Utah lawmakers are considering making it the first state to declare pornography a public health crisis, similar to cigarettes. State Sen. Todd Weiler (R) recently introduced a legislative resolution that would recognize a range of “societal harms” from the pornography “epidemic.”

“I’m hoping this will start educating people that pornography is actually addictive, that it’s harmful to families and relationships,” says Senator Weiler in a phone interview.

Weiler acknowledges First Amendment rights to make and view pornography. Although the resolution does not put forward any particular policy solution, he says he ultimately “would like to see the US work toward an Internet that is porn free unless you opt into it.”

The proposal has rekindled age-old cultural battles over sexual norms and morality – but it also pushes the conversation into a broader framework.

Some critics of the Utah resolution see it as yet another conservative attempt to shore up heterosexual marriage as the acceptable context for sex. A Salon.com headline ridiculed it as “porn hysteria.” But where some see an effort to reframe conservative morality under the guise of public health, crafters of the legislation point to issues from elementary school age children accessing hard-core porn to cases of sex trafficking and child abuse.

Conservatives aren’t the only ones making the case for considering pornography’s role in harming social well-being. Some feminists have been working for decades to raise awareness about what they see as pornography’s contribution to “rape culture.”

Now they are being joined by parents, pediatricians, psychologists, and other professionals who say they are seeing devastating impacts, especially on young people, because of the explosion of online access to graphic and often violent images – and exposure to pornography at younger ages.

“The porn industry has hijacked children’s sexuality, and parents have been asleep at the wheel,” says Gail Dines, a professor at Wheelock College and founder of Culture Reframed, which is working to educate parents, pediatricians, and other professionals about how to talk with children to build up “resilience and resistance to the harms of the culture” of pornography.

Among youths seeking help from an online treatment program for negative impacts of pornography as of July 2015, the average age of first exposure was 11.9.

But while some youths seek out sexually explicit material online, the level of unwanted exposure has decreased, according to a series of studies by the University of New Hampshire’s Crimes Against Children Research Center. After an initial increase between 2000 and 2005 (from 24 percent to 34 percent of Internet users ages 10 to 17), unwanted exposure declined by 2010, to 23 percent of users.

Pediatricians say they are seeing injuries among their young patients that stem from the type of sexual activity commonly depicted in porn, Professor Dines says.

Most research on the issue can only explore correlations between pornography and behaviors such as sexual aggression, dependency on frequent use, and difficulties sustaining relationships. There’s an active debate about degrees of correlation, and even more debate on whether pornography has any causal role – with people on either side accusing those on the other of sometimes relying on junk science.

Dines argues that the weight of evidence suggests that viewing pornography (much of which is now the type once labeled “hard core”) is reshaping the way boys think about sexuality and relationships.

Much online pornography depicts anger and contempt toward women, researchers say. In turn, the hookup culture that pornography has helped proliferate on college campuses is “having a profound effect on the self-esteem of young women and girls,” Dines says.

In interviews with college students, Dines has found that men frequently tell her that their favorite sex act is something that mimics a common scene in pornography that she and others find degrading to women – and in some cases is leading to physical injuries. But she says many also tell her they want to stop their porn-viewing habits and don’t know how.

Other feminists push back against the idea that porn is by nature misogynistic, noting that many women enjoy pornography.

During the last wave of strong feminist arguments against the pornography industry, in the 1980s and early ’90s, “the pornographers won that struggle and beat back any attempt to modify public policy,” says Robert Jensen, an author on the subject and a journalism professor at the University of Texas at Austin.

But with the proliferation of research on teen development, brain science, and the potential for harmful addictions, the public health framework may get a new hearing.

Pornography addiction is not an officially recognized diagnosis, “but it can fall under the broad category of behavioral addictions,” says David Greenfield, founder of The Center for Internet and Technology Addiction and a professor of psychiatry at the University of Connecticut.

Of all the problems associated with the Internet that Dr. Greenfield treats, he says No. 2 is pornography and other online sexual behavior.

When it comes to young people, Greenfield says parents and others need better education about the fact that pornography isn’t a realistic portrayal of relationships, and that repeated exposure can lead to harmful consequences.

That requires some adults to overcome ingrained inhibitions in order to discuss sexuality, he says.

“We live in a culture that celebrates sexuality on an overt level, in ads, movies, music,” Greenfield says. “On the covert side, people are just as inhibited with regard to sexuality as we’ve ever been. The schism … creates sexual pathology.”

Some others in the medical community say blaming pornography distracts from the many other variables that influence sexual behavior.

“People use the term addiction in a manipulative way, to invoke fear,” says David Ley, a clinical psychologist in Albuquerque, N.M., and the author of “The Myth of Sex Addiction.”

“I’m not a fan of adolescents seeing porn…. But if you tell a teenager to be afraid of something and not do it, we are creating a situation where that teen is going to be compelled to be interested in it.”

His reading of various research studies leads him to conclude that “porn plays a tiny role in impacting adolescent behavior.”

“In certain people who are already predisposed to sexual violence … watching violent porn for them probably does increase their risk of sexual violence,” Ley says. “But that is not most people.”

Weiler’s proposed resolution in Utah is based on an idea put forward by The National Center on Sexual Exploitation (formerly Morality in Media). The group hosted a national symposium last year, and if Utah’s resolution passes, 10 or more states may follow suit, Weiler says.

The footnoted version of the resolution cites a range of research and writings on the topic, including that of Dines.

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But for some critics, the underlying message still appears to be an attempt to reaffirm religious, traditional values. One of the concerns the resolution cites, for instance, is that pornography is “linked to lessening desire in young men to marry, dissatisfaction in marriage, and infidelity.”

The proposal may be “a backlash against a lot of progress we’ve made for the LGBTQ community … in fighting discrimination” in the state, says Susie Porter, director of gender studies at the University of Utah in Salt Lake City.