Ci a ion: Villa ejo-Ca ballido, B.;
Pulido, C.M.; Zubi i-Esnaola, H.;
Oli e , E. Young People’s Voices and
Science o O e coming Toxic
Rela ionships Rep esen ed in Sex
Educa ion.In . J. En i on. Res. Public
Heal h 2022,19, 3316. h ps://
doi.o g/10.3390/ije ph19063316
Academic Edi o s: Da id L. Rowland
and Paul B. Tchounwou
Recei ed: 30 Decembe 2021
Accep ed: 9 Ma ch 2022
Published: 11 Ma ch 2022
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In e na ional Jou nal o
En i onmen al Resea ch
and Public Heal h
A icle
Young People’s Voices and Science o O e coming Toxic
Rela ionships Rep esen ed in Sex Educa ion
Bea iz Villa ejo-Ca ballido 1, C is ina M. Pulido 1, Ha kai z Zubi i-Esnaola 2and Es he Oli e 3,*
1Depa men o Jou nalism and Communica ion S udies, Au onomous Uni e si y o Ba celona,
08193 Bella e a, Spain; [email p o ec ed] (B.V.-C.); [email p o ec ed] (C.M.P.)
2Depa men o Language and Li e a u e Didac ics, Uni e si y o he Basque Coun y UPV/EHU,
20018 San Sebas ian, Spain; [email p o ec ed]
3Depa men o Sociology, Uni e si y o Ba celona, 08034 Ba celona, Spain
*Co espondence: es he [email p o ec ed]
Abs ac :
The scien i ic li e a u e has p esen ed e idence o how ic ion se ies impac he socialisa ion
o young people’s ela ionships. Howe e , he e is a gap in he e idence on how dialogic in e ac ions
o e come he nega i e impac o he ic ion se ies on he socialisa ion o oxic ela ionships. This
esea ch analyses dialogic in e ac ions based on scien i ic e idence ela ed o oxic ela ionships
ha con ibu e o o e coming his ype o ela ionship. Fi s , we de eloped a communica i e
con en analysis o eigh episodes o one o he mos -wa ched ic ion se ies by young people, Sex
Educa ion. A e ha , we conduc ed ou communica i e in e iews wi h he young audience o
collec hei oices abou he impac o hese oxic ela ionships ep esen ed in his ic ion se ies in
hei daily con e sa ions. The esul s indica e ha in such cases, he e is a need o p omo e dialogic
in e ac ions abou his ic ion se ies, ocusing he dialogue on which ype o masculini y de elops a
oxic ela ionship and which, on he con a y, p omo es heal hy ela ionships.
Keywo ds: ic ion se ies; oxic ela ionship; young; socialisa ion; dialogic in e ac ion; impac
1. In oduc ion
Since he mid- wen ie h cen u y, se e al ypes o esea ch ha e shown how audio isual
p oduc s can gene a e e ec s on he audience and hei own ision o eali y, especially
on he younges [1–4]. One o hese is he esea ch Cul u al Indica o s [5], which measu ed
iolence on ele ision and i s e ec s on socie y. Mo e han 4000 scenes om di e en
p og ammes and measu emen s o iolen scenes we e used as he sample. The esea ch
eam ound ha people who a e mo e exposed o he sc een a e mo e in luenced by media
con en han hose who a e no , which hey e med “mains eaming” [
5
]. They u he
s a ed ha i he pe son’s li ed expe iences a e in line wi h wha is b oadcas , his in luences
he iewe wice as much, esul ing in an inc ease in he deg ee o cul i a ion [5].
Today mo e han wice as many young people wa ch ideos on a daily basis [
6
],
making hem he main consume s o audio isual p oduc s. The eme gence o digi al
pla o ms has changed young people’s iewing habi s; hey decide wha o wa ch and
when [
7
,
8
]. Young people wa ch ele ision se ies h ough hese pla o ms, which p o ide
he young pe son wi h he en e ainmen unc ion, he in o ma i e unc ion, and a ious
social unc ions [
9
]. In ela ion o he way young people consume hese p oduc s, se e al
s udies show ha he con en s o he se ies consumed by boys and gi ls a e di e en . While
gi ls a e mo e likely o p e e o wa ch mo e omance and d ama, boys p e e o wa ch
ac ion and humou [
10
,
11
] and, as men ioned ea lie , he con en consumed in luences
he iewe .
In . J. En i on. Res. Public Heal h 2022,19, 3316. h ps://doi.o g/10.3390/ije ph19063316 h ps://www.mdpi.com/jou nal/ije ph
In . J. En i on. Res. Public Heal h 2022,19, 3316 2 o 12
1.1. Impac o Fic ion Se ies on he Socialisa ion o Young People’s A ec i e-Sexual Rela ionships
In ic ion se ies, he e is a p oli e a ion o images and language ela ed o he cha ac e s.
Many o hese can p o oke emo ions and in luence he alues and beha iou s o he
audience [12–14].
Thus, i is ound ha you h se ies aimed a a young audience ha e signi ican alue,
bo h o ele ision p oduc ion and he ecep ion o he audience, who a e a a ime o
iden i y cons uc ion [
15
]. Wa d and Ri adeney a [
16
], who examined 314 young s uden s,
ound a co ela ion be ween he amoun o audio isuals iewed and pa icipan s’ sexual
a i udes, expec a ions, and beha iou s.
