The question of how to raise kids in a world of ubiquitous pornography of the violent and misogynistic bent has long been on the radar of the American Academy of Pediatrics. It is of particular concern to pediatrician David Hill, who chairs the organization’s Council on Communications and Media. His group has been less than explicit about issuing guidelines on pornography versus non-pornography, seeing vital character-shaping cues from all types of media as germane to health. “We do recommend that parents keep screens out of kids bedrooms, to the extent they’re able to,” Hill told me. “We encourage parents to co-view TV and movies with kids, to give perspective. Movies and TV shows often do not show consequences for high-risk behaviors.” In many cases, high-risk behaviors of all sorts run together.

“That is not to suggest that you co-view pornography,” he said with a laugh. Obvious as that may seem, what we do know about the effects of viewing pornography on kids remains largely speculative. If access to pornography is categorically threatening to public health, he posits, why would it be that the U.S. is seeing historic lows in rates of teenage pregnancy and sexually transmitted infectious diseases? Why, too, would rates of domestic violence and rape be continuing to fall?

“I think the conclusions we can draw from the science are very limited,” said Hill. Usually, public-health crises are based on outcomes rather than risk factors, however plausible. While Dines and others cite many correlations between pornography consumption and negative health outcomes, the causal relationship is rarely explicit. Making that leap is especially tenuous when studies rely on subjects recalling and reporting information about taboo behaviors and thoughts, a notoriously unreliable approach. Yet, Hill notes, no one is going to do a prospective trial where kids are given porn in a controlled environment to see how they are affected.

“Now, as a parent,” he pivoted, “I am concerned. My experience with parental controls has been disappointing at best.”

Weiler has the same sense. “A lot of people say this is a parental thing, but I've had mothers tell me that they block pornography in their homes, and their kids get tablets at school, take them to McDonald's and log onto Wi-Fi, and they're sitting in McDonald's watching porn.”

McDonald's is working to stem this issue of errant purveyance of porn to minors, Weiler said. “But the same is true with libraries. They put their hand over their heart and say it's a first amendment issue. And it is! But we would be appalled if libraries and McDonald’s were handing out cigarettes to children.”

Weiler prefers to intervene upstream of the First Amendment. In the U.K. in 2013, David Cameron asked Internet service providers to create an opt-in option for pornography. Hence Weiler’s interest in a national movement. “If we can get 15 states to take this stand,” he said, “I think we can start putting pressure on Congress to do what England has done.”