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ADDRESS

PREPARED FOR
C, Everett Koop, M.D,
SURGEON GENERAL
U.S, PuBiic HEALTH SERVICE
AND

Deputy ASSISTANT SECRETARY FOR HEALTH
U.S, DEPARTMENT OF HEALTH AND HUMAN SERVICES

PRESENTED BY THEODORE 0. CRON AT THE WHITE House BRIEFING FOR THE
RELIGIOUS ALLIANCE AGAINST PORNOGRAPHY
WASHINGTON, D.C,
NovemBer 13, 1986
(GREETINGS TO HOSTS, GUESTS, ETC.)

IT’S MY PRIVILEGE TODAY TO REPRESENT OUR SURGEON GENERAL. DR. C,
EVERETT KOOP, WHO WANTED VERY MUCH TO BE WITH YOU BUT WHO. AT THIS
VERY MOMENT, UNFORTUNATELY, IS PREPARING FOR SURGERY. OUR THOUGHTS
AND PRAYERS ARE WITH HIM.

DR. KOOP DID. HOWEVER, WANT HIS MESSAGE ON PORNOGRAPHY DELIVERED
TO THIS AUDIENCE. AND, AS HIS SPECIAL ASSISTANT FOR THE PAST SIX
YEARS, I AM HAPPY TO OBLIGE.

MY REMARKS WILL BE FOCUSED ON THE PARTICULAR PUBLIC HEALTH
CONCERNS RAISED BY THE ISSUE OF PORNOGRAPHY, I REALIZE THAT OUR
TRAINING AND EXPERIENCES IN PUBLIC HEALTH AND MEDICINE MAY DIFFER FROM
YOURS, YET -- ON CERTAIN MATTERS -- PHYSICIANS, NURSES, PSYCHOLOGISTS,
AND THE CLERGY CAN ALL AGREE.
2

WE SHARE, FOR EXAMPLE, SIMILIAR FEELINGS...

ABOUT THE SANCTITY OF HUMAN LIFE...

AND THE NECESSITY TO PRACTICE OUR RESPECTIVE CALLINGS WITH A
STRONG LEAVENING OF DECENCY AND MORALITY...

AND WE SHARE SIMILAR FEELINGS ON WHAT WE ARE OBLIGED TO DO -- ON
OUR OWN AS WELL AS THROUGH OUR INSTITUTIONS -- TO MAKE SURE THAT
THIS WORLD IS A SANER, HEALTHIER PLACE WHEN WE LEAVE. THAN IT WAS
WHEN WE CAME IN,

SUCH A MORAL PERSPECTIVE OUGHT TO BE AN INTEGRAL PART OF ANYONE'S
PROFESSIONAL PRACTICE, REGARDLESS OF HIS OR HER FAITH OR CONFESSIONAL
PREFERENCE,
3

THIS PERSPECTIVE WAS CERTAINLY INTEGRAL TO THE PRACTICE OF
PEDIATRIC SURGERY, WHICH DR. KOOP PURSUED FOR 35 YEARS BEFORE HE WAS
CHOSEN BY PRESIDENT REAGAN TO BE THE COUNTRY’S SURGEON GENERAL.

THIS PAST SUMMER, AT HARVARD UNIVERSITY'S CELEBRATION OF ITS
350TH BIRTHDAY, DR. KOOP REMINDED HIS CAMBRIDGE AUDIENCE THAT THE
FIRST EUROPEAN SETTLERS NAVIGATED THEIR WAY ACROSS THE ATLANTIC A FULL
CENTURY BEFORE THE INVENTION OF THE QUADRANT AND THE SPRING-WOUND
CLOCK.

