aggression positing that an impersonal approach to sex interacts with exposure to pornography to predict the likelihood of committing sexual assault, only a few studies have actually tested this prediction.

  Pornography, impersonal sex, and sexual aggression: A test of the confluence model in a national probability sample of men in the U.S. · 2021 · DOI

• Despite theory positing that realism perceptions moderate the relationship between sexual media use and sexual behavior, very few studies have tested pornography exposure x perceived realism interactions in general, and no previous inquiry appears to have tested this interaction in the context of pornography exposure and condom use.

  Casual Condomless Sex, Range of Pornography Exposure, and Perceived Pornography Realism · 2021 · DOI

• Using a longitudinal experimental design with a lack of non-intervention control (initial N = 950; final N = 539), we found that narratives had consistently positive effects on all measured aspects of stigmatization (dangerousness, intentionality), whereas an informative alternative had mixed results, and actually increased perceptions of pedophiles' levels of deviance.

  Humanizing Pedophilia as Stigma Reduction: A Large-Scale Intervention Study · 2021 · DOI

• To address this gap in the literature, this study utilized a quantitative analysis of the posts from 806 users from four separate pedophile support forums to identify the correlates of self-disclosed contact with minors.

  Examining Self-Reported Physical Contact With Minors Among Pedophile Support Forum Users · 2019 · DOI

• Although many sexual and gender minorities (SGM) assigned male at birth (AMAB) use sexual networking applications intended for adult sexual minority men, little is known about adolescents' use of these technologies and characteristics of their online-met partners.

  Geosocial Networking Application Use, Characteristics of App-Met Sexual Partners, and Sexual Behavior Among Sexual and Gender Minority Adolescents Assigned Male at Birth · 2019 · DOI

• BACKGROUND AND AIMS: Internet pornography consumption is prevalent among college students and problematic for some, yet little is known regarding the psychological constructs underlying problematic Internet pornography use (PIPU).

  The relationship between sexual sensation seeking and problematic Internet pornography use: A moderated mediation model examining roles of online sexual activities and the third-person effect · 2018 · DOI

Most-cited papers in Sexuality, Behavior, and Technology

• Unwanted and Wanted Exposure to Online Pornography in a National Sample of Youth Internet Users · PEDIATRICS · 2007 · 311 citations
• Feigning sexual desire: Consenting to unwanted sexual activity in heterosexual dating relationships · The Journal of Sex Research · 1998 · 229 citations
• Pornography Use: Who Uses It and How It Is Associated with Couple Outcomes · The Journal of Sex Research · 2012 · 225 citations
• Less Sex, but More Sexual Diversity: Changes in Sexual Behavior during the COVID-19 Coronavirus Pandemic · Leisure Sciences · 2020 · 216 citations
• The Prevalence of Sexting Behaviors Among Emerging Adults: A Meta-Analysis · Archives of Sexual Behavior · 2020 · 199 citations
• Processes Underlying the Effects of Adolescents’ Use of Sexually Explicit Internet Material: The Role of Perceived Realism · Communication Research · 2010 · 192 citations
• Body Image, Eating Disorders, and the Drive for Muscularity in Gay and Heterosexual Men · Journal of Homosexuality · 2004 · 188 citations
• Sexual Objectification Increases Rape Victim Blame and Decreases Perceived Suffering · Psychology of Women Quarterly · 2013 · 173 citations
• “Without Porn … I Wouldn't Know Half the Things I Know Now”: A Qualitative Study of Pornography Use Among a Sample of Urban, Low-Income, Black and Hispanic Youth · The Journal of Sex Research · 2014 · 169 citations
• Third-Person Effect, Gender, and Pornography on the lnternet · Journal of Broadcasting & Electronic Media · 2002 · 155 citations

Most recent work

• Problematic Pornography Use and Psychological Distress in the USA: A Nationally Representative Study · Archives of Sexual Behavior · 2026
• Hair testosterone and cortisol interactively predict problematic pornography use in a male sample · Journal of Behavioral Addictions · 2026
• Moral Views on Pornography and Pornography Use: It Might Be Complicated · Journal of Sex & Marital Therapy · 2026
• Social Media Use and Attitudes Toward Premarital Sex in China: A Chain-Mediating Analysis · Sexuality Research and Social Policy · 2026
• Replicating and Extending the Dependency-Resentment Hypothesis · Journal of Sex & Marital Therapy · 2026
• Pornography Consumption, Body Image, and Sexual Schemas Among Incel and Non-Incel Men · Journal of Sex & Marital Therapy · 2026
• Frequency of pornography use and family values among romanians: a moderated mediation model involving religiosity and moral disapproval · Sexual & Relationship Therapy · 2026
• Prevalence and Factors Associated with Intentional Pornography Access among Spanish Adolescents · Sexuality Research and Social Policy · 2026
• From Pornography to Somatic Symptoms. A Moderated Mediation Model Involving Moral Disapproval of Pornography and Difficulties in Emotion Regulation · International Journal of Sexual Health · 2026
• Psychometric Evaluation of the Nonmainstream Pornography Use Extent Scale · Sexual Health & Compulsivity · 2026

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