The audio isual na a i e is he backbone o he s o y, which changes acco ding o
he audio isual gen e and he a ge audience niche [
17
]. Lo e ela ionships a e one o he
mos common hemes in audio isual s o y elling, mainly because hey eign in he wo ld
o d eams and he desi es o he audience [
18
]. Wexman [
19
] poin s ou ha he powe o
he discou se p oduced h ough he ep esen a ion o lo e ela ionships impac s omance
s yles in socie y. Wa d [
20
], who esea ched 259 young people, s a ed ha he e was a
co ela ion be ween wha hey consumed and hei sexual a i udes and assump ions.
Sexuali y is ano he key heme in you h se ies, as i is key in he ansi ion om
childhood o adul hood. Sexuali y is ep esen ed oday wi h mo e cha ac e s o di e en
sexual o ien a ions and gende s han in he p e ious e a. [
21
]. An example appea s in
he se ies o eenage s Sex Educa ion, which, acco ding o Ma chini [
22
], ep esen s a
sexuali y ha has been silenced un il now by mo al and eligious dogmas. Dudek, Woode,
and G een [
23
], who also analysed he ways in which young people a e ep esen ed as
p oduce s and consume s o po nog aphic/e o ic na a i es in his same se ies, ound ha
his con en can p o ide sexual in o ma ion and knowledge.
A ec i e-sexual ela ionships in ic ional se ies a e o en associa ed wi h con lic s [
15
],
which can ake a ious o ms o physical and/o psychological iolence. Be idge [
24
],
who explo ed na a i es o sexual iolence in U.S. p og ammes be ween 1990 and 2008,
ound ha many depic ions o sexual iolence appea wi hin he sexual cul u e.
Bleakley, Jamieson, and Rome [
25
] analysed he highes -g ossing ilms be ween
1950 and 2006, a o al o 855 p oduc s. The esul s we e ha male cha ac e s a e mo e
likely o be po ayed as iolen , while emale cha ac e s a e mo e likely o pa icipa e
in and be depic ed in sexually explici scenes. The au ho s concluded ha iolence and
explici sex has inc eased in bo h male and emale cha ac e s. Se e al ic ion se ies ha e
appea ed depic ing iolence in a ec i e-sexual ela ionships, such as Bu y he Vampi e
Slaye (
1997–2003
), whe e sexual and mu an ela ionships abound, whe e ha ed becomes
lo e and iolence becomes e o ic en anglemen s [
26
]; Los P o egidos (2010–2012), whe e
one o he a ec i e-sexual ela ionships be ween wo adolescen s is linked o abuse [
27
];
B eaking Bad (2008–2013), in which he ela ionship be ween Wal e Whi e, he p o agonis
o he se ies, includes he p o agonis ying o isola e, deg ade, exploi , igh en and con ol
his wi e Skyle . These ac ics a e well documen ed in s udies ocused on abuse. Thus, he
au ho poin s ou ha he lack o emphasis on ins ances o coe ci e con ol by w i e s and
di ec o s makes he pa ly esponsible o con ibu ing o a cul u e o misogyny. Mo eo e ,
accusa ions o ic im-blaming by ans o he se ies owa ds Skyle a e e iden in nume ous
online blogs, an o ums, and social media pla o ms [
28
]. In he same ein, I ene [
29
], in
his s udy on he se ies Ame ican Ho o S o y (2011–2021) ound ha in 2011, he p oduce s
added amilia ho o ilm subgen es o he ew i e, using gen e s a egies in i e seasons.
P oduce s made agg essi e use o pa a-cinema ic echniques o cons uc a cul p oduc
ou o hype -sexualized ho o image y and na a i es.
The e o e, hese ic ion se ies ha ela e a ec i e-sexual ela ionships wi h iolence
can cul i a e in iewe s an unde s anding and ole ance o iolence in such ela ionships.
1.2. Toxic and Heal h Rela ionships
In addi ion o he in luence ha media con en gene a es in he audience, i should be
conside ed as well ha a ec i e-sexual ela ionships ha e a di ec impac on people’s heal h,
In . J. En i on. Res. Public Heal h 2022,19, 3316 3 o 12
bo h emo ionally and physically. Depending on he ype o a ec i e-sexual ela ionship
ha is es ablished, i can ha e a posi i e o nega i e impac on heal h.
Domina ion and disc imina ion a e wo componen s ha indica e he poo quali y
o a ela ionship, which is called a oxic ela ionship [
30
] and p oduced in he e osexual
and/o homosexual ela ionships [
31
–
33
]. These elemen s o powe and dominance appea
in Dominan T adi ional Masculini y (DTM) [
34
,
35
], masculini y ha can be socialised o
supp ess emo ions in o de o main ain dominance o women [
36
]. Likewise, Connell [
37
]
no es ha hese ypes o masculini y a e always iolen .
In con as , heal hy ela ionships expe ience a highe le el o ela ional sa is ac ion
and posi i e a ec [
38
]. These ypes o ela ionships a e os e ed by men who belong o
he model called he New Al e na i e Masculini y (NAM), ha combines good alues
and a ac ion [
34
]. Fo his eason, hey seek a ec i e-sexual ela ionships based on
desi e and lo e, hus dis ancing hemsel es om people wi h non-egali a ian and/o
iolen alues. This ype o masculini y is cha ac e ised by sel -con idence, b a e y, and
cou age [
34
]. Fu he mo e, his masculini y shows ejec ion o nega i e a i udes such as
sexism, acism, and double s anda ds [
39
,
40
]. The e o e, his masculini y publicly ejec s
non-egali a ian a i udes.