THEY HAD NO TECHNOLOGY TO SAIL WITH. INSTEAD, THEY HAD A HUMANE
INTUITION...A COMMITMENT TO THEIR COMMUNITY...AND A STERN, TENACIOUS
FAITH. AND DR. KOOP WENT ON TO WONDER IF, TODAY, WE MIGHT HAVE MORE
TECHNOLOGY THAN IS GOOD FOR US...BUT LESS OF THE FAITH THAT WE SO
DESPERATELY NEED.
4

FAITH WAS THEIR COMPASS, AND FAITH SHOULD BE OUR COMPASS AS
WELL,

AND TODAY, WE ARE CONFRONTING AN ISSUE WHICH IS A TEST OF OUR
FAITH...OUR FAITH AS CITIZENS,..OUR FAITH AS CLERGY AND PUBLIC HEALTH
WORKERS...AND OUR FAITH AS HUMAN BEINGS.

THE ISSUE IS...PORNOGRAPHY.

AT ONE TIME, THE PUBLIC’S CONCERN DEALT ALMOST EXCLUSIVELY WITH
BOOK STORES AND MOVIE THEATERS THAT SPECIALIZED IN PORNOGRAPHY. BUT
TODAY ’S HUCKSTERS OF PORNOGRAPHY HAVE INVADED CABLE TELEVISION.
POPULAR MUSIC, TELEPHONE COMMUNICATIONS. AND THE WHOLE NEW FIELD OF
HOME VIDEOS. THROUGH THESE NEW TECHNOLOGIES THEY'VE EXPANDED THEIR
MARKETS OF SLEAZE AND TRASH,
5

DESPITE THIS, WE TEND TO GIVE PORNOGRAPHY LOW PRIORITY IN THE
OVERALL SCHEME OF PUBLIC HEALTH CONCERNS. BUT TO IGNORE THE EVIDENCE
ANY LONGER WOULD BE TO MAKE A CONSCIOUS DECISION NOT TO SEE
PORNOGRAPHY AS A CLEAR AND PRESENT DANGER TO AMERICAN PUBLIC HEALTH.

AND WE BELIEVE IT IS,
THE DEGREE TO WHICH PORNOGRAPHY HAS BECOME A SERIOUS SOCIAL
PROBLEM CAN BE SEEN, OF COURSE, IN THE RECENT REPORT OF THE ATTORNEY

GENERAL’S COMMISSION ON PORNOGRAPHY,

THAT REPORT CLEARLY INDICATES THAT WE CAN NO LONGER DISMISS
PORNOGRAPHY AS HARMLESS AND THEN JUST FORGET ABOUT IT,

THE LAST COMMISSION SAID THAT BACK IN 1970...AND IT WAS WRONG.
AND TODAY WE KNOW -- WITH MORE PRECISION -- JUST HOW WRONG IT WAS,
6

A YEAR AGO, THE ATTORNEY GENERAL'S COMMISSION DECIDED TO EXPLORE
THE SPECIFIC EFFECTS THAT PORNOGRAPHY MIGHT HAVE UPON THE PUBLIC
HEALTH. THE COMMISSION INVITED SURGEON GENERAL KOOP TO GIVE TESTIMONY
ON THE SUBJECT IN JUNE OF 1985,

AT THAT TIME, DR. KOOP SUGGESTED THAT THE U.S, PUBLIC HEALTH
SERVICE MIGHT TAKE A LOOK AT THE LINKAGE BETWEEN PORNOGRAPHY AND
HEALTH. IF THE COMMISSION MEMBERS THOUGHT IT MIGHT BE HELPFUL. THE
MEMBERS AGREED AND EVEN PROVIDED THE SUPPORT FOR A MODEST BUT
NEVERTHELESS USEFUL CONTRIBUTION,

IT TOOK THE FORM OF A “SURGEON GENERAL’S WORKSHOP ON PORNOGRAPHY
AND PUBLIC HEALTH” THAT WAS HELD THIS PAST JUNE,
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FOR THAT OCCASION, DR. KOOP CALLED TOGETHER 20 OF THE BEST PEOPLE
HE COULD FIND... RESEARCHERS AND CLINICIANS..,PEOPLE WITH NATIONAL AND
INTERNATIONAL REPUTATIONS...AND ASKED THEM TO THINK ABOUT SEVERAL
QUESTIONS IN THE COURSE OF THAT TWO-DAY WORKSHOP:

FIRST, WHAT DO WE KNOW WITH SOME DEGREE OF CERTAINTY ABOUT THE
EFFECTS OF PORNOGRAPHY UPON THE PHYSICAL AND MENTAL
HEALTH OF OUR PEOPLE, ESPECIALLY UPON YOUNG CHILDREN AND
ADOLESCENTS?

