Study links sexual violence to violent sexual media exposure. An innovative study of adolescent perpetrators of sexual violence, published online (October 7) in JAMA Pediatrics, focused on adolescent perpetrators rather than victims and studied female as well as male perpetrators. The report found "clear associations" between viewing violent X-rated materials and sexually violent behavior. It also found that female perpetrators became active later than males. The report suggested that the "frequent consumption" of sexual, violent, and sexually violent media should "be a marker of concern" for providers of adolescent health care, called for school programs supporting bystander intervention, and supported policies that could enhance the likelihood of perpetrators being identified earlier. Data were gathered from Growing Up with Media, a longitudinal survey that examines associations between violent behavior and exposure to violent media. The study's definition of sexual violence is broad (including unwanted touching and kissing, for example, and considering "psychological coercion" violence). The report didn't assess whether exposure to violent sexual media was a cause or a result of violent sexual behavior.