These in luences on heal h, in addi ion o he emo ional, can ha e physical e ec s.
Recen esea ch by Chuang [
41
] ound ha oman ic ela ionships a e associa ed wi h in-
c eased gu mic obio a di e si y and o he heal h bene i s. Howe e , when hese oman ic
ela ionships go h ough “hea b eak” o “pos - ela ionship g ie ”, uni e sal li e s ess oc-
cu s ha a ec s he mic obio a. O he esea ch highligh s ha poo -quali y a ec i e-sexual
ela ionships can lead o dep ession [
42
], anxie y [
43
], ea [
44
], anguish [
45
], memo y
dis u bances [
46
], emo ional diso de s [
47
], en i onmen ally-sensi i e physiological im-
pai men (e.g., o cen al ne ous, endoc ine, and immune sys ems) [
48
], di e en soma ic
symp oms [
49
], and e en an inc ease in he endency o commi suicide in some people [
50
].
In addi ion, he e is inc eased dissa is ac ion wi h he ela ionship [51].
1.3. Science-Based Dialogic In e ac ion abou Heal h in Rela ionships
Sociological s udies show how a dialogical u n has aken place h oughou socie y in
ecen decades [
52
], which a ec s human ela ionships. This dialogue is key o os e ing
socie al ans o ma ion [53].
This dialogue can also con ibu e o changes in and imp o emen o a ec i e-sexual
desi es and a ac ion. This is demons a ed by wo s udies ela ed o socializa ion in
a ec i e-sexual ela ionships. The i s s udy deals wi h he social impac on psychology in
he ield o gende iolence in adolescence. Conduc ed by Racione o and o he au ho s [
54
],
a change was obse ed in he beha iou o gi ls who decided o alk abou heal h and
oxic ela ionships. They conduc ed se en in e en ions wi h 15–16-yea -old gi ls in he
amewo k o he esea ch p og amme on p e en i e socialisa ion o gende iolence.
Speci ically, spaces o dialogue we e es ablished be ween he esea ch eam and he
esea ch pa icipan s o suppo he ee econs uc ion o men al and a ec i e models o
a ac ion h ough c i ical analysis o he dominan coe ci e discou se. Thus, he young
women we e able o be e unde s and hei own and o he s’ a ec i e-sexual hinking,
emo ions, and beha iou s in a ou o he ejec ion o iolence and he dialogue suppo ed
he modi ica ion o adolescen gi ls’ sexual p e e ences o di e en ypes o men. A he
end o he esea ch, hey obse ed ha some pa icipan s used he knowledge gained in
he p ojec o help hei iends and communi ies e lec on pa e ns o coe ci e sexual
a ac ion, he quali y o hei in ima e ela ionships, and he di e en e ec s o sexual
iolence and oxic ela ionships on heal h. In addi ion, some o he gi ls decided o end
hei oxic ela ionships a e he in e en ions.
The second s udy e e s o he MEMO4LOVE esea ch, h ough he publica ion om
Pad ós-Cuxa , Molina-Roldán, Gisme o, and Tellado [
46
]. They conduc ed a ques ionnai e
(n= 141) o ind adolescen s’ pee in e ac ions ha p omo e heal hy o oxic a ec i e-sexual
ela ionships and conduc ed i e communica i e ocus g oups wi h boys and gi ls. They
In . J. En i on. Res. Public Heal h 2022,19, 3316 4 o 12
ound ha he impac o sha ing e idence o he ad e se e ec s o oxic ela ionships
wi h iolen masculini ies on heal h wi h adolescen s p oduced a ans o ma ion o he
pee g oup. In pa icula , non- iolen boys gained sel -con idence and gi ls eo ien ed o
ein o ced hei a ac ion o non- iolen boys.
The e o e, dialogue spaces ha deal wi h lo e o a ec i e-sexual ela ionships can
gene a e a change in choices and as es ha can enhance oxici y- ee ela ionships. Despi e
all he scien i ic con ibu ions made o da e, i is s ill unknown how science-based dialogic
in e ac ions o e come he nega i e impac o ic ion se ies on he socialisa ion o oxic
ela ionships. The ques ion ha his esea ch seeks o cla i y is whe he he in e ac ions
wi h young consume s o his audio isual con en , h ough he use o scien i ic e idence in
he discussion, can help hem o a oid he men al and physical heal h e ec s caused by
oxic ela ionships. Knowing whe he his ype o in e ac ion p oduces a change in young
people will help o e adica e oxic ela ionships and a oid he heal h p oblems caused. To
do his, we used o ou esea ch he se ies Sex Educa ion, one o he mos -wa ched se ies o
adolescen s oday. In o de o iden i y how dialogic in e ac ions on ic ion se ies help o
iden i y oxic ela ionships ha cause heal h consequences, we s a ed wi h analysis o one
o he s o ies ep esen ed in Sex Educa ion, whe e he boy iden i ied as ha ing Dominan
T adi ional Masculini y ea s badly bo h a gi l and a boy wi h whom he has o has had
a ec i e-sexual ela ionships and he consequences o hem on heal h o bo h he gi l and
he boy.
2. Ma e ials and Me hods
Communica i e Me hodology [
55
,
56
] has been applied in his esea ch, as i includes
he oices o he people in es iga ed h oughou he p ocess on opics such as communica-
ion and heal h, wi h he aim o os e ing a ans o ma i e impac on he esea ch subjec s
hemsel es [57].