SECOND, WHAT KINDS OF THINGS DO WE STILL NEED TO KNOW...IN OTHER
WORDS, WHAT IS OUR RESEARCH AGENDA FOR THE FUTURE?

 

AND THIRD, AS PROFESSIONALS IN PUBLIC HEALTH AND MEDICINE, WHAT DO
WE THINK OUGHT TO BE DONE NEXT, EITHER BY OUR COLLEAGUES
IN RESEARCH AND CLINICAL PRACTICE OR BY OUR GOVERNMENT?

 
8

THE PARTICIPANTS GAVE THOUGHTFUL ANSWERS TO THESE THREE QUESTIONS
AND ACQUITTED THEMSELVES VERY WELL.

T WON'T REPEAT ALL THE DISCUSSION THAT OCCURRED, BUT I WILL SHARE
WITH YOU THE FIVE STATEMENTS OF CONSENSUS THAT DID EMERGE. THEY‘RE
NEW...AND THEY’RE IMPORTANT.

FIRST, THE PARTICIPANTS AGREED THAT, QUOTE -- “CHILDREN AND
ADOLESCENTS WHO PARTICIPATE IN THE PRODUCTION OF PORNOGRAPHY
EXPERIENCE ADVERSE, ENDURING EFFECTS” -- UNQUOTE.

 

THE PARTICIPANTS REGARDED THIS KIND OF THING AS SEXUAL VICTIMIZATION
OF YOUNG PEOPLE. “PURE AND SIMPLE.” THEY NOTED THAT THERE WAS A
CONNECTION BETWEEN THE INVOLVEMENT OF CHILDREN IN THE PRODUCTION OF
PORNOGRAPHIC MATERIALS AND THEIR SUBSEQUENT ENTRAPMENT INTO THE WORLD
OF CHILD PROSTITUTION,
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DR. MIMI SILBERT OF SAN FRANCISCO REPORTED ON THE MENTAL HEALTH
IMPLICATIONS OF THIS. SHE NOTED THAT JUVENILE PROSTITUTES WHO ARE
“TRAPPED IN A SELF-DESTRUCTIVE CYCLE, FEEL THEMSELVES TO BE OUT OF
CONTROL OF THEIR LIVES. ESSENTIALLY THEY HAVE DEVELOPED A CHRONIC
DISORDER AS A RESULT OF THEIR VICTIMIZATION.” SHE GOES ON TO SAY THAT
THEY ARE UNABLE “TO SEPARATE THEMSELVES FROM THE SEXUAL EXPLOITATION
IN ORDER TO RE-ESTABLISH A POSITIVE LIFE.”

NEXT, THE PARTICIPANTS AGREED THAT -- QUOTE -- “PROLONGED USE OF

PORNOGRAPHY INCREASES BELIEFS THAT LESS COMMON SEXUAL PRACTICES
ARE MORE COMMON” -- UNQUOTE.

