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Debunking Justin Lehmiller’s “Is Erectile Dysfunction Really on the Rise in Young Men” (2018)

August 28, 2018/0 Comments/in Uncategorized /by psadmin

Justin Lehmiller, a regular paid contributor to Playboy Magazine, and now partnering with xHamster, unconvincingly attempts to debunk the well documented rise in youthful erectile dysfunction with this April, 2018 blog post. Since it was published David Ley and Nicole Prause frequently tweet Lehmiller’s blog post as “proof” that youthful ED rates haven’t changed in the last 30 years. According to Ley and Prause this means that porn use cannot cause sexual problems.

It shouldn’t surprise anyone that Lehmiller is a close ally of Nicole Prause, having featured her in at least ten of his blog posts. These and many other Lehmiller blogs perpetuate the same false narratives: porn use causes no problems and porn addiction/porn-induced sexual dysfunctions do not exist. Nicole Prause is probably behind the Lehmiller article, as she is obsessed with debunking PIED, having waged a 3-year war against this academic paper, while simultaneously harassing and libeling young men who have recovered from porn-induced sexual dysfunctions. See documentation: Gabe Deem #1, Gabe Deem #2, Alexander Rhodes #1, Alexander Rhodes #2, Alexander Rhodes #3, Noah Church, Alexander Rhodes #4, Alexander Rhodes #5, Alexander Rhodes #6, Alexander Rhodes #7, Alexander Rhodes #8, Alexander Rhodes #9, Alexander Rhodes#10, Gabe Deem & Alex Rhodes together, Alexander Rhodes#11, Alexander Rhodes #12, Alexander Rhodes #13.

Update (April, 2019): In an attempt to silence YBOP’s criticism, a handful of authors formed a group to steal YBOP’s trademark (headed by Nicole Prause, and including Justin Lehmiller & David Ley). See this page for details: Aggressive Trademark Infringement Waged by Porn Addiction Deniers (www.realyourbrainonporn.com). If you are looking for an analysis of a study that you cannot in the following critique check this page: Porn Science Deniers Alliance (AKA: “RealYourBrainOnPorn.com” and “PornographyResearch.com”). It examines the trademark infringers’ “research page,” including its cherry-picked outlier studies, bias, egregious omission, and deception.

Before we address Lehmiller’s sleight of hand attempting to make porn-induced sexual dysfunction disappear, let’s examine the evidence.

Historical ED rates

Erectile dysfunction was first assessed in 1940s when the Kinsey report concluded that the prevalence of ED was less than 1% in men younger than 30 years, and less than 3% in those 30–45. While ED studies on young men are relatively sparse, this 2002 meta-analysis of 6 high-quality ED studies reported that 5 of the 6 reported ED rates for men under 40 were approximately 2%. The 6^th study reported figures of 7-9%, but the question used could not be compared to assessments used for the 5 other studies, and did not assess chronic erectile dysfunction. The anomalous study asked, “Did you have trouble maintaining or achieving an erection any time in the last year?” (Yet this inconsistent study is the one that Lehmiller irresponsibly uses for comparison.)

At the end of 2006 the world of online porn changed. Free, streaming porn tube sites came online and gained instant popularity. This changed the nature of porn consumption radically. For the first time in history, viewers could click to new material or escalate to more extreme material with ease during a masturbation session without any wait.

Nine studies published since 2010

Ten studies published since 2010 reveal a tremendous rise in erectile dysfunctions. This is documented in this lay article and in this peer-reviewed paper involving 7 US Navy doctors – Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016). In the 10 studies, erectile dysfunction rates for men under 40 ranged from 14% to 37%, while rates for low libido ranged from 16% to 37%. Other than the advent of streaming porn (2006) no variable related to youthful ED has appreciably changed in the last 10-20 years (smoking rates are down, drug use is steady, obesity rates in males 20-40 up only 4% since 1999 – see this study).

The recent jump in sexual problems coincides with the publication of 35 studies linking porn use and “porn addiction” to sexual problems and lower arousal to sexual stimuli. It’s important to note that the first 5 studies in the list demonstrate causation, as participants eliminated porn use and healed chronic sexual dysfunctions. For some reason, Lehmiller failed to acknowledge the existence of any of this research. In addition to the studies listed, this page contains articles and videos by over 130 experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and have successfully treated, porn-induced ED and porn-induced loss of sexual desire.

Sexual dysfunctions or not, porn use doesn’t heat up the bedroom; over 70 studies link porn use to less sexual and relationship satisfaction. As far as we know all studies involving males (which is the majority of studies) have reported more porn use linked to poorer sexual or relationship satisfaction. While a handful of published studies correlate greater porn use in females to neutral (or better) sexual satisfaction, the vast majority most have not. See this list of 40 studies involving female subjects reporting negative effects on arousal, sexual satisfaction, and relationships.

Lehmiller’s sleight of hand

Lehmiller carefully selected two mismatched studies, with data separated by 18 years, in an attempt to convince the reader that ED rates have always been around 8% for men under 40:

1) The “way things were study” from 1992 is the one that asked: “Did you have trouble maintaining or achieving an erection any time in the last year?” Rates of yes to this question were between 7-9%.