We s a ed by wa ching seasons 1, 2, and 3 o he se ies Sex Educa ion in o de o
know he cha ac e s and hei ela ionships, hen we s a ed he e iew by ca ying ou
a communica i e con en analysis o he i s season o he ic ional se ies Sex Educa ion,
b oadcas by Ne lix. Subsequen ly, communica i e ocus g oups wi h a communica i e
o ien a ion we e conduc ed wi h young gi ls and boys in ela ion o wo oxic ela ionships
ha appea in he eigh episodes o he se ies. Figu e 1shows he da a collec ion p ocess
es ablished o his esea ch.
In . J. En i on. Res. Public Heal h 2022, 19, x FOR PEER REVIEW 4 o 13
The second s udy e e s o he MEMO4LOVE esea ch, h ough he publica ion om
Pad ós-Cuxa , Molina-Roldán, Gisme o, and Tellado [46]. They conduc ed a ques ion-
nai e (n = 141) o ind adolescen s’ pee in e ac ions ha p omo e heal hy o oxic a ec-
i e-sexual ela ionships and conduc ed i e communica i e ocus g oups wi h boys and
gi ls. They ound ha he impac o sha ing e idence o he ad e se e ec s o oxic ela-
ionships wi h iolen masculini ies on heal h wi h adolescen s p oduced a ans o -
ma ion o he pee g oup. In pa icula , non- iolen boys gained sel -con idence and gi ls
eo ien ed o ein o ced hei a ac ion o non- iolen boys.
The e o e, dialogue spaces ha deal wi h lo e o a ec i e-sexual ela ionships can
gene a e a change in choices and as es ha can enhance oxici y- ee ela ionships. De-
spi e all he scien i ic con ibu ions made o da e, i is s ill unknown how science-based
dialogic in e ac ions o e come he nega i e impac o ic ion se ies on he socialisa ion o
oxic ela ionships. The ques ion ha his esea ch seeks o cla i y is whe he he in e ac-
ions wi h young consume s o his audio isual con en , h ough he use o scien i ic e i-
dence in he discussion, can help hem o a oid he men al and physical heal h e ec s
caused by oxic ela ionships. Knowing whe he his ype o in e ac ion p oduces a
change in young people will help o e adica e oxic ela ionships and a oid he heal h
p oblems caused. To do his, we used o ou esea ch he se ies Sex Educa ion, one o he
mos -wa ched se ies o adolescen s oday. In o de o iden i y how dialogic in e ac ions
on ic ion se ies help o iden i y oxic ela ionships ha cause heal h consequences, we
s a ed wi h analysis o one o he s o ies ep esen ed in Sex Educa ion, whe e he boy
iden i ied as ha ing Dominan T adi ional Masculini y ea s badly bo h a gi l and a boy
wi h whom he has o has had a ec i e-sexual ela ionships and he consequences o hem
on heal h o bo h he gi l and he boy.
2. Ma e ials and Me hods
Communica i e Me hodology [55,56] has been applied in his esea ch, as i includes
he oices o he people in es iga ed h oughou he p ocess on opics such as communi-
ca ion and heal h, wi h he aim o os e ing a ans o ma i e impac on he esea ch sub-
jec s hemsel es [57].
We s a ed by wa ching seasons 1, 2, and 3 o he se ies Sex Educa ion in o de o
know he cha ac e s and hei ela ionships, hen we s a ed he e iew by ca ying ou a
communica i e con en analysis o he i s season o he ic ional se ies Sex Educa ion,
b oadcas by Ne lix. Subsequen ly, communica i e ocus g oups wi h a communica i e
o ien a ion we e conduc ed wi h young gi ls and boys in ela ion o wo oxic ela ion-
ships ha appea in he eigh episodes o he se ies. Figu e 1 shows he da a collec ion
p ocess es ablished o his esea ch.
Figu e 1. Flowcha o he Da a Collec ion and Analysis p ocess.
2.1. Communica i e Con en Analysis Da a Collec ion
Fo his s udy, we i s conduc ed a communica i e con en analysis [
58
] o he i s
eigh episodes o he se ies. To analyse hem, he esea ch eam p e iously wa ched he
h ee seasons o he ic ion se ies (24 episodes) in o de o ind ou abou he a ec i e-sexual
ela ionships ha appea h oughou he se ies. Once he a ec i e-sexual ela ionships
In . J. En i on. Res. Public Heal h 2022,19, 3316 5 o 12
we e iden i ied, we p oceeded o analyze he male cha ac e s who mee he cha ac e is ics
o adi ional masculini y, ha is, who in lic physical, men al, o sexual ha m o su e ing,
h ea s o commi such ac s, coe cion, and o he o ms o dep i a ion o libe y on he
pe son wi h whom he es ablishes he a ec i e-sexual ela ionship. In his case, he cha ac e
o Adam, who assaul s and in imida es o he people and has e y ew academic p ospec s,
ep esen s oxic masculini y. Adam is a cha ac e who, in he second season, hinks
he may be bisexual and has wo a ec i e-sexual ela ionships. The i s ela ionship
is he e osexual, wi h Aimee, a popula high school gi l. The second ela ionship is a
homosexual ela ionship wi h E ic, a boy who openly says he is homosexual and who is
ha assed by Adam.
