Gender Differences in Associations Between Problematic Pornography Use and Symptoms of Depression and Anxiety: Insights From a Large-Scale Study

Problematic pornography use (PPU) has been associated with symptoms of depression and anxiety. These associations have been studied in clinical and adolescent samples, but little attention has been paid to gender differences in international general population samples. This study examined relationships between PPU, anxiety symptoms, and depression symptoms, with a focus on potential gender differences.

Data were obtained from the International Sex Survey (ISS), a large-scale, cross-sectional study conducted across 42 countries. It involved 82,243 participants (Mean_age = 32.39 years, SD = 12.52; 39.6% men, 57.0% women, 3.4% gender diverse). Participants completed validated measures, including the Problematic Pornography Consumption Scale (PPCS) and the Brief Symptom Inventory's (BSI-18) depression and anxiety symptoms subscales. A one-way ANOVA was used to assess gender differences, while regression analysis examined the role of gender (i.e., men, women, and gender-diverse individuals) in the associations between psychological distress (i.e., depression and anxiety symptoms) and PPU.

Men reported the highest PPU levels, whereas gender-diverse participants reported the highest anxiety and depression levels, followed by women. PPU was positively correlated with anxiety and depression symptoms, with small-to-moderate associations (r = 0.207 and r = 0.249, respectively). Gender significantly moderated both associations, with the steepest positive slopes among men, suggesting that they might rely more heavily on pornography as a maladaptive coping mechanism.

This study highlights differences between PPU and mental health across gender identities. While gender-diverse individuals experience the highest levels of psychological distress, men demonstrate the strongest link between such distress and PPU. These findings highlight the need for gender-sensitive mental-health interventions addressing PPU and its psychological implications.