THIS SHOULD COME AS NO SURPRISE, SINCE THE CONCLUSION IS THE SAME THAT
OCCURS WHEN WE TALK ABOUT VIOLENCE AND OTHER ACTS OF ANTI-SOCIAL
BEHAVIOR:
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REPEATED EXPOSURE TO THEM -- VIA TELEVISION, FOR EXAMPLE, OR
MOVIES SUCH AS THE SO-CALLED “SLASHER FILMS” -- TENDS TO BUILD UP
THE IMPRESSION THAT PEOPLE ARE DOING SUCH THINGS MORE OFTEN THAN
TS ACTUALLY THE CASE,

THE WORK OF DR. DOLF ZILLMAN OF THE UNIVERSITY OF INDIANA IS
SIGNIFICANT IN THIS REGARD. HIS WORK CLEARLY INDICATES THAT MASSIVE
EXPOSURE TO UNCOMMON AND EVEN BIZARRE HETEROSEXUAL PRACTICES --
INCLUDING SADOMASOCHISM AND EVEN BESTIALTY -- LEADS PERSONS, WHO ARE
SO EXPOSED, TO BELIEVE THAT SUCH PRACTICES ARE MUCH MORE COMMON THAN
THEY REALLY ARE,

DR. ZILLMAN’S FINDINGS, BY THE WAY, FIT IN WITH WHAT WE‘RE
LEARNING ELSEWHERE IN THE FIELD OF COGNITIVE PSYCHOLOGY AND HOW WE
REACH CONCLUSIONS ON THINGS ABOUT WHICH WE’RE A LITTLE UNCERTAIN,
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THE THIRD CONSENSUS STATEMENT SAID, QUOTE -- “PORNOGRAPHY THAT
PORTRAYS SEXUAL AGGRESSION AS PLEASURABLE FOR THE VICTIM INCREASES
THE ACCEPTANCE OF THE USE OF COERCION IN SEXUAL RELATIONS” --
UNQUOTE.

THIS KIND OF PORNOGRAPHY WOULD APPEAR TO BE THE CAUSE FOR MUCH OF
THE RAPE THAT OCCURS TODAY. IMPRESSIONABLE MEN -- MANY OF THEM STILL
IN ADOLESCENCE -- SEE THIS MATERIAL AND BEGIN TO BELIEVE THAT WOMEN
LIKE TO BE HURT...THEY LIKE TO BE HUMILITATED AND FORCED TO DO THINGS
THEY DON’T WANT TO DO,..OR THEY LIKE TO APPEAR TO BE FORCED TO DO
THINGS THEY REALLY DQ WANT 10 DO.

 

THIS IS ANOTHER FALSE STEREOTYPE...ANOTHER VICIOUS KIND OF MYTH-
OLOGY. BUT THIS IS A MYTH THAT LEADS TO THE PAIN AND EVEN THE DEATHS
OF VICTIMIZED WOMEN,
12

PROFESSOR NEIL MALAMUTH OF U.C.L.A. REPORTED THAT HIS MOST RECENT
RESEARCH INDICATED THAT MEN WHO SCORE HIGH ON A “LIKELIHOOD-TO-RAPE”
SCALE, WHICH HAS BEEN VALIDATED IN OTHER RESEARCH, ARE PRECISELY THE
KIND OF MEN WHO ARE MOST AFFECTED BY PORNOGRAPHY THAT DEPICTS A
VICTIMIZED WOMAN ENJOYING THE CRIME OF RAPE OR OF ASSAULT THAT'S BEING
COMMITTED AGAINST HER,

FOURTH, AND I QUOTE -- “ACCEPTANCE OF COERCIVE SEXUALITY APPEARS
TO BE RELATED TO SEXUAL AGGRESSION” -- UNQUOTE,

ALTHOUGH IT WAS VERY CAUTIOUSLY FRAMED, THIS CONSENSUS STATEMENT,
ALONG WITH THE PREVIOUS ONE, COMPLETES THE CIRCLE OF SEXUAL VIOLENCE,

WHAT IT MEANS IS THIS: IF A MAN IS EXPOSED TO A STEADY STREAM OF
SEXUALLY VIOLENT MATERIAL IN WHICH THE VICTIM SEEMS TO BE ENJOYING THE
EXPERIENCE, HE GETS THE IDEA THAT COERCION AND VIOLENCE ARE ACCEPTABLE
IN SEXUAL RELATIONS,
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AND THEN HE MAY VERY WELL TAKE THE NEXT STEP, HE WILL CONVERT
HIS ATTITUDE INTO HIS BEHAVIOR. IN OTHER WORDS, HE WILL BECOME THE
PERPETRATOR HE’S BEEN READING ABOUT IN PORNOGRAPHIC MAGAZINES OR
WATCHING IN PORNOGRAPHIC FILMS AND VIDEOS.