2.2. Analysis o Sex Educa ion
The chap e s we e analyzed in No embe 2021 wi h he MAXQDA p og am, speci -
ically he scenes whe e he wo a ec i e-sexual ela ionships es ablished by he h ee
cha ac e s men ioned in he p e ious poin we e isualised o discussed. A esea che ,
who was ained in his ype o analysis, made h ee isualisa ions o each o he chap e s
and ca ego ised hose scenes ha p oduced consequences on heal h (see Table 1). The sub-
ca ego ies we e Men al Heal h and Physical Heal h. This ca ego y and subca ego y we e
p e iously sub ac ed om he scien i ic li e a u e. Once analysed, hey we e supe ised
by ano he membe o he esea ch eam and discussed wi h he esea ch eam. As a esul
o he dialogue be ween he esea che s, he inal con en analysis was con i med and he
i s esul s we e ob ained.
Table 1. Ca ego y and subca ego ies o Communica i e Con en Analysis.
Ca ego y Subca ego y Desc ip ion
Consequence on Heal h
Men al Heal h
I e e s o he men al heal h consequences o being
in an a ec i e-sexual ela ionship wi h a DTM.
Physical Heal h
I e e s o he physical heal h consequences o being
in an a ec i e-sexual ela ionship wi h a DTM.
2.3. Communica i e In e iew Da a Collec ion
Immedia ely a e ob aining he esul s o he Communica i e Con en Analysis, we
selec ed wo gi ls and wo boys aged 16–24 who consume se ies on he online pla o m o
whom we asked ques ions such as “Do you hink ha he heal h consequences o being
wi h a pa ne who is a Dominan T adi ional Masculini y a e adequa ely e lec ed in ic ion
se ies?” In addi ion, ou Communica i e In e iews we e conduc ed o see wha discou se
hey had abou he heal h consequences o oxic ela ionships. Table 2shows he p o iles o
he in e iewees h ough he Communica i e In e iew.
Table 2. P o iles o he in e iewees h ough he Communica i e In e iews.
Anonymised Code (In e iewees) Age
Nancy 19
Ab aham 16
Jon 20
Ma ia 21
The young people and he pa en s o he mino we e p e iously in o med and signed
o o ally epo ed e hical consen , which was p e iously passed by he E hics Commission
o he CREA (Communi y o Resea ch on Excellen o All) and ob ained he e e ence
numbe 20211228. In his way, his esea ch adhe es o in e na ional e hical s anda ds
ela ed o da a collec ion. The da a om he Communica i e In e iews we e app op ia ely
coded and anonymised.
In . J. En i on. Res. Public Heal h 2022,19, 3316 6 o 12
In hese in e iews, a esea che discussed wi h he young people he esul s ob ained
om he scien i ic li e a u e and he con en analysis in his s udy. Based on his in o ma-
ion, he in e iewees wa ched wo ideos wi h scenes om he i s season o he se ies,
speci ically he ela ionship be ween Adam and Aimee i s and be ween Adam and E ic
second. In e iewees e lec ed on he wo ela ionships and hei impac on heal h. The
in e iews we e eco ded and a e ba im ansc ip o he young people’s con ibu ions
was made.
2.4. Communica i e In e iews Analysis
The Communica i e In e iews we e hen analysed in he p e iously men ioned
esea ch p og amme. In his case, he ca ego ies ha e eme ged om he heo e ical con i-
bu ions made wi h he objec o s udy and ha e included he in e p e a ion o ien a ion o
he analysis o he applied me hodology [
55
]. The e o e, he analysis o he con ibu ions
o he young people in e iewed ocused on he ollowing: on one hand, on he e bal
language ha does no ela e DTM o nega i e heal h consequences, e e ed o as exclusion,
and on he o he hand, on he e bal language ha iden i ies he ela ionship displaying
DTM wi h nega i e heal h consequences o heal hy ela ionships wi h posi i e heal h
consequences, e e ed o as ans o ma i e (see Table 3).
Table 3. Ca ego ies o Communica i e In e iews.
Ca ego ies Desc ip ion
Exclusion The e bal language does no ela e DTM o nega i e heal h consequences.
T ans o ma ion
The e bal language does ela e he ela ionship displaying DTM wi h nega i e
heal h consequences o heal hy ela ionships wi h posi i e heal h consequences.
3. Resul s
The dialogic in e ac ions wi h scien i ic con ibu ions and he expe iences li ed by he
g oup o young people ha e a ou ed he con ibu ion o o e coming and de ec ing oxic
a ec i e-sexual ela ionships ha cause nega i e e ec s on heal h.
The esul s ob ained by each o he esea ch ools a e shown below.
3.1. Resul s o he Con en Analysis
In he i s season o he ic ion se ies, he e a e 28 scenes in which he heal h conse-
quences o ha ing a oxic a ec i e-sexual ela ionship displaying adi ional dominan
masculini y appea . O hese scenes, 21 a e linked o Adam’s ela ionship wi h E ic, while
se en a e ela ed o Adam’s ela ionship wi h Aimee (see Figu e 2).
In . J. En i on. Res. Public Heal h 2022, 19, x FOR PEER REVIEW 7 o 13
In he i s season o he ic ion se ies, he e a e 28 scenes in which he heal h conse-
quences o ha ing a oxic a ec i e-sexual ela ionship displaying adi ional dominan
masculini y appea . O hese scenes, 21 a e linked o Adam’s ela ionship wi h E ic, while
se en a e ela ed o Adam’s ela ionship wi h Aimee (see Figu e 2).
Figu e 2. Resul s conce ning he a ec i e-sexual ela ionships analysed.
