Summary: A large international study investigated problematic pornography use (PPU) across 42 countries, surveying more than 82,000 people of varied genders and sexual orientations. The research shows that while most adults have viewed pornography, a measurable minority—around 3% by one assessment—experience patterns of use that cause significant life disruptions. Despite these consequences, few affected individuals seek treatment, highlighting gaps in awareness, support, and access to care.
This study found that pornography use is widespread—up to 94% of adults in some regions have used it—but problematic use that meets clinical concern affects a smaller portion of the population. The findings show minimal differences in PPU by sexual orientation and confirm that men report higher levels of PPU than women or gender-diverse respondents. The study emphasizes the need for improved recognition, culturally sensitive resources, and research into effective help and prevention strategies.
Key Facts:
- This research is among the first large-scale investigations to include women and gender-diverse people when assessing problematic pornography use internationally.
- Using validated assessment tools, the study estimates that roughly 3% of respondents may meet criteria for problematic pornography use, with variation depending on the measurement applied.
- Only a small fraction of those identified as at risk have sought help; many others wanted treatment but faced barriers such as cost or availability.
Source: University of Montreal
A major international study led by a Canadian psychologist illuminates how problematic pornography use affects people across different regions, genders, and sexual orientations.
Published in the journal Addiction, the study analyzed responses from 82,243 participants in 42 countries. Unlike many earlier investigations, it deliberately included a diverse sample—women, transgender and non-binary people, and individuals with a range of sexual orientations—so that prevalence and patterns could be compared across groups and cultures.
UdeM assistant professor of psychology Beáta Bőthe and an international consortium of researchers used established questionnaires to measure what clinicians refer to as problematic pornography use (PPU): patterns of consumption that the user cannot control and that lead to significant negative consequences, such as work or relationship problems and emotional distress. The study clarifies that moral guilt about pornography alone does not equate to PPU; clinical concern rests on loss of control and real-life harm.
Widespread exposure, limited treatment-seeking
The researchers report that in North America, Europe, and Australia between 70% and 94% of adults have used pornography at some point. Applying validated scales, they found that about 3.2% of participants met the threshold for being at risk of problematic pornography use on the primary measure (the Problematic Pornography Consumption Scale). Men reported higher rates of PPU than women or gender-diverse respondents, while no consistent differences emerged across sexual orientations.
Despite this prevalence, help-seeking was rare: only 4–10% of people who screened positive for PPU had ever sought treatment, and another 21–37% said they wanted help but did not obtain it, often citing barriers like cost or lack of available services. This gap between need and treatment uptake points to stigma, limited resources, and practical obstacles that prevent people from accessing care.
Varied forms of pornography and consumption patterns
The study notes the many ways people access sexually explicit material online, including:
- Video and feature-length productions ranging from amateur to professional content.
- Still images and photographs, including digitally created artwork.
- Erotic literature and stories found on websites and forums.
- Live webcam performances that may include viewer interaction.
- Virtual reality and interactive formats that create immersive sexual experiences.
- Online chat rooms and forums used for sexually explicit exchange and content sharing.
- Animated pornography, including genres such as hentai.
The study did not collect detailed data on the specific kinds of content consumed, so it cannot say whether the materials matched respondents’ sexual orientations. Nonetheless, the authors emphasize that frequency of viewing does not automatically imply problematic use; the defining features are loss of control and tangible negative consequences.
Influences on consumption and risk
Researchers observed that younger adults—those who grew up with ready internet access—tend to view online pornography more frequently than older cohorts. For people who identify as transgender or non-binary, pornography can play a role in identity exploration and representation, which may shape preferences and consumption patterns. Although sexual minority individuals sometimes report higher frequency of viewing, this does not translate into higher levels of PPU compared with heterosexual peers.
Bőthe and colleagues stress that patterns of pornography use and the risk of PPU are shaped by a complex mix of personal factors, cultural norms, and societal attitudes. In some cultures, taboo and stigma may suppress open discussion or help-seeking—particularly among women—while in other contexts access and anonymity may encourage use.
About this addiction and psychology research news
Author: Jeff Heinrich
Source: University of Montreal
Contact: Jeff Heinrich – University of Montreal
Image: The image is credited to Neuroscience News
Original Research (open access): Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools by Beáta Bőthe et al., published in Addiction. This research validates screening tools and reports on PPU prevalence across 42 countries.
Abstract
Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools
Background and aims
Problematic pornography use (PPU) is a common presentation of Compulsive Sexual Behavior Disorder as defined in the 11th edition of the International Classification of Diseases. While sexual behavior differences related to culture, gender, and sexual orientation are documented, data on PPU beyond Western samples and among women, transgender, non-binary, and sexually diverse individuals have been limited. This study aimed to (a) validate three assessment tools—the long and short versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) and the Brief Pornography Screen (BPS)—and (b) estimate PPU risk across diverse populations.
Methods
Drawing on the pre-registered International Sex Survey (n = 82,243; mean age = 32.4 years, SD = 12.5) spanning 42 countries on five continents, the study evaluated psychometric properties (factor structure, measurement invariance, reliability) of the PPCS, PPCS-6, and BPS and examined associations with related variables such as treatment-seeking. The analysis compared PPU risk across groups including three gender categories.
Results
All three measures demonstrated strong psychometric performance in confirmatory factor analyses. Based on the PPCS, 3.2% of participants were classified as at risk for PPU, with notable variation by country and gender (men showing the highest rates). There were no consistent differences by sexual orientation. Only 4–10% of those at risk had ever sought treatment, and another 21–37% desired treatment but did not receive it due to barriers such as affordability.
Conclusions
The study validates three cross-cultural screening tools (PPCS, PPCS-6, and BPS) across 26 languages and provides population estimates of problematic pornography use risk ranging from approximately 3.2% to higher values depending on the instrument and subgroup. PPU prevalence varies by gender and country, and the findings underscore the need for accessible assessment, culturally informed services, and further research into prevention and treatment.