Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India

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The ease of access to sexually explicit material (SEM) coupled with adolescents’ impulsivity makes them prone to excessive SEM exposure and may affect the development of sexuality via the perceived realism of such content. This study was done to study the influence between problematic smartphone usage (PSU) and sexuality development among late adolescent boys. Methods One hundred and thirty-four adolescents aged 18-19 years, studying in a medical university, participated in this cross-sectional study. Smartphone Addiction Scale – short version (SAS-SV) to evaluate PSU and a content validated semi-structured proforma to evaluate gender identity, sexual orientation, sources of information on pubertal changes, and exposure to pornographic content was used. We expressed results as proportion and summary measures (Mean±SD), Chi-square test to find influence between PSU and adolescent sexuality development. Results We found a 45.5% prevalence of PSU. Among study participants, 88% were attracted to the opposite sex, 6% were attracted to the same-sex, and 6% were attracted to both sexes. Three per cent of participants liked wearing clothes of the opposite sex, 7.5% wanted to be members of the opposite sex, whereas 10.4% were not comfortable with their genitalia. They obtained information regarding pubertal changes from friends (85) and media (78). Many had exposure to pornographic content (90%), with the youngest being nine years old. Conclusion Nearly half of the late adolescents have PSU. Pornographic contents are accessed through Smartphones. 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F1000Research 2025, 13 :1079 ( https://doi.org/10.12688/f1000research.150657.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] Sharath M Manya https://orcid.org/0000-0002-0601-0707 1 , Jayashree K https://orcid.org/0000-0003-3931-5360 1 , Prasanna Mithra https://orcid.org/0000-0002-7153-411X 2 , Preeti M Galagali 3 , Sara J Ommen https://orcid.org/0009-0006-0732-3058 2 Sharath M Manya https://orcid.org/0000-0002-0601-0707 1 , Jayashree K https://orcid.org/0000-0003-3931-5360 1 , [...] Prasanna Mithra https://orcid.org/0000-0002-7153-411X 2 , Preeti M Galagali 3 , Sara J Ommen https://orcid.org/0009-0006-0732-3058 2 PUBLISHED 07 Jan 2025 Author details Author details 1 Department of Pediatrics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India 2 Department of Community Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India 3 Director and Consultant Adolescent Health, Bangalore Adolescent Care and Counselling Centre, Bangalore, Karnataka, India Sharath M Manya Roles: Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation Jayashree K Roles: Conceptualization, Data Curation, Methodology, Supervision, Writing – Review & Editing Prasanna Mithra Roles: Conceptualization, Methodology, Supervision, Validation, Visualization, Writing – Review & Editing Preeti M Galagali Roles: Conceptualization, Validation, Visualization Sara J Ommen Roles: Methodology, Resources, Supervision, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Manipal Academy of Higher Education gateway. Abstract Background Better affordability of data plans and an increase in “budget” smartphones have resulted in an exponential rise in internet and smartphone users. The ease of access to sexually explicit material (SEM) coupled with adolescents’ impulsivity makes them prone to excessive SEM exposure and may affect the development of sexuality via the perceived realism of such content. This study was done to study the influence between problematic smartphone usage (PSU) and sexuality development among late adolescent boys. Methods One hundred and thirty-four adolescents aged 18-19 years, studying in a medical university, participated in this cross-sectional study. Smartphone Addiction Scale – short version (SAS-SV) to evaluate PSU and a content validated semi-structured proforma to evaluate gender identity, sexual orientation, sources of information on pubertal changes, and exposure to pornographic content was used. We expressed results as proportion and summary measures (Mean±SD), Chi-square test to find influence between PSU and adolescent sexuality development. Results We found a 45.5% prevalence of PSU. Among study participants, 88% were attracted to the opposite sex, 6% were attracted to the same-sex, and 6% were attracted to both sexes. Three per cent of participants liked wearing clothes of the opposite sex, 7.5% wanted to be members of the opposite sex, whereas 10.4% were not comfortable with their genitalia. They obtained information regarding pubertal changes from friends (85) and media (78). Many had exposure to pornographic content (90%), with the youngest being nine years old. Conclusion Nearly half of the late adolescents have PSU. Pornographic contents are accessed through Smartphones. READ ALL READ LESS Keywords Adolescent boys, sexual orientation, gender identity, smartphone addiction, pornography, problematic smartphone usage Corresponding Author(s) Jayashree K ( [email protected] ) Close Corresponding author: Jayashree K Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Manya SM et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Manya SM, K J, Mithra P et al. Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.12688/f1000research.150657.2 ) First published: 20 Sep 2024, 13 :1079 ( https://doi.org/10.12688/f1000research.150657.1 ) Latest published: 07 Jan 2025, 13 :1079 ( https://doi.org/10.12688/f1000research.150657.2 ) Revised Amendments from Version 1 Reviewer 1 had raised certain pertinent queries with respect to the points mentioned in introduction, methodology and discussion. As per the queries raised by the reviewer 1, we have made few changes to convey those relevant points in a better manner. Hence, few of the references related to the manuscript are also rearranged. Reviewer 1 had raised certain pertinent queries with respect to the points mentioned in introduction, methodology and discussion. As per the queries raised by the reviewer 1, we have made few changes to convey those relevant points in a better manner. Hence, few of the references related to the manuscript are also rearranged. See the authors' detailed response to the review by Sudhir Prabhu READ REVIEWER RESPONSES Introduction Adolescence is a stage of transition from childhood to adulthood that includes rapid physical, cognitive, and psychosocial growth. 1 , 2 It is a critical period, as many behavioral patterns emerge during this period, which may persist throughout life. 3 Psychological well-being and overall health of adolescents are major concerns worldwide. 4 Adolescents engage in life-threatening behaviors, such as alcohol and substance use, unsafe sex, poor eating, and heightened risk-taking, which affects their psychological well-being. 4 , 5 According to the 2011 census, in India, 1/4 th of the population are adolescents (253 million), and 54% belong to the 10-14 age group, and nearly 46% are in the 15-19 years of age. 6 Adolescents are highly attracted to modern technologies because they are psycho-socially immature and more prone to smartphone addiction due to the influence of the environment and peers. 7 Reports highlight that adolescents are highly addicted to smartphones, equivalent to substances and various types of behavioral addiction. 8 A meta-analysis by Davey et al. showed prevalence of smartphone abuse among Indian adolescents to be approximately 39% - 44%. 