Adam’s a ec i e-sexual ela ionship wi h Aimee is a s able ela ionship, bu las s
exac ly un il he second episode o he season. Howe e , a e ending hei ela ionship,
Adam s a s bea ing he boys who a e ela ed o Aimee. Fi s , in he second episode, he
bea s up a guy she was li ing wi h a a pa y. Then, in he se en h episode, he hi s
Aimee’s hen-boy iend. The ela ionship is no a heal hy one. Speci ically, Aimee appea s
in se en scenes whe e we see he nega i e consequences o he men al heal h. The p o-
agonis has sexual insecu i ies, eels uncom o able wi h Adam’s insis ence on wan ing
o be in i ed o he pa y she o ganises, and su e s s ess and anxie y when she lea ns
ha he ex-boy iend iolen ly en e ed he house wi hou he consen and when he s a s
hi ing he boys wi h whom Aimee has some kind o a ec i e-sexual ela ionship. Thus,
al hough he p o agonis o his ela ionship has no su e ed physical iolence, he wo
boys wi h whom she had some kind o a ec i e-sexual ela ionship ha e su e ed i .
Adam’s a ec i e-sexual ela ionship wi h E ic is a oxic ela ionship om he i s
chap e o he las episode analysed (see Figu e 3). E ic is a ic im o ha assmen by Adam,
bo h men al and physical. This ela ionship causes he ic im o li e in si ua ions o con-
inuous iolence, speci ically in 21 scenes in which he consequences on heal h a e seen,
21 o men al heal h, among which he e a e ou scenes in which he e a e also conse-
quences on physical heal h.
Figu e 2. Resul s conce ning he a ec i e-sexual ela ionships analysed.
In . J. En i on. Res. Public Heal h 2022,19, 3316 7 o 12
Adam’s a ec i e-sexual ela ionship wi h Aimee is a s able ela ionship, bu las s
exac ly un il he second episode o he season. Howe e , a e ending hei ela ionship,
Adam s a s bea ing he boys who a e ela ed o Aimee. Fi s , in he second episode, he
bea s up a guy she was li ing wi h a a pa y. Then, in he se en h episode, he hi s Aimee’s
hen-boy iend. The ela ionship is no a heal hy one. Speci ically, Aimee appea s in se en
scenes whe e we see he nega i e consequences o he men al heal h. The p o agonis has
sexual insecu i ies, eels uncom o able wi h Adam’s insis ence on wan ing o be in i ed o
he pa y she o ganises, and su e s s ess and anxie y when she lea ns ha he ex-boy iend
iolen ly en e ed he house wi hou he consen and when he s a s hi ing he boys wi h
whom Aimee has some kind o a ec i e-sexual ela ionship. Thus, al hough he p o agonis
o his ela ionship has no su e ed physical iolence, he wo boys wi h whom she had
some kind o a ec i e-sexual ela ionship ha e su e ed i .
Adam’s a ec i e-sexual ela ionship wi h E ic is a oxic ela ionship om he i s
chap e o he las episode analysed (see Figu e 3). E ic is a ic im o ha assmen by
Adam, bo h men al and physical. This ela ionship causes he ic im o li e in si ua ions o
con inuous iolence, speci ically in 21 scenes in which he consequences on heal h a e seen,
21 o men al heal h, among which he e a e ou scenes in which he e a e also consequences
on physical heal h.
In . J. En i on. Res. Public Heal h 2022, 19, x FOR PEER REVIEW 8 o 13
Figu e 3. Main esul s on he nega i e heal h consequences o Adam and E ic’s a ec i e-sexual e-
la ionships.
The scenes whe e he ic im is seen o ha e men al heal h e ec s a e ela ed o eel-
ings o sadness o discou agemen , con used hough s abou Adam’s beha iou s, exces-
si e wo ies o ea s abou any e en ha links he wo o hem, and occasional excessi e
ange wi h he people a ound hem. His men al si ua ion some imes pushes him o he
edge, especially when p oblems wi h his bes iend o issues o his sexual iden i y ge
mixed up. Wi hin he scenes o consequences expe ienced by he p o agonis o his ela-
ionship, he men al and physical consequences a e mixed in ou scenes. Si ua ions o
physical iolence a e ela ed o physical heal h e ec s such as ba e ing and also o he
men al heal h consequences discussed ea lie in his pa ag aph. I should be no ed ha
one o he mos iolen scenes, bo h physically and men ally, ended wi h a sexual in e -
cou se in which he ic im el pleasu e.
3.2. T ans o ma ion h ough Science-Based Dialogic In e ac ion
The in e iewees s a e ha hey do no usually alk abou he a ec i e-sexual ela-
ionships depic ed in he se ies wi h hei iends. Howe e , hey may do so a some poin
wi h a close ela i e. Howe e , hey poin ou ha i is no an ac ha is ca ied ou e-
quen ly, and i i is, i is no wi h scien i ic in o ma ion abou a ec i e-sexual ela ionships
and he e ec s on heal h.
Two o he people in e iewed who had ollowed he se ies said ha he i s ime
hey wa ched he se ies, hey liked i , mainly because i alked abou sexual opics ha a e
aboo, such as sexual p ac ices o diseases.
“The i s season, I liked i a lo because i began o b ing o ligh he whole issue o
p oblems ha can occu when ha ing sex o diseases o how o emo e he aboo a li le
bi ” (Ma ia).
