The studies described by FTND are not rigorous. The assessment of possible positive effects was not included in any of the studies cited. Sex film users were not sampled in any representative way, and the studies ended up with biased samples reporting distress regarding their sex film use. Further, none of these studies provided controls for masturbation, an activity that almost always coincides with sex film use and is more likely to actually drive any claimed health effect. Most cited studies rely on self-reporting, an unreliable measure of sexual behavior that does not correspond to objective observations.