Sexual and Partner Violence Prevention and Popular Media

In this issue, Bonomi and colleagues ¹ provide a thoughtful and concerning description of young women's perceptions of the intensely popular book and film Fifty Shades of Grey. Through the eyes of college age women who participated in focus group discussions, we learn from this article how young women are at once fascinated and repulsed by intensely controlling and abusive relationships. As researchers, practitioners, and advocates engaged in women's health promotion, we should consider our role in addressing harmful images and narratives that condone violence against women.

As the authors note, the American Academy of Pediatrics has encouraged conversations about media and the harmful effects of media in the context of anticipatory guidance for children and adolescents. Their 2009 policy statement on music and music videos, ² for example, strongly encourages parents and pediatricians to be aware of the song lyrics and video content that youth are consuming, and to create opportunities to talk to children and youth about the harmful messages embedded in these media. Simultaneously, we need to advocate for films, song lyrics, and videos that depict healthy relationships, sexual consent, gender equity, nonviolent conflict resolution, substance use avoidance, and pregnancy prevention. Increasingly, adolescent health promotion programs are including training and skills building around media literacy (i.e., learning to analyze and critique advertisements, music lyrics, and videos) to address smoking prevention, substance misuse, and teen dating violence. Studies that rigorously test the effectiveness of such media literacy programs on adolescent health behaviors are needed.

Anticipatory guidance in pediatric offices, social advocacy around media content, and media literacy programs can be potentially effective strategies for prevention of violence against women. As pediatric patients transition into young adulthood, however, they have few opportunities to engage in structured discussions around media. Bonomi and colleagues suggest that the focus group discussions prompted significant reflection and exchanges among their participants about healthy and unhealthy relationships and what they want for themselves. Intentional discussions around the depictions of violence against women and rigid gender and sexual messages and stereotypes in the popular media are being incorporated into gender-based violence prevention programming, especially targeting young men, in global settings. ³ In the context of national attention on college campus sexual assault prevention, closer examination of the effectiveness of such structured critical analysis of films and music (including sexually explicit material on the Internet) as a component of changing attitudes and behaviors around sexual violence among young adults is needed.

Finally, for clinicians, how should we be approaching talking to our patients about media and their perceptions of the images and narratives they are consuming? A universal education and brief counseling approach about what healthy relationships look like and discussing harm reduction strategies to increase safety for oneself and one's peers is one promising strategy. ⁴ Clinicians might also consider offering information to their adolescent and young adult patients integrated into their patient education materials about being smart consumers of media (this handout is an example of such educational material ⁵ ). Finally, asking our patients about their exposure to pornography (specifically violent and coercive depictions of sexual acts) may be helpful not only in identifying and supporting patients exposed to sexual violence (being made to do things sexual they do not want to do), but also in providing an opportunity to discuss healthy, positive, and consensual sex.