Howe e , when asked i hey knew abou oxic ela ionships, hey only emembe ed
Adam and E ic’s ela ionship. Acco ding o hem, he cha ac e could gene a e his ag-
g essi eness because he could ha e p oblems ecognising himsel as homosexual because
he had a adi ional a he o because socie y has made him agg essi e. A he beginning
o he in e iew, one o he gi ls in e iewed poin ed ou ha socie y is esponsible o
his agg essi eness o no le ing him be he way he is, homosexual. “I hink he is agg es-
si e because o wha socie y has done o Adam, o no le ing him be he way he is”
(Ma ia).
The young people ha e become mo e awa e o oxic ela ionships and hei e ec s
on heal h a e lea ning abou he scien i ic in o ma ion p o ided du ing he in e iew,
especially when iden i ying Adam's DTM, he heal h e ec s o agg essi e masculini y, he
Figu e 3.
Main esul s on he nega i e heal h consequences o Adam and E ic’s a ec i e-sexual ela ionships.
The scenes whe e he ic im is seen o ha e men al heal h e ec s a e ela ed o eelings
o sadness o discou agemen , con used hough s abou Adam’s beha iou s, excessi e
wo ies o ea s abou any e en ha links he wo o hem, and occasional excessi e ange
wi h he people a ound hem. His men al si ua ion some imes pushes him o he edge,
especially when p oblems wi h his bes iend o issues o his sexual iden i y ge mixed
up. Wi hin he scenes o consequences expe ienced by he p o agonis o his ela ionship,
he men al and physical consequences a e mixed in ou scenes. Si ua ions o physical
iolence a e ela ed o physical heal h e ec s such as ba e ing and also o he men al heal h
consequences discussed ea lie in his pa ag aph. I should be no ed ha one o he mos
iolen scenes, bo h physically and men ally, ended wi h a sexual in e cou se in which he
ic im el pleasu e.
3.2. T ans o ma ion h ough Science-Based Dialogic In e ac ion
The in e iewees s a e ha hey do no usually alk abou he a ec i e-sexual ela ion-
ships depic ed in he se ies wi h hei iends. Howe e , hey may do so a some poin wi h
a close ela i e. Howe e , hey poin ou ha i is no an ac ha is ca ied ou equen ly,
and i i is, i is no wi h scien i ic in o ma ion abou a ec i e-sexual ela ionships and he
e ec s on heal h.
In . J. En i on. Res. Public Heal h 2022,19, 3316 8 o 12
Two o he people in e iewed who had ollowed he se ies said ha he i s ime
hey wa ched he se ies, hey liked i , mainly because i alked abou sexual opics ha a e
aboo, such as sexual p ac ices o diseases.
“The i s season, I liked i a lo because i began o b ing o ligh he whole issue o
p oblems ha can occu when ha ing sex o diseases o how o emo e he aboo a li le
bi ” (Ma ia).
Howe e , when asked i hey knew abou oxic ela ionships, hey only emembe ed
Adam and E ic’s ela ionship. Acco ding o hem, he cha ac e could gene a e his agg es-
si eness because he could ha e p oblems ecognising himsel as homosexual because he
had a adi ional a he o because socie y has made him agg essi e. A he beginning o
he in e iew, one o he gi ls in e iewed poin ed ou ha socie y is esponsible o his
agg essi eness o no le ing him be he way he is, homosexual. “I hink he is agg essi e
because o wha socie y has done o Adam, o no le ing him be he way he is” (Ma ia).
The young people ha e become mo e awa e o oxic ela ionships and hei e ec s
on heal h a e lea ning abou he scien i ic in o ma ion p o ided du ing he in e iew,
especially when iden i ying Adam’s DTM, he heal h e ec s o agg essi e masculini y,
he socialisa ion capaci y o he se ies in young people, and he exis ence o his ype o
ela ionship in hei en i onmen .
A e wa ching he wo ideos o he wo a ec i e-sexual ela ionships analysed, all
ou young people de ec ed Adam’s DTM, mainly because o his agg essi eness agains he
boys wi h whom Aimee and E ic ha e ela ionships. One o he boys in e iewed iden i ies
he cha ac e ’s DTM and u he adds ha he agg essi eness is Adam’s own aul o being
jealous. “Adam is a adi ional dominan masculini y. Nei he Aimee no E ic is o blame, i
is Adam’s own aul because he is jealous” (Jon). All ou in e iewees iden i ied his ype
o masculini y in ac ual cases ha hey know o in eal ela ionships in hei en i onmen s,
be hose o amily, iends, o acquain ances. One o he gi ls men ioned how she knows o
close ela ionships which a e oxic in which he pa ne is con olled o o de ed no o alk
o he opposi e sex. “Yes, I ha e hea d in ela i es o mine whe e hey ell hei pa ne s
ha as long as we a e oge he , don’ alk o he opposi e sex” (Nancy).
The young people in e iewed iden i ied he heal h consequences o being in a ela-
ionship wi h Adam. One o he boys poin ed ou heal h p oblems seen in he case o Aimee
and E ic and poin ed ou ha hey we e ge ing wo se and wo se. “E ic’s heal h is ge ing
wo se and wo se. You can also see i in he o he gi l” (Jon). This iden i ica ion allowed
hem o analyse he ela ionships hey know in eal li e. Rema kably, one o he boys
in e iewed explained how he has iends who ha e old him ha ha ing ela ionships
like his makes hem i ed, disconce ed, and sick. “I ha e had people who o e ime i has
a ec ed hem physically. They a e mo e i ed, o hey don’ know wha o do and o cou se,
in he end, i a ec s you e e ywhe e. The e a e people who ge sick”. (Ab aham).