9 Billieux et al. documented that problematic smartphone use (PSU) is defined as “an inability to regulate one’s use of the smartphone, which eventually involves negative consequences in daily life”. 10 It is a behavioral or psychological dependence on mobile devices that is closely linked to excessive digital media use, such as Internet addiction disorder. 11 PSU has been considered as a measure of smartphone addiction and is associated with various psychopathologies. 12 Adolescents with PSU are highly exposed to viewing sexualized content through videos and reality programs. In addition to these sources, social media platforms and various mobile applications have increased sexual content. 13 The adolescents are more frequently engaged in online sex chat, and are thereby exposed to cyberbullying and online harassment. 14 PSU may lead to impulsiveness, which plays a pivotal role in an increased number of sexual partners. 15 The term sexual orientation refers to the sex to which individuals are sexually or romantically attracted. Gender identity refers to an individual’s basic sense of being male, female, transgender, or something else. 16 Gender orientation is biologically determined, and sexual expressions have many external influences, such as the media. For the present study, the identification of gender roles, orientation and identity was considered as the development of sexuality based on previous works in literature. 17 However, there is a paucity of information on how PSU affects sexuality in adolescence. The present study aimed to understand the existing patterns of smartphone usage among late adolescents and their association with the development of adolescent male sexuality. Methods Study design & participants We conducted a cross-sectional study among male students pursuing medical, dental, and allied health sciences courses aged between 18 and 19 years at a medical university in Mangalore, an urban area in the South Indian State of Karnataka. Late adolescent boys who were unwilling to participate were termed non-responders and were excluded from the study. The study duration was 11 months (November 2019–September 2020). We followed a convenience sampling method to recruit study participants. The STROBE guidelines were adhered to, and a complete checklist was provided in the reporting guidelines. Sample size All male students aged between 18 and 19 years who pursued the above-mentioned courses in the study institute were screened, and those over age and unwilling to participate were excluded from the study. The study flow diagram is shown in the following Figure 1 : Figure 1. The study flow diagram. Study tool Following the consenting process, a content-validated semi-structured questionnaire (Google Form) was electronically mailed to all participants who were willing to participate in the study, and responses were collected. Students who had not completed the Google form were reminded using a WhatsApp message (24 hours after sending the questionnaire) and telephonic conversation (48 hours after sending the questionnaire). The questionnaire included demographic details, The Smartphone Addiction Scale – short version (SAS-SV), 18 and questions on gender identity, sexual orientation, sources of information regarding pubertal changes, and body image issues. Smartphone usage and addiction using SAS-SV developed by Kwon et al., 18 consists of 10 items with 6 point Likert type scale. The scale items were scored from 1 to 6, with 1 being ‘strongly disagree’ and 6 being ‘strongly agree.’ The total possible score was between 10 and 60, with higher scores indicating higher chances of smartphone addiction. Based on the findings of a previous study, the cut-off for smartphone addiction was determined to be 31 in the present study. 18 Data analysis Data analysis was performed using IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. Results are expressed as proportions and summary measures (mean ± standard deviation) using appropriate tables and figures. The influence between smartphone usage and sexual development was assessed using the chi-square test and independent sample t-test. Statistical significance was set at P <0.05. Results A total of 149 students were screened, and nine were excluded from the study because they were older. Among the remaining 140 students, 6 were unwilling to participate in this study; hence, they were excluded. The response rate was 95.7%. Of the 134 students, 98 were medical students, 20 were dental students, and 16 were allied health sciences students. Among the students, 90.3% were permanent residents of India, followed by 6.7% nonresidential Indians, and 3% foreign nationals. Most of the students resided in the hostel (85.1%), while 13.4% of the students lived at home, and 1.5% stayed in an apartment with friends. In the present study, based on a predetermined cut off score of 31 on SAS-SV, the prevalence of problematic smartphone use (PSU) was 45.5% among the students. As shown in Figure 2 , 85 students obtained information about pubertal changes from friends, followed by books/magazines (81), schoolteachers (79), and movies (78). In contrast, fewer adolescents turned to mothers (n=16), fathers (n=17), or doctors (n=18) for information related to pubertal changes. Figure 2. Source of understanding about pubertal changes. As shown in Table 1 , regarding sexual orientation and gender identity among the students, 3% of the students desired to wear the dress of the opposite sex, while 94.8% did not, and 2.2% were not unsure. Among these students, 87.3% were happy with their current sexual identity, while 7.5% of them wanted to be members of the opposite sex. 86.6% Of students were comfortable with their genitalia, whereas 10.4% were unsatisfied. Romantic feelings towards the opposite sex were perceived to be normal by 91.8% of the students, while 5.2% felt abnormal, and 3% were not unsure. Out Of these students, 88% were attracted to the opposite sex, while 6% were attracted to the same sex, and 6% were attracted to both sexes. Table 1. Smart phone usage and body characteristics of the study participants (n=134). Are you worried about your: Responses Smart phone usage * P value 31 No. (%) Physique No 27 (36.9) 23 (37.7) 0.932 Yes 46 (63.1) 38 (62.3) Weight No 35 (47.9) 24 (39.3) 0.318 Yes 38 (52.1) 37 (60.7) Height No 52 (71.2) 47 (77.0) 0.445 Yes 21 (28.8) 14 (23.0) Skin colour No 59 (80.8) 49 (80.3) 0.943 Yes 14 (19.2) 12 (19.7) Scalp hair No 46 (63.0) 34 (55.7) 0.392 Yes 27 (37.0) 27 (44.3) Body hair No 59 (80.8) 55 (90.2) 0.131 Yes 14 (19.2) 06 (09.8) Optic aid No 60 (82.2) 49 (80.3) 0.783 Yes 13 (17.8) 12 (19.7) Genitals No 66 (90.4) 51 (83.6) 0.239 Yes 07 (09.4) 10 (16.4) * ≥31 on SAS-SV scale was considered problematic for smartphone use. Table 2 shows no significant association between PSU and gender identity or PSU and sexual orientation. Regarding the knowledge of adolescent sexuality, 72% attended classes on the topics related to sex in schools, 19% had not attended, and 9% were not sure. Table 2. Gender identity and sexual orientation (n=134). Responses Yes n (%) No n (%) Don’t know n (%) Do you like wearing clothes of the opposite sex? 04 (03.0) 127 (94.8) 03 (02.2) Would you like to be a member of the opposite sex? 10 (07.5) 117 (87.3) 07 (05.2) Do you feel uncomfortable with your genitalia? 14 (10.4) 116 (86.6) 04 (03.0) Do you feel romantic feeling towards the opposite sex is normal? 