Why I Wrote an Article About Porn
I’m thrilled to announce that porn is getting a spotlight front and center in AJOT’s July/August “The Issue Is…” Section. In my career, I’ve always found that what is a regular and daily occurrence for me, is often quite unique within the OT profession. That is to say, I talk about porn all day long. So, I was both honored and excited when Dr. Emily Rothman, Chair of Boston University’s OT Department, asked me to co-author a peer-reviewed article about pornography and how OTs can prepare for conversations about porn.
Our article explores ways the conversation about porn could come up in an OT treatment session and provides guidance on how to explore with clients whether porn enhances participation in daily occupations or interferes with it, or a mix of both. We also discuss how our own personal bias or perceptions about porn can influence the OT intervention and how to uphold the OT Code of Ethics throughout.
In my own sex therapy and pelvic floor therapy practice, I ask about porn during my initial assessment, typically within the section that I ask about self-pleasure. I’ve held so many conversations about porn, and what I’ve noticed is that it can both enhance people’s sexual wellness or interfere with their overall sexual goals. Sussing that out with clients can be very helpful and, I’ve often found, clients are very interested in my clinical opinion.
The most common suggestion I make that utilizes porn to achieve sexual goals, is when I recommend an audio porn app (Dipsea or Quinn) to women who are exploring ways to build their desire for sex. I typically suggested they listen to a porn story as a preparatory activity to partnered sex. They can either listen to it by themselves or with their partner. I never just come right out with this suggestion, it’s always after going through an activity analysis, listening to the client, and considering tailored suggestions specific to them.
The most common way I’ve seen porn show up as a hindrance is when I work with men who report erectile dysfunction with vaginal sex and/or difficulty orgasming vaginally. After extensive exploration and conversation, I often find clients report a typical masturbation habit of what I call “private, rushed, and rough” with porn use as an accelerator to the arousal. Masturbating to porn and vaginal penetration with a partner couldn’t be more different. It’s like going to swim practice when your sport is football. They're just two different sports. I make sure to communicate that I don’t have a specific bias towards porn, I just like to point out how the client could be sensitizing themselves to respond to a specific stimulus (their grip vs a vaginal canal). We then go into a conversation about how they can use masturbation to actually resensitize themselves to respond to a larger variety of stimulation.
Again, I’m so honored and grateful to AJOT for including this important conversation. Please check out the article and if you’re interested in chatting more with me about this topic, check out my mentorship options.
Rothman, E. F., & Ellis, K. M. (2026). The Issue Is—Pornography: What Occupational Therapy Practitioners Need to Know for Clinical Practice. American Journal of Occupational Therapy, 80(4), 8004347020