NATURALLY, THIS RESEARCH IS BASED ALMOST ENTIRELY ON SELF-
REPORTED EXPERIENCES BY CONVICTED RAPISTS AND OTHERS, BUT THIS KIND
OF CLINICAL EVIDENCE HAS BEEN ACCUMULATING SINCE 1965,

WHILE PORNOGRAPHY HAS THUS FAR NOT BEEN IDENTIFIED AS THE MOST
CRITICAL INFLUENCE FOR SUCH BEHAVIOR, THE WORKSHOP PARTICIPANTS
NEVERTHELESS AGREED THAT PORNOGRAPHY SIGNIFICANTLY CONTRIBUTED TO SUCH
BEHAVIOR.

FIFTH AND FINALLY, QUOTE -- “IN LABORATORY STUDIES MEASURING
SHORT-TERM EFFECTS, EXPOSURE TO VIOLENT PORNOGRAPHY INCREASES
PUNITIVE BEHAVIOR TOWARD WOMEN” -- UNQUOTE,
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THIS, ALSO. IS OBVIOUSLY IMPOSSIBLE TO PROVE BY CONTROLLED
EXPERIMENTS. IT’S DIFFICULT TO ACCUMULATE HARD RESEARCH DATA ON
VIOLENT OUTCOMES OF PORNOGRAPHY BECAUSE OF THE OVER-RIDING ETHIC THAT
PREVENTS US FROM DOING HARM TO HUMAN SUBJECTS IN RESEARCH. NEVER-
THELESS, THIS FIFTH CONCLUSION CAN BE SAFELY DRAWN FROM THE FEW
ETHICALLY CIRCUMSCRIBED EXPERIMENTS THAT HAVE BEEN DONE.

AMONG THESE HAVE BEEN A NUMBER OF LABORATORY STUDIES BY DR.
EDWARD DONNERSTEIN OF THE UNIVERSITY OF CALIFORNIA. THOSE STUDIES
INDICATE, AS HE EMPHASIZED TO US IN JUNE, THAT MEN EXHIBIT HIGH LEVELS
OF AGGRESSIVE BEHAVIOR AFTER SEEING, FOR EXAMPLE, A SEXUALLY AGGRES-
SIVE FILM. THEY WILL. IN EFFECT, “ACT OUT” ANY VIOLENT FANTASIES
WHICH WERE STIMULATED BY VIEWING SUCH SEXUALLY VIOLENT PORNOGRAPHY.

THOSE, THEN, ARE THE 5 KEY CONCLUSIONS THAT CAME OUT OF THE
"SURGEON GENERAL’S WORKSHOP ON VIOLENCE AND PUBLIC HEALTH.”
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WE BELIEVE IT’S THEREFORE FAIR TO SAY, BASED ON THESE > CONSENSUS
STATEMENTS, THAT PORNOGRAPHY DOES STIMULATE ATTITUDES AND BEHAVIOR
THAT DO HAVE GRAVELY NEGATIVE CONSEQUENCES FOR INDIVIDUALS AND FOR
SOCIETY. THOSE CONSEQUENCES INCLUDE THE IMPAIRMENT OF THE MENTAL.
EMOTIONAL, AND PHYSICAL HEALTH OF CHILDREN AND ADULTS -- THAT'S CLEAR
ENOUGH -- AND MAY THUS CONTRIBUTE SIGNIFICANTLY TO THE BURDEN OF
ILLNESS AND PREMATURE DEATH IN OUR SOCIETY. AND PORNOGRAPHY ADVERSELY
EFFECTS THE HEALTH OF BOTH THE VICITM AND THE VICTIMIZER.