123 (91.8) 07 (05.2) 04 (03.0) Do you have attraction/feeling towards another person of the opposite sex? 123 (91.8) 04 (03.0) 07 (05.2) Do you have attraction/feeling towards another person of the same-sex? 08 (06.0) 119 (88.8) 07 (05.2) Do you have attractions/feelings toward people of both sexes? 08 (06.0) 114 (85.1) 12 (09.0) Regarding normal male sexuality, 92.5% of the students were aware of the mental changes occurring during puberty, 90.3% were aware that adolescence was the final opportunity for growth (final height), and 83.6% of the study population indulged in masturbation. Among the adolescents indulged in masturbation, 28% felt guilty after masturbation, 30% felt masturbation caused severe damage to health, and 99.1% of the students preferred masturbation in private and thought it was not normal to masturbate in public. There was no statistically significant association between PSU on gender identity and sexual orientation ( Table 3 ) Table 3. Effect of PSU on Gender Identity and sexual orientation (n=134). Responses Problematic smartphone usage P value No n (%) Yes n (%) Liking wearing clothes of the opposite sex No 71 (54.6) 59 (45.4) 1 Yes 02 (50.0) 02 (50.0) Liking to be a member of the opposite sex No 69 (55.6) 55 (44.4) 0.511 Yes 04 (40.0) 06 (60.0) Feeling uncomfortable with own genitalia No 65 (54.2) 55 (45.8) 1 Yes 08 (57.1) 06 (42.9) Feeling that romantic feeling towards the opposite sex is normal No 08 (72.7) 03 (27.3) 0.344 Yes 65 (52.8) 58 (47.1) Having attraction/feeling towards another person of the opposite sex No 06 (54.5) 05 (45.5) 1 Yes 67 (54.5) 56 (45.5) Having attraction/feeling towards another person of the same sex No 67 (53.2) 59 (46.8) 0.290 Yes 06 (75.0) 02 (25.0) Having attractions/feelings toward people of both sexes No 66 (53.7) 60 (46.3) 0.071 Yes 07 (87.5) 01 (12.5) . In our study, 90% students had watched pornographic content and one of the students had watched when he was 9 years old, 4.2% watched porn content before they turned 10, and 58% watched the porn content between 15-18 years. Most of the students (95%) wanted to watch the porn content alone, and 90.8% watched the porn content through smartphones. Regarding the frequency of watching porn content, 45% viewed less than once a week, and 37% watched 2-3 times per a week. After watching the pornographic content, the psychological behaviour shows that 7.5% of the students felt altered perception of communicating with the opposite sex, 11.7% responded that watching porn content had altered the study pattern, and 12.5% answered that it affected their academic performance. However, 71% of the students revealed that they had been sexting at least once. Our study did not find a statistically significant association between PSU and exposure to pornographic content ( Table 4 ). Table 4. Association between smartphone usage and pornography. Responses Problematic smartphone usage P value No (n=66) n (%) Yes (n=54) n (%) At what age did you first watch a pornographic movie (PORN)? Mean (SD) 14.43 (1.99) 15.16 (2.16) 0.056 How frequently do you watch PORN? ≤once a week 29 (43.9) 25 (46.3) 0.841 ≥once a day 07 (10.6) 04 (07.4) 2-3 times a week 23 (34.8) 21 (38.8) once a day 7 (10.6) 04 (07.4) Does it affect academic performance? No 60 (90.9) 46 (85.2) 0.331 Yes 6 (9.1) 8 (14.8) Discussion Sexuality, which involves showing interest in a desired activity, orientation, and preference, is a normal phenomenon during adolescence. Adolescent sexuality includes an array of factors, such as intimate partnerships, gender identity, sexual orientation, religion, and culture. 19 Adolescent sexuality development correlates better with the biopsychosocial model. 20 The array of biological, psychological, and social factors plays a predominant role in the progression of adolescent sexuality. Social factors such as parents’ attitudes related to sexuality, parenting style, relationship with peers, and cultural influence are the major attributes of adolescent sexual attitudes. 21 Recently, the media have also greatly influenced adolescent sexuality. Adolescents have easy access to information on sexuality, sex crimes, and violence through the media, influencing their perceptions and attitudes toward sexuality. 22 Further, television and the Internet also provide fast access to sexual content, altering adolescents’ perception towards sexuality. 23 Smartphone provides various benefits such as fast internet access, video calling, easy access to social media, and gaming. 24 Increased smartphone use leads to addictive behavior. One commonly referred term is Problematic Smartphone Use (PSU), similar to behavioral addictions such as substance-related, gambling, and Internet addiction disorder. 25 Adolescents are more vulnerable to problematic smartphone use because of the imbalance between the reward and behavioral control systems. 18 A recent meta-analysis showed that Indian adolescents are highly addicted to smartphones and exhibit problematic sexual behaviors. 9 So, we conducted the present study to evaluate the impact of problematic smartphone use on male adolescent sexuality development. The late adolescent stage is the period of sexual orientation stability and also development to maturity towards responding to various aspects of the gender-related issue, smartphone usage; we chose the adolescents in 18-19 years age group. The prevalence of smartphone addiction based on the SAS-SV cut-off score of 31 was found to be 45.5%, which reflects a higher PSU as compared to Chinese students (38.5%), 26 European countries Belgium (21.5%) 25 and American university students (20.1%). 15 This discrepancy might be due to differences in sampling methods and the rapid development of telecommunication with cheaper and faster internet along with an increase in the budget of smartphones in India. 27 In our study, transvestism, is observed in 3% of the students. Among the participants, 10.4% reported dissatisfaction with their genitalia. Men’s attitudes toward genitals have been shown to affect their psychological status. Thus, in men with dissatisfied genitals, it creates a state of insecurity, and in men with contented genitals, it gives confidence. 28 The majority of the participants, 91.8%) thought romantic feelings towards their female counterparts were normal. Romantic relationships during adolescence are essential for development and well-being. Further, it has a positive association with the development of personal identity, self-esteem, and social competence and is useful for career planning. It has been positively associated with the formation of personal identity, adaptability to change, self-esteem, social competence, scholastic achievement, and career planning. 29 Late adolescence (16–18 years) occurs when consolidation of romantic bonds occurs, elevating the risk of a poor-quality romantic relationship. 30 In our study, normal romantic relationships towards the opposite sex might be due to a greater preference for cyber-relationship applications such as web chats and social networking chat rooms. These social networking chat rooms offer online romantic relations, which might be heightened by excessive or problematic internet use. 31 We report 6% of same-sex attraction among the students; however, in a study conducted by Nama et al. among Canadian medical students in Ottawa, 18% of the medical students were involved in same-sex attraction or gay behavior. 32 Further, our study reported no significant associations between sexual orientation, gender identity, and PSU. In this study, a higher number of students (85%) obtained information regarding the pubertal changes from their friends. Previous studies have also revealed that males share information regarding puberty and first wet dreams with their friends. 