Most of us have attended sex-ed classes in school. If we’re lucky, we’ll learn about consent and how to roll a condom onto a banana. But the classroom rarely goes into the specifics of sexual health and wellbeing – including what to do when a condom breaks.
Where can you get the morning-after pill in your local area? What about post-exposure prophylaxis for HIV? When do you need testing for sexually transmitted infections (STIs)? And where to find support if the test comes back positive?
Governments, community health organisations, peer-led health networks and commercial services use social media to share essential sexual health information with young people and adults alike. This includes up-to-date, evidence-based information on HIV and STI testing and treatment, and the latest on reproductive health care.
Online outreach of this kind has been widely recognised as a low-cost, accessible means of providing sexual and reproductive health content to those whose needs aren’t always met by traditional school-based education or legacy media outlets.
Current online safety rules are focused on removing harmful content, not on supporting health promotion. Unfortunately, sexual health content is often flagged as “against community standards” and suppressed by platforms – a practice known as shadowbanning.
But Australia’s promised new “digital duty of care” provides an opportunity to remedy that, creating a safe and healthy online environment for all.
What is a digital duty of care?
A digital duty of care is sometimes referred to as “safety by design”. It will require social media platforms to establish risk management systems. They must identify potential risks from their services and take reasonable steps to prevent or mitigate serious harms.
It will apply to all online service providers. This includes social media services, messaging apps, online gaming services, online dating services, and search engines.
The duty will sit alongside and complement Australia’s pioneering social media minimum age law. It will also significantly upgrade current expectations for online service providers to ensure a safe online environment for everyone.
The content that deserves protection
However, there’s a danger the duty will focus exclusively on certain kinds of harmful content, such as deepfakes.
It’s important to define content that should be removed or restricted, but this approach also assumes that content promoting the public good doesn’t require definition or protection.
Some content is in the public interest, such as public health information, news, or legitimate self-expression. Only regulating harmful content overlooks potential harms from suppressing or removing useful posts.
For instance, community health organisations use social media for outreach to adults with specific sexual health needs. This includes women’s health, LGBTQI+ health, and HIV prevention and health care.
Research shows that using culturally appropriate images – which may be playful and even suggestive – and direct, nonjudgmental language reduces the fear and stigma often associated with sexual health concerns.
Digital sexuality education and wellbeing content is produced globally, both by independent content creators (or “influencers”) and various organisations.
Young people highly value peer-to-peer online spaces, from TikTok to Reddit. Here, they can share their lived experience of sexual and reproductive health concerns, including advice on how to seek clinical care.
Barriers are increasing
However, government and community-based public health organisations increasingly face barriers when they do digital outreach.
In Australia, account and content restrictions have negatively affected evidence-based health advice for marginalised communities. This includes information on HIV treatments and harm-reduction approaches to drug use. Such content has also been rejected by platform advertising services.
This vital information is not suppressed because platforms have a deliberate agenda against it. Instead, it’s an inevitable byproduct of automated content moderation systems that suppress and remove content found to be “sexually suggestive” or inappropriately “political”.
Complaining to platforms about content suppression or moderation mistakes hasn’t improved the situation. In fact, reporting content to moderators is something politically-motivated groups may weaponise when they want to suppress certain information, or when they want to amplify health misinformation. This is a known public health and human rights threat.
How can we improve under a duty of care?
The digital duty of care should recognise that restricting digital platform user access to relevant public health information is itself a critical harm, and must be prevented.
A proactive and positive duty of care should require platforms not just to remove content, but to maintain inclusive digital environments.
We may not need a wholesale redesign of algorithms to achieve this. Instead, government-funded health organisations could be made exempt from moderation. Public health communicators could be granted expedited pathways when they need to appeal content moderation decisions. And the moderation system could be regularly reviewed in terms of its impacts on health-related content.
Australia’s online safety laws need an upgrade. A digital duty of care can require online platforms and services to actively support safe, inclusive, healthy and rights-respecting digital environments for all Australians.