A he same ime, he young people in e iewed alked abou how wa ching hese
se ies can u he socialise iolence in ela ionships, whe he he e osexual o homosexual.
One o he gi ls in e iewed poin ed ou ha hese chap e s o iolence a e gi en in
he se ies as some hing no mal, and he audience doesn’ ealise i . “I is p esen ed as
some hing e y no mal, e y good, no hing happens, bu i you analyse i a li le, i is e y
ha d” (Ma ia). Tha is why hey poin ed ou ha audio isual p o essionals should make
hese ela ionships no no mal and no p esen hem as “cool”. One o he boys poin ed ou
ha audio isual p oduc ions should no add a ac i eness o show no malisa ion o oxic
ela ionships. “To begin wi h, he se ies should no show ha hese ela ionships a e cool
o no mal, especially because no all o hem a e like ha ” (Ab aham).
These dialogical in e ac ions wi h scien is s and young people ha e helped hem
o mo e easily iden i y iolen ela ionships and hei e ec s on heal h. The e o e, hey
poin ou ha i is impo an o alk abou hese issues, bu on a scien i ic basis. One o
he in e iewees men ioned ha hese issues should be discussed wi h p o essionals o
ha e a scien i ic basis. “I hink hese issues should be discussed wi h a p o essional o
scien is ” (Jon).
In . J. En i on. Res. Public Heal h 2022,19, 3316 9 o 12
4. Discussion
The e idence-based dialogical in e ac ions wi h he young people in e iewed ha e
con ibu ed o e lec ion and dialogue abou oxic ela ionships and hei e ec s on heal h.
This dialogue based on scien i ic e idence has p o ided ools o analyse and iden i y his
p oblem ha appea s bo h in he se ies and in eal li e. This co obo a es ha dialogue
abou heal hy and oxic ela ionships can p omo e change and imp o emen in young
people owa ds heal hy ela ionships [35,54].
Science-based dialogues allow o he expansion o knowledge ha hey did no p e i-
ously ha e abou oxic ela ionships and hei e ec s on heal h, which is no accomplished
h ough o he ypes o in e ac ions, so b inging science o ci izens can p o ide g ea e
c i ical capaci y and media li e acy because i is no jus abou ha ing in e ac ions, bu
abou ha ing quali y in e ac ions based on science.
Se ials ha e an impac on he socialisa ion o young people [15], especially on sexual
beha iou s [
16
]. Sex Educa ion, while p o iding in o ma ion on sexual p ac ice o ech-
nique [
23
], does no discuss wi h whom o ha e heal hy and iolen - ee ela ionships
no does i discuss o condemn Adam’s agg essi e beha iou , which can socialise young
people in o gende -based iolence. So al hough he se ies wan s o b eak sexual aboos, i
con inues o ep oduce he same beha iou s, a ac ion, and iolence in a ec i e-sexual
ela ionships as o he se ies [26–28].
Young people who in e ac wi h scien is s on he subjec o con ac wi h science in
sexual and emo ional ela ionships and heal h issues can p o ide young people wi h a ool
ha allows hem o analyse and iden i y DTM [
34
,
40
] and so allows hem o di e en ia e
unheal hy ela ionships om heal hy ones. This is an iden i ica ion ha , in addi ion o
applying o ela ionships in ic ion, can also be applied in eal li e, as he young people
in e iewed in his esea ch ha e.
The e o e, os e ing science-based dialogical in e ac ions among young people and
he communica i e analysis o audio isual p oduc s a ou s he c i ical capaci y o boys
and gi ls ega ding he a ec i e-sexual ela ionships hey ha e and hose o people a ound
hem. Talking abou and seeing h ough se ies such as Sex Educa ion he physical and
men al heal h p oblems gene a ed by oxic ela ionships p o okes ejec ion in all young
people. The e o e, he p omo ion o spaces be ween science and young people can a ou
he p e en ion o illnesses, as well as gende iolence.
This esea ch ad ances he knowledge be ween a ec i e-sexual ela ionships and
heal h in audio isual p oduc s. A he same ime, i helps young people o ans o m
hei ela ionships and hose a ound hem. Howe e , i would be necessa y o go u he
in u u e esea ch wi h mo e young people and analyse he impac on socialisa ion in
a ec i e-sexual ela ionships o se ies ha p omo e heal hy ela ionships wi h NAM men
and hei e ec s on heal h.
5. Conclusions
Science-based dialogic in e ac ions wi h young people abou ela ionships and heal h
acili a e he iden i ica ion o DTM, oxic ela ionships, and hei e ec s on heal h, n iden i ica-
ion ha can con ibu e o o e coming oxic ela ionships, and hus iolence in ela ionships.
The e o e, i would be ad isable o hese dialogical in e ac ions be ween young
people and science on lo e and heal h o be p omo ed in hose spaces whe e young people
spend mos o hei ime, such as educa ional cen es. I is also obse ed ha audio isual
p oduc ions such as ic ion se ies should p omo e hese spaces o e lec ion in o de o
p o oke he audience’s hinking and c i ical capaci y.
Au ho Con ibu ions:
Concep ualiza ion, E.O. and C.M.P.; me hodology, C.M.P.; o mal analysis,
B.V.-C.; w i ing—o iginal d a p epa a ion, B.V.-C.; da a cu a ion; B.V.-C.; e iew and edi ing, C.M.P.
and H.Z.-E.; unding acquisi ion, E.O. All au ho s ha e ead and ag eed o he published e sion o
he manusc ip .
Funding: This esea ch ecei ed no ex e nal unding.