33 In this study, 72% of adolescents attended sex education in schools. In a study done by Kumar et al. shows that 97.1% of students like to have sex education during their school life period. 34 Further, genital growth in boys has been reported to be associated with altered cognitive function. 35 In this study, 92.5% of students were aware of mental changes during puberty, 90.3% aware that adolescence is a final opportunity for growth, and 83.6% of students had self-explored genitalia. In this study, 28% of students felt guilty after masturbation, 30% felt masturbation could induce serious damage to health, and 99.1% preferred private masturbating practice and not in public. Similar to our report, a study conducted among Chinese students showed an association between floating anxiety, somatic and hysterical symptoms, and masturbation. 2 In our study, 90% of the students had viewed porn content, which is comparable to other studies conducted among adolescent boys in Sweden (98%) 36 and Australia (87%). 37 In the current study, 45% viewed porn content less than once a week, and 37% watched 2-3 times per a week, which is higher as compared to a study done among Polish students, where 34% viewed pornographic content once a week and 24% few times a week. 38 In this study, watching pornographic content did not influence students’ psychological behavior and study patterns. Similar to our report, a study conducted on Croatian adolescents showed that viewing pornography displayed no significant negative alteration in adolescent subjective well-being, depression or anxiety, or self-esteem. 39 In a study conducted by Šević et al. among Croatian adolescents, watching porn content or sexually explicit material online did not affect academic grades, study patterns, or well-being. 40 In contrast, Beyens et al. reported that watching online pornographic content has a negative association with students’ academic performance when compared between baseline and six months. 41 Further, we did not observe a significant association between problematic smartphone use and pornographic content exposure. The strength of this study is that it is the first of its kind to correlate adolescent sexuality with smartphone usage using a standardized questionnaire (Smartphone Addiction Scale – short version, SAS-SV). This study has some limitations. Considering the smaller sample size and enrolment of only health sciences students, the results cannot be generalized. This study implies the formulation of structured awareness programs to be carried out by health professionals and to educate parents about handling adolescent issues. In addition, it encourages adolescent health programs to create knowledge about risky behaviors and community support groups. This study highlights the need to include comprehensive sex education as part of the school curriculum and to educate young Internet users on the safe and responsible use of the Internet. Ethics and consent The study was approved by the Institutional Ethics Committee on 15/01/2020 (approval number: IEC KMC MLR 01/2020/36) and the Head of the Institute. Eligible participants were contacted individually using the MS Teams platform. The purpose of the study, the role of their participation, the study procedure, and confidentiality were explained, and informed consent was obtained online using google forms from each participant. Data availability Underlying data Open Science Framework: Influence of Smartphone Usage on the development of sexuality among Late Adolescent Boys in Health Sciences Colleges of South India. https://doi.org/10.17605/OSF.IO/KVM4A 42 This dataset contains the following underlying data: • Excel Data file Extended data Open Science Framework: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India. https://doi.org/10.17605/OSF.IO/KVM4A 42 This dataset contains the following underlying extended data: • Participant information sheet. • Informed consent form • Study Questionnaire Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0) Reporting guidelines Open Science Framework: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India. https://doi.org/10.17605/OSF.IO/KVM4A 42 It contains the STROBE checklist for the Influence of Smartphone Usage on the development of sexuality among Late Adolescent Boys in Health Sciences Colleges of South India. 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Reference Source Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 20 Sep 2024 ADD YOUR COMMENT Comment Author details Author details 1 Department of Pediatrics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India 2 Department of Community Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India 3 Director and Consultant Adolescent Health, Bangalore Adolescent Care and Counselling Centre, Bangalore, Karnataka, India Sharath M Manya Roles: Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Writing – Original Draft Preparation Jayashree K Roles: Conceptualization, Data Curation, Methodology, Supervision, Writing – Review & Editing Prasanna Mithra Roles: Conceptualization, Methodology, Supervision, Validation, Visualization, Writing – Review & Editing Preeti M Galagali Roles: Conceptualization, Validation, Visualization Sara J Ommen Roles: Methodology, Resources, Supervision, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 07 Jan 2025, 13:1079 https://doi.org/10.12688/f1000research.150657.2 version 1 Published: 20 Sep 2024, 13:1079 https://doi.org/10.12688/f1000research.150657.1 Copyright © 2025 Manya SM et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Manya SM, K J, Mithra P et al. Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.12688/f1000research.150657.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 07 Jan 2025 Revised Views 0 Cite How to cite this report: Mandara A. Reviewer Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.176146.r361743 ) The direct URL for this report is: https://f1000research.com/articles/13-1079/v2#referee-response-361743 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Jan 2025 Anjan Mandara , Consultant adolescent psychiatrist, Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK Approved VIEWS 0 https://doi.org/10.5256/f1000research.176146.r361743 The article addresses the impact of smartphone usage on sexuality development in young people attending health and allied courses in an urban city. It is a cross sectional study carried out on biological males attending college and the response rate ... Continue reading READ ALL The article addresses the impact of smartphone usage on sexuality development in young people attending health and allied courses in an urban city. It is a cross sectional study carried out on biological males attending college and the response rate for the cohort was high. A standardised questionnaire was used to collect data and Smartphone Addiction Scale ( SAS-VS) was used to evaluate smartphone use. SAS-VS has got good reliability and validity for assessment of smartphone addiction in community and research settings. Appropriate statistical analysis tool was used to analyse the collected data. The conclusions drawn from the study were compared against published literature and limitations from the study were identified. The participants of the study were biological male students enrolled in health and allied health courses in Mangalore between the ages of 18 and 19. The authors have identified that sample size and sample source are limiting factors for the study. It would have been beneficial to invite all students irrespective of their biological sex or gender be invited to take part in the study. I did not have access to the questionnaire developed by the study team or understanding of the process followed to develop it. It would have been useful to see the content of the questionnaire. Based on the results from the data collection, I noted that there was no specific mention of sexual orientation like pan sexual or asexual taken into consideration in the questionnaire. Major points None Minor points The authors may wish to develop further on development of gender identity and sexual orientation. For eg. Most people develop and understanding and know their gender by age 3-5 years where as sexual orientation is more a developmental process. Authors may consider commenting on impact of social and communication difficulties ( pervasive developmental disorder) and sexual orientation Authors may wish to comment/consider sexual orientations not described in paper like pansexual and asexual. Authors may wish to share the questionnaire they used to collect the data. