I think they know the difference between what is real or not. It probably has nothing to do with the issue.
Japanese men view porn at an abnormally high rate, and the porn they watch is generally depictions of underage girls and hybrids of underage girls and women with ridiculously large breasts. On the flip side has an abnormally low rate of sexual interest in adult women.
And is it that they are watching too much porn? Nope, Germany ties Japan for most porn viewing in the free world, and we have the most sex of any country the Western world (Often we rank below Switzerland, but it is not relevant because Switzerland watches around as much porn as Japan and Germany). Where it differs is German porn usually revolves around sex clubs, pickups, massage parlours, husband/wife, public sex, party/gangbangs, office related, and other sorts of normal sex scenarios.
Japan masturbates about 50% more than the US... but it is not that masturbation has replaced sex for them when you factor that Germans masturbate about DOUBLE the rate of the US (#1 in the Western world, and #2 in the entire world, with Argentina taking #1), so that is not the factor either.
Is it that Japanese are bad at sex? Maybe, but no, apparently Germans are considered the worst lovers on planet earth :/, so that is NOT it either!
Bottom line: it's undoubtedly the pedophilia epidemic in Japan. That's about the only differing factor...
...Well there is the penis size thread. Germans are the largest cocked men in the western world (Congo beats us overall), and Japan is the second smallest (South Korea shrinks in just below them). So that might have something to do with it. http://gamrconnect.vgchartz.com/dev2016/thread.php?id=226522&page=1
I describe myself as a little dose of toxic masculinity.