AS A RESULT OF DR. KOOP’S LEADERSHIP AND THE CONTRIBUTIONS BY ALL
THE PARTICIPANTS AT THAT WORKSHOP, WE CAN SAY THAT THE RECORD IS NOW
MUCH CLEARER AND MUCH LESS AMBIGUOUS, WITH REGARD TO THE EFFECTS UPON
AMERICAN LIFE OF PORNOGRAPHY...PARTICULARLY CHILD PORNOGRAPHY AND
SEXUALLY VIOLENT PORNOGRAPHY.
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I BROUGHT WITH ME TODAY SOME 50 COPIES OF THE REPORT OF THE
SURGEON GENERAL’S WORKSHOP FOR THOSE OF YOU WHO MAY BE INTERESTED IN
THE COMPLETE DOCUMENT. IF THESE RUN OUT, YOU CAN STILL SECURE A FREE
COPY BY WRITING DIRECTLY TO ME, TED CRON,..C-R-O-N...IN CARE OF THE
OFFICE OF THE SURGEON GENERAL. WASHINGTON, D.C. 20201,

AT THIS POINT I MIGHT ADD THAT OUR APPROACH TO PORNOGRAPHY HAD
NOTHING TO DO WITH A CITIZEN’S RIGHTS UNDER THE FIRST AMENDMENT.
RATHER. WE WERE CONCERNED ONLY WITH THE SCIENTIFIC RECORD REGARDING
PUBLIC SPEECH OR WRITING THAT MAY POSSIBLY ENDANGER THE LIFE OR
DIMINISH THE WELL-BEING OF ANY CITIZEN. THAT’S THE PUBLIC HEALTH
PERSPECTIVE.

AND SUCH A PERSPECTIVE GUIDED THE SURGEON GENERAL THROUGHOUT THIS
EFFORT ON BEHALF OF THE ATTORNEY GENERAL’S COMMISSION ON PORNOGRAPHY.
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THE CONCLUSIONS OF THAT WORKSHOP POINT IN JUST ONE DIRECTION:

PORNOGRAPHY IS ANTI-HUMAN AND ANTI-FEMININE IN PARTICULAR.

ITS APPEAL IS TO A DARK AND DESTRUCTIVE IMPULSE,

IT 1S THE KIND OF THING WE MUST GUARD AGAINST. UNFORTUNATELY,
THIS IS NOT A NEW ASSIGNMENT FOR MEN AND WOMEN OF GOOD CONSCIENCE.
I’M SURE YOU WILL RECALL THE ADVICE THAT KING SOLOMON OFFERED HIS SONS
IN PROVERBS, CHAPTER 6,

HE WARNED OF “THE WICKED MAN” WHO “GOES ABOUT WITH CROOKED
SPEECH, WINKS HIS EYES, SCRAPES WITH HIS FEET. POINTS WITH HIS FINGER.
(AND) WITH PERVERTED HEART DEVISES EVIL, CONTINUALLY SOWING DISCORD;
THEREFORE.” SAYS PROVERBS, 6:15, “CALAMITY WILL COME UPON HIM
SUDDENLY; IN A MOMENT HE WILL BE BROKEN BEYOND HEALING.”
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AS PEOPLE CONCERNED WITH LIFE AND HEALTH, WE WISH CALAMITY UPON
NO ONE. HOWEVER, I SUSPECT THAT SURGEON GENERAL KOOP AND THE PUBLIC
HEALTH SERVICE ITSELF WOULD NOT BE OVERCOME WITH SORROW IF THE
PORNOGRAPHY INDUSTRY, IN THE WORDS OF PROVERBS, WERE “IN A MOMENT...
BROKEN BEYOND HEALING.”

AGAIN, THANK YOU FOR THIS OPPORTUNITY TO BE HERE ON BEHALF OF A
GREAT PUBLIC SERVANT, OUR SURGEON GENERAL. DR. C. EVERETT KOOP.

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