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Mandara A. Reviewer Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.176146.r361743 ) The direct URL for this report is: https://f1000research.com/articles/13-1079/v2#referee-response-361743 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Prabhu S. Reviewer Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.176146.r356982 ) The direct URL for this report is: https://f1000research.com/articles/13-1079/v2#referee-response-356982 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 09 Jan 2025 Sudhir Prabhu , Department of Community Medicine, Father Muller Medical College, Mangalore, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.176146.r356982 The authors have carefully considered and adequately addressed all of the scientific and technical concerns raised ... Continue reading READ ALL The authors have carefully considered and adequately addressed all of the scientific and technical concerns raised in the previous review. Based on the author responses, I believe the manuscript has been significantly improved. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Immunization, Adolescent health, Primary health care I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Prabhu S. Reviewer Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.176146.r356982 ) The direct URL for this report is: https://f1000research.com/articles/13-1079/v2#referee-response-356982 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 20 Sep 2024 Views 0 Cite How to cite this report: Prabhu S. Reviewer Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.165247.r326604 ) The direct URL for this report is: https://f1000research.com/articles/13-1079/v1#referee-response-326604 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 11 Oct 2024 Sudhir Prabhu , Department of Community Medicine, Father Muller Medical College, Mangalore, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.165247.r326604 The research article submitted by the authors clearly answers the research question about the impact of problematic smartphone usage and sexuality among late adolescent males, both of which are important public health issues. However I have a few concerns about ... Continue reading READ ALL The research article submitted by the authors clearly answers the research question about the impact of problematic smartphone usage and sexuality among late adolescent males, both of which are important public health issues. However I have a few concerns about the study which I would seek clarification from the authors : Major : 1. How was development of sexuality defined for this descriptive study : was it sexual orientation or sexual identity or something else ? 2. Sexual awareness may begin at early adolescents (9-12 yrs) , what was the reason authors tried to address or justify development of sexuality or influence of smartphone on sexuality at the age of 18-19 yrs ? Was this based on any observations or references or any other issues specific in your region? 3. Discussion section mentions about friends/peers being the major source for information, but results also show magazines and videos also which may be due to stigma to discuss with teachers, family or health professionals. Kindly elaborate this as it is relevant for the study objective with smartphone being the most easily handy and private source for all information for an adolescent. Minor 1. Abstract mentions about "exposure to pornographic content with youngest being 9 years old" study subjects being late adolescents does this mean at the age of 9 ? 2. Are smartphone addiction and problematic smartphone usage used as synonyms for this study? Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Immunization, Adolescent health, Primary health care I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Prabhu S. Reviewer Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.165247.r326604 ) The direct URL for this report is: https://f1000research.com/articles/13-1079/v1#referee-response-326604 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 07 Jan 2025 Jayashree K , Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, 576104, India 07 Jan 2025 Author Response Major: How was development of sexuality defined for this descriptive study: was it sexual orientation or sexual identity or something else? Author response: Thank you for ... Continue reading Major: How was development of sexuality defined for this descriptive study: was it sexual orientation or sexual identity or something else? Author response: Thank you for the comment. Sexuality has different components which includes biological sex, gender identity, social sex-role, and sexual orientation. In the present study we considered gender role identification, gender orientation as development of sexuality. The same has now been incorporated in the introduction section. 2.Sexual awareness may begin at early adolescents (9-12 yrs), what was the reason authors tried to address or justify development of sexuality or influence of smartphone on sexuality at the age of 18-19 yrs ? Was this based on any observations or references or any other issues specific in your region? Author response: Yes, it begins at early adolescence but there is lot sexual experimentation with respect to how they dress up and their activities/ likes/dislikes/ whom they hang out with/ gender roles etc, occur throughout the adolescent period and it keeps changing. But by the time they enter late adolescence a stable sexuality usually develops. Another reason why we didn’t take early adolescence is smartphone usage with respect to questions related to different components of sexuality may pose ethical issues also they are not mature enough to understand the questionnaire. The same has now been added to our Discussion section for further clarity. 