he rationale for exploring adolescent pornography usage, with examination of possible negative emotional health outcomes, is integral to the role of the school nurse

he rationale for exploring adolescent pornography usage, with examination of possible negative emotional health outcomes, is integral to the role of the school nurse. The role of the school nurse is to lead on, coordinate and deliver the 4-5-6 approach of the Healthy Child Programme (Public Health England, 2018). This model specifically states that school nurses need to support young people with a number of high impact areas. These include; developing resilience and wellbeing; keeping young people safe and promoting healthy lifestyles. Therefore, the rationale for this paper is integral to the school nurses’ role. Possible psycho-sexual implications of online pornography consumption in adolescents correlate with multiple high-impact areas, specifically promoting healthy lifestyles, developing resilience and wellbeing, thereby warranting further examination on the topic, especially with the current significance of emotional health in adolescents. The Office for National Statistics (2015) quotes 1 in 8 children aged 10 to 15 reported symptoms of mental illness in the UK. Additionally, The Children’s Society (2018) found that 1 in 10 school aged children have a diagnosable mental illness in the UK. There is also evidence on young people’s use of pornographic material, with Martellozzo et al. (2017) finding that 48% of 11 – 16-year olds surveyed had seen pornography online. Of this, the proportions wishing to emulate pornography increase with age: 21% for 11-12-year olds; 39% for the 13-14-year olds and 42% for the 15-16-year olds (Martellozzo et al., 2017). These statistics resonate with the primary author’s school nursing practice. Through sexual health assessments and delivery of health promotion lessons, young people highlight concerns regarding sexual expectations from relationships, including body image, duration of sex and the ‘need’ to perform certain acts with partners. Alongside this, they would also mention watching pornographic material and feeling a pressure to emulate this. These findings suggest pornography consumption impacts young people’s self-esteem and stress levels. A reasonable hypothesis might state that when adolescents watch pornography, especially without appropriate sources of information or education on the topic of (relationship and) sex education, they conclude that the medium represents the societal norm, and therefore ‘should’ be emulated. Suleiman et al. (2017) state that when young people enter adolescence, the brain develops to prioritise positive risk taking, to learn from new experiences; this includes engaging in romantic and sexual relationships. The NSPCC (2019), surveyed young people, who said one of the reasons adolescents watch sexual content online is to learn about sex and sexual identities. Evidence has sometimes highlighted an association between viewing sexually explicit material and an increase in sexually risky behaviours, possibly signifying that adolescents who watch pornography are likely to imitate it (Koletic et al., 2019). Research is inconsistent, however, with Matkovic, Cohen and Stulhofer (2018) and Martyniuk and Stulhofer (2018) finding little association. The latter authors suggest the likelihood of an unobserved variable in the relationship between pornography Richard Ainsworth-Masiello is a Registered Mental Health Nurse and Specialist Community Public Health Nurse at Oxleas NHS Foundation Trust and a Post Graduate Student, University of Greenwich. Dr David T Evans, OBE, NTF, is Professor in Sexualities and Genders: Health and Well-Being, University of Greenwich.