2) In contrast, this “modern study” with 2010-12 data (from NATSAL) is the one that asked whether men had trouble getting or keeping an erection for a period of three or more months during the last year.” This study reported the following rates of sexual functioning problems in 16-21 year old males:

Lacked interest in having sex: 10.5%
Difficulty reaching climax: 8.3%
Difficulty achieving or maintaining an erection: 7.8%

Lehmiller “summarized” these findings for the vision-impaired as he tried to mislead them:

Although these data were collected in different Western countries and the question wording differed, it’s striking how similar the figures are considering that the data were collected 20 years apart. This suggests that perhaps rates of ED aren’t on the rise among young men after all.

Sorry Justin, but the questions are not “worded differently”; they are completely different questions. The 1992 study asked whether over the course of the last year at any point you had trouble getting it up. This includes when you were drunk, sick, just wanked three times in a row, experienced performance anxiety, whatever. I’m surprised it’s only 7-9%. In contrast, the 2010 study asked whether you had a persistent problem of erectile dysfunction over a period of three months or more. This was for 16-21 year olds, not men 39 and under!

As one recovery-forum member observed, Justin Lehmiller’s “science analysis” is Buzzfeed level clickbait, not science journalism.

But you may ask: Why are the ED rates about 8% in the 2010-2012 study, yet 14-37% in the 9 other studies published since 2010?

First, 8% isn’t insignificant, as 8% would indicate a 600%-800% increase for men under 40.
Second, it wasn’t men under 40 – it was 16 to 21 year olds, so virtually none of them should have chronic ED. In the 1940s, the Kinsey report concluded that the prevalence of ED was less than 1% in men younger than 30 years,
Third, unlike the other 9 studies that employed anonymous surveys, this study used face to face in-home interviews. (It’s quite possible that adolescents would be less than fully forthcoming under such circumstances.)
The study gathered its data between August, 2010 and September, 2012. Studies reporting a significant rise in under-25 ED first appeared in 2011. More recent studies on 25-and-under sujects report even higher rates (see this 2014 study on Canadian adolescents).
Many of the other studies used the IIEF-5 or IIEF-6, which assess sexual problems on a scale, as opposed to the simple yes or no (in the past 3 months) employed in Lehmiller’s cherry-picked paper.

Two studies using the exact same questionnaire: 2001 vs. 2011 (GSSAB)

Before leaving this topic, it would be well to look at some of the most irrefutable research that demonstrates a radical rise in ED rates over a decade using very large samples (which increase reliability). All the men were assessed using the same (yes/no) question about ED, as part of the Global Study of Sexual Attitudes and Behavior (GSSAB), administered to 13,618 sexually active men in 29 countries. That occurred in 2001-2002.

A decade later, in 2011, the same “sexual difficulties” (yes/no) question from the GSSAB was administered to 2,737 sexually active men in Croatia, Norway and Portugal. The first group, in 2001-2002, were aged 40-80. The second group, in 2011, were 40 and under.

Based on the findings of prior studies one would predict the older men would have far higher ED scores than the younger men, whose scores should have been negligible. Not so. In just a decade, things had changed radically. The 2001-2002 ED rates for men 40-80 were about 13% in Europe. By 2011, ED rates in Europeans, ages 18-40, ranged from 14-28%!

What changed in men’s sexual environment during this time? Well, major changes were internet penetration and access to porn videos (followed by access to streaming porn in 2006, and then smartphones on which to view it). In the 2011 study on Croatians, Norwegians and Portuguese, the Portuguese had the lowest rates of ED and the Norwegians had the highest. In 2013, internet penetration rates in Portugal were only 67%, compared with 95% in Norway.

In line with clinical, anecdotal, and experimental evidence

The image below appeared in an analysis of ED posts from MedHelp forums. “Nearly 60% of men posting on the forums were under 24 years old. This was a surprising finding for researchers, as erectile dysfunction is generally considered a condition that strikes older men.”

An Irish Times poll asked thousands of readers about ED, and the number of men 24-34 with issues was 28%:

Click on graphics from 2015 Irish Times poll to see ED rates, which show higher rates in young men than in men 35-49!

Documented recovery stories

About 3,000 self-reports of recovery from ED and other sexual dysfunctions after quitting internet porn can be found on these pages:

Experts, not employed by Playboy, who recognize and treat porn-induced sexual dysfunctions

Justin Lehmiller may be right in step with a few agenda-driven sexologists, but he’s out of step with professionals who treat men. Since YBOP came online in 2011 over 120 sexual experts (urology professors, urologists, psychiatrists, psychologists, sexologists, MDs) who acknowledge and treat porn-induced sexual problems have published articles or appeared on radio and TV. Note: Urologists have twice presented evidence of porn-induced sexual dysfunctions at annual conferences of the American Urological Association.

Video of a lecture: Porn-induced ED (parts 1-4) presented at the American Urologic Association Conference, May 6-10, 2016. Urologist Tarek Pacha.
New findings: Study sees link between porn and sexual dysfunction (2017) – Data from an upcoming study, presented at the 2017 American Urological Association Conference.

List of articles, broadcasts, radio shows, and podcasts that involve sexual experts who confirm the existence of porn-induced sexual dysfunctions (in chronological order):

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