3.Discussion section mentions about friends/peers being the major source for information but results also show magazines and videos also which may be due to stigma to discuss with teachers, family or health professionals. Kindly elaborate this as it is relevant for the study objective with smartphone being the most easily handy and private source for all information for an adolescent. Author response: Thank you for the suggestion. Our study found that friends/peers are the major source of information about pubertal changes followed by books/magazines as mentioned in the results section. We also found that only a small proportion of them turned to parents or health professionals for any information or concerns regarding the same. These findings aligned with other studies as described in the discussion section. As you rightly pointed out, smartphones, with their private nature, have emerged as a primary source of information for adolescents. This is especially true for sensitive topics where young people may feel uncomfortable engaging in open dialogue with adults. We have further elaborated on this in our discussion section. Minor: Abstract mentions about "exposure to pornographic content with youngest being 9 years old" study subjects being late adolescents does this mean at the age of 9? Author response: Thank you. It means the study subject who is a late adolescent started watching porn when he/she was 9 years old. The same has been mentioned in the sentence of Results section “In our study, 90% students had watched pornographic content and one of the students had watched when he was 9 years old…………………..” 2.Are smartphone addiction and problematic smartphone usage used as synonyms for this study? Author response: Yes. We used the Smartphone Addiction Scale-Short Version (SAS-SV) to identify Problematic Smartphone Use (PSU) among study participants. Participants scoring 31 & above on the SAS-SV were considered to have problematic smartphone use. Throughout the study, the terms 'problematic smartphone use' and 'smartphone addiction' are used interchangeably. For better clarity, we have now mentioned this in the introduction section. Major: How was development of sexuality defined for this descriptive study: was it sexual orientation or sexual identity or something else? Author response: Thank you for the comment. Sexuality has different components which includes biological sex, gender identity, social sex-role, and sexual orientation. In the present study we considered gender role identification, gender orientation as development of sexuality. The same has now been incorporated in the introduction section. 2.Sexual awareness may begin at early adolescents (9-12 yrs), what was the reason authors tried to address or justify development of sexuality or influence of smartphone on sexuality at the age of 18-19 yrs ? Was this based on any observations or references or any other issues specific in your region? Author response: Yes, it begins at early adolescence but there is lot sexual experimentation with respect to how they dress up and their activities/ likes/dislikes/ whom they hang out with/ gender roles etc, occur throughout the adolescent period and it keeps changing. But by the time they enter late adolescence a stable sexuality usually develops. Another reason why we didn’t take early adolescence is smartphone usage with respect to questions related to different components of sexuality may pose ethical issues also they are not mature enough to understand the questionnaire. The same has now been added to our Discussion section for further clarity. 3.Discussion section mentions about friends/peers being the major source for information but results also show magazines and videos also which may be due to stigma to discuss with teachers, family or health professionals. Kindly elaborate this as it is relevant for the study objective with smartphone being the most easily handy and private source for all information for an adolescent. Author response: Thank you for the suggestion. Our study found that friends/peers are the major source of information about pubertal changes followed by books/magazines as mentioned in the results section. We also found that only a small proportion of them turned to parents or health professionals for any information or concerns regarding the same. These findings aligned with other studies as described in the discussion section. As you rightly pointed out, smartphones, with their private nature, have emerged as a primary source of information for adolescents. This is especially true for sensitive topics where young people may feel uncomfortable engaging in open dialogue with adults. We have further elaborated on this in our discussion section. Minor: Abstract mentions about "exposure to pornographic content with youngest being 9 years old" study subjects being late adolescents does this mean at the age of 9? Author response: Thank you. It means the study subject who is a late adolescent started watching porn when he/she was 9 years old. The same has been mentioned in the sentence of Results section “In our study, 90% students had watched pornographic content and one of the students had watched when he was 9 years old…………………..” 2.Are smartphone addiction and problematic smartphone usage used as synonyms for this study? Author response: Yes. We used the Smartphone Addiction Scale-Short Version (SAS-SV) to identify Problematic Smartphone Use (PSU) among study participants. Participants scoring 31 & above on the SAS-SV were considered to have problematic smartphone use. Throughout the study, the terms 'problematic smartphone use' and 'smartphone addiction' are used interchangeably. For better clarity, we have now mentioned this in the introduction section. Competing Interests: None Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 07 Jan 2025 Jayashree K , Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, 576104, India 07 Jan 2025 Author Response Major: How was development of sexuality defined for this descriptive study: was it sexual orientation or sexual identity or something else? Author response: Thank you for ... Continue reading Major: How was development of sexuality defined for this descriptive study: was it sexual orientation or sexual identity or something else? Author response: Thank you for the comment. Sexuality has different components which includes biological sex, gender identity, social sex-role, and sexual orientation. In the present study we considered gender role identification, gender orientation as development of sexuality. The same has now been incorporated in the introduction section. 2.Sexual awareness may begin at early adolescents (9-12 yrs), what was the reason authors tried to address or justify development of sexuality or influence of smartphone on sexuality at the age of 18-19 yrs ? Was this based on any observations or references or any other issues specific in your region? Author response: Yes, it begins at early adolescence but there is lot sexual experimentation with respect to how they dress up and their activities/ likes/dislikes/ whom they hang out with/ gender roles etc, occur throughout the adolescent period and it keeps changing. But by the time they enter late adolescence a stable sexuality usually develops. Another reason why we didn’t take early adolescence is smartphone usage with respect to questions related to different components of sexuality may pose ethical issues also they are not mature enough to understand the questionnaire. The same has now been added to our Discussion section for further clarity. 3.Discussion section mentions about friends/peers being the major source for information but results also show magazines and videos also which may be due to stigma to discuss with teachers, family or health professionals. Kindly elaborate this as it is relevant for the study objective with smartphone being the most easily handy and private source for all information for an adolescent. Author response: Thank you for the suggestion. Our study found that friends/peers are the major source of information about pubertal changes followed by books/magazines as mentioned in the results section. We also found that only a small proportion of them turned to parents or health professionals for any information or concerns regarding the same. These findings aligned with other studies as described in the discussion section. As you rightly pointed out, smartphones, with their private nature, have emerged as a primary source of information for adolescents. This is especially true for sensitive topics where young people may feel uncomfortable engaging in open dialogue with adults. We have further elaborated on this in our discussion section. Minor: Abstract mentions about "exposure to pornographic content with youngest being 9 years old" study subjects being late adolescents does this mean at the age of 9? Author response: Thank you. It means the study subject who is a late adolescent started watching porn when he/she was 9 years old. The same has been mentioned in the sentence of Results section “In our study, 90% students had watched pornographic content and one of the students had watched when he was 9 years old…………………..” 2.Are smartphone addiction and problematic smartphone usage used as synonyms for this study? Author response: Yes. We used the Smartphone Addiction Scale-Short Version (SAS-SV) to identify Problematic Smartphone Use (PSU) among study participants. Participants scoring 31 & above on the SAS-SV were considered to have problematic smartphone use. Throughout the study, the terms 'problematic smartphone use' and 'smartphone addiction' are used interchangeably. For better clarity, we have now mentioned this in the introduction section. Major: How was development of sexuality defined for this descriptive study: was it sexual orientation or sexual identity or something else? Author response: Thank you for the comment. Sexuality has different components which includes biological sex, gender identity, social sex-role, and sexual orientation. In the present study we considered gender role identification, gender orientation as development of sexuality. The same has now been incorporated in the introduction section. 2.Sexual awareness may begin at early adolescents (9-12 yrs), what was the reason authors tried to address or justify development of sexuality or influence of smartphone on sexuality at the age of 18-19 yrs ? Was this based on any observations or references or any other issues specific in your region? Author response: Yes, it begins at early adolescence but there is lot sexual experimentation with respect to how they dress up and their activities/ likes/dislikes/ whom they hang out with/ gender roles etc, occur throughout the adolescent period and it keeps changing. But by the time they enter late adolescence a stable sexuality usually develops. Another reason why we didn’t take early adolescence is smartphone usage with respect to questions related to different components of sexuality may pose ethical issues also they are not mature enough to understand the questionnaire. The same has now been added to our Discussion section for further clarity. 3.Discussion section mentions about friends/peers being the major source for information but results also show magazines and videos also which may be due to stigma to discuss with teachers, family or health professionals. Kindly elaborate this as it is relevant for the study objective with smartphone being the most easily handy and private source for all information for an adolescent. Author response: Thank you for the suggestion. Our study found that friends/peers are the major source of information about pubertal changes followed by books/magazines as mentioned in the results section. We also found that only a small proportion of them turned to parents or health professionals for any information or concerns regarding the same. These findings aligned with other studies as described in the discussion section. As you rightly pointed out, smartphones, with their private nature, have emerged as a primary source of information for adolescents. This is especially true for sensitive topics where young people may feel uncomfortable engaging in open dialogue with adults. We have further elaborated on this in our discussion section. Minor: Abstract mentions about "exposure to pornographic content with youngest being 9 years old" study subjects being late adolescents does this mean at the age of 9? Author response: Thank you. It means the study subject who is a late adolescent started watching porn when he/she was 9 years old. The same has been mentioned in the sentence of Results section “In our study, 90% students had watched pornographic content and one of the students had watched when he was 9 years old…………………..” 2.Are smartphone addiction and problematic smartphone usage used as synonyms for this study? Author response: Yes. We used the Smartphone Addiction Scale-Short Version (SAS-SV) to identify Problematic Smartphone Use (PSU) among study participants. Participants scoring 31 & above on the SAS-SV were considered to have problematic smartphone use. Throughout the study, the terms 'problematic smartphone use' and 'smartphone addiction' are used interchangeably. For better clarity, we have now mentioned this in the introduction section. Competing Interests: None Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 20 Sep 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 2 (revision) 07 Jan 25 read read Version 1 20 Sep 24 read Sudhir Prabhu , Father Muller Medical College, Mangalore, India Anjan Mandara , Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Mandara A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Jan 2025 | for Version 2 Anjan Mandara , Consultant adolescent psychiatrist, Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK 0 Views copyright © 2025 Mandara A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The article addresses the impact of smartphone usage on sexuality development in young people attending health and allied courses in an urban city. It is a cross sectional study carried out on biological males attending college and the response rate for the cohort was high. A standardised questionnaire was used to collect data and Smartphone Addiction Scale ( SAS-VS) was used to evaluate smartphone use. SAS-VS has got good reliability and validity for assessment of smartphone addiction in community and research settings. Appropriate statistical analysis tool was used to analyse the collected data. The conclusions drawn from the study were compared against published literature and limitations from the study were identified. The participants of the study were biological male students enrolled in health and allied health courses in Mangalore between the ages of 18 and 19. The authors have identified that sample size and sample source are limiting factors for the study. It would have been beneficial to invite all students irrespective of their biological sex or gender be invited to take part in the study. I did not have access to the questionnaire developed by the study team or understanding of the process followed to develop it. It would have been useful to see the content of the questionnaire. Based on the results from the data collection, I noted that there was no specific mention of sexual orientation like pan sexual or asexual taken into consideration in the questionnaire. Major points None Minor points The authors may wish to develop further on development of gender identity and sexual orientation. For eg. Most people develop and understanding and know their gender by age 3-5 years where as sexual orientation is more a developmental process. Authors may consider commenting on impact of social and communication difficulties ( pervasive developmental disorder) and sexual orientation Authors may wish to comment/consider sexual orientations not described in paper like pansexual and asexual. Authors may wish to share the questionnaire they used to collect the data. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Mandara A. Peer Review Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.176146.r361743) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1079/v2#referee-response-361743 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Prabhu S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 09 Jan 2025 | for Version 2 Sudhir Prabhu , Department of Community Medicine, Father Muller Medical College, Mangalore, India 0 Views copyright © 2025 Prabhu S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors have carefully considered and adequately addressed all of the scientific and technical concerns raised in the previous review. Based on the author responses, I believe the manuscript has been significantly improved. Competing Interests No competing interests were disclosed. Reviewer Expertise Immunization, Adolescent health, Primary health care I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Prabhu S. Peer Review Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.176146.r356982) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1079/v2#referee-response-356982 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Prabhu S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 11 Oct 2024 | for Version 1 Sudhir Prabhu , Department of Community Medicine, Father Muller Medical College, Mangalore, India 0 Views copyright © 2024 Prabhu S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The research article submitted by the authors clearly answers the research question about the impact of problematic smartphone usage and sexuality among late adolescent males, both of which are important public health issues. However I have a few concerns about the study which I would seek clarification from the authors : Major : 1. How was development of sexuality defined for this descriptive study : was it sexual orientation or sexual identity or something else ? 2. Sexual awareness may begin at early adolescents (9-12 yrs) , what was the reason authors tried to address or justify development of sexuality or influence of smartphone on sexuality at the age of 18-19 yrs ? Was this based on any observations or references or any other issues specific in your region? 3. Discussion section mentions about friends/peers being the major source for information, but results also show magazines and videos also which may be due to stigma to discuss with teachers, family or health professionals. Kindly elaborate this as it is relevant for the study objective with smartphone being the most easily handy and private source for all information for an adolescent. Minor 1. Abstract mentions about "exposure to pornographic content with youngest being 9 years old" study subjects being late adolescents does this mean at the age of 9 ? 2. Are smartphone addiction and problematic smartphone usage used as synonyms for this study? Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Immunization, Adolescent health, Primary health care I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 07 Jan 2025 Jayashree K, Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, 576104, India Major: How was development of sexuality defined for this descriptive study: was it sexual orientation or sexual identity or something else? Author response: Thank you for the comment. Sexuality has different components which includes biological sex, gender identity, social sex-role, and sexual orientation. In the present study we considered gender role identification, gender orientation as development of sexuality. The same has now been incorporated in the introduction section. 2.Sexual awareness may begin at early adolescents (9-12 yrs), what was the reason authors tried to address or justify development of sexuality or influence of smartphone on sexuality at the age of 18-19 yrs ? Was this based on any observations or references or any other issues specific in your region? Author response: Yes, it begins at early adolescence but there is lot sexual experimentation with respect to how they dress up and their activities/ likes/dislikes/ whom they hang out with/ gender roles etc, occur throughout the adolescent period and it keeps changing. But by the time they enter late adolescence a stable sexuality usually develops. Another reason why we didn’t take early adolescence is smartphone usage with respect to questions related to different components of sexuality may pose ethical issues also they are not mature enough to understand the questionnaire. The same has now been added to our Discussion section for further clarity. 3.Discussion section mentions about friends/peers being the major source for information but results also show magazines and videos also which may be due to stigma to discuss with teachers, family or health professionals. Kindly elaborate this as it is relevant for the study objective with smartphone being the most easily handy and private source for all information for an adolescent. Author response: Thank you for the suggestion. Our study found that friends/peers are the major source of information about pubertal changes followed by books/magazines as mentioned in the results section. We also found that only a small proportion of them turned to parents or health professionals for any information or concerns regarding the same. These findings aligned with other studies as described in the discussion section. As you rightly pointed out, smartphones, with their private nature, have emerged as a primary source of information for adolescents. This is especially true for sensitive topics where young people may feel uncomfortable engaging in open dialogue with adults. We have further elaborated on this in our discussion section. Minor: Abstract mentions about "exposure to pornographic content with youngest being 9 years old" study subjects being late adolescents does this mean at the age of 9? Author response: Thank you. It means the study subject who is a late adolescent started watching porn when he/she was 9 years old. The same has been mentioned in the sentence of Results section “In our study, 90% students had watched pornographic content and one of the students had watched when he was 9 years old…………………..” 2.Are smartphone addiction and problematic smartphone usage used as synonyms for this study? Author response: Yes. We used the Smartphone Addiction Scale-Short Version (SAS-SV) to identify Problematic Smartphone Use (PSU) among study participants. Participants scoring 31 & above on the SAS-SV were considered to have problematic smartphone use. Throughout the study, the terms 'problematic smartphone use' and 'smartphone addiction' are used interchangeably. For better clarity, we have now mentioned this in the introduction section. View more View less Competing Interests None reply Respond Report a concern Prabhu S. Peer Review Report For: Influence of Smartphone Usage on development of Sexuality among Late Adolescent Boys in Health Sciences Colleges of South India [version 2; peer review: 2 approved] . F1000Research 2025, 13 :1079 ( https://doi.org/10.5256/f1000research.165247.r326604) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1079/v1#